Category ►►► Health Insurance Insurrections

January 5, 2014

Broken Clock

Health Insurance Insurrections
Hatched by Dafydd

Barack "You can keep it" Obama is well along the path to utterly demolishing the American health-insurance system. He bulldozed a series of grotesque "reforms" through a supine Congress, market distortions that will swiftly kill all the old insurance plans Americans have used for years. He schemes to replace them with Obamacare exchanges and ultimately single-payer, government-controlled medical care. Far from ensuring against medical catastrophe, these monetary black holes will instead "spread the wealth around"... that is, suction it from the middle class and redistribute it to politicians, Progressivists, and rent-seekers.

Yet Obama has inadvertently done us a huge favor: The destruction of the American health "insurance" monstrosity will in fact usher in a new medical paradigm that is rational, workable, and fair, and a tremendous improvement over what we used to have.

Many have pointed out that what we call health "insurance" is anything but. Real insurance is like what you have on your house, a policy that pays for unexpected catastrophes: If your house catches fire, for example, the insurer pays a very substantial portion of the cost to repair or replace it.

But it doesn't pay the homeowner to repaint the house, exterminate termites, fix leaky faucets, or replace burnt-out lightbulbs. Those problems are not "damage" but maintenance or ordinary living expenses.

Similarly, your auto comprehensive and collison insurance pays for unexpected damage to your car due to an accident; but it won't give you a dime towards changing the oil, fixing the valves, or tanking up with gasoline. Again, those are considered maintenance or ordinary operation of the vehicle.

But so-called health insurance -- pre-Obamacare -- paid for many things that should have been considered either maintenance (the annual checkup) or ordinary health-care expenses (prescription drugs). Insurance is intended to be a gamble: The company bets that you will never have a catastrophic health problem, while you bet that you will, by gum. But expecting a payoff from the insurer every time you refill your prescription for Nexium or Lipitor is no gamble -- it's a regular expense.

When the health insurer must pay for regular expenses, "insurance" has instead become a pre-paid health-care plan. And naturally, the premium reflects that distinction, causing the rapid rise in health-care premiums and higher deductables: An insurance company that doesn't raise rates when consumers increase their service demands will quickly find itself out of business.

But now, with falsely so-called health insurance falling into a death spiral, due to Obamacare, the One has inadvertently brought some real light; Obama has swept away the dreck of our former health-care Ponzi scheme and cleared the decks for what we really need to replace both the old third-party system and the looming enormity of government monopoly: a doctor-patient private subscription plan.

A number of doctors, revolting against Obamacare's intent to turn doctors into government employees (as with horrific Britain's National Health Service) have already begun the transformation. Here's how it could work:

  • Doctors form coalitions with other doctors and specialists, hospitals, and alternative health-care facilities such as nursing homes and outpatient care.
  • A consumer then buys a subscription to the coalition of his choice. He would make his choice on the basis of a particular doctor he likes, or on the facilities available, or the types of services the coalition offers. The subscription is a monthly payment the consumer makes to the coalition -- superficially resembling an insurance premium, but without the third-party middleman, the insurance company: The consumer deals directly with the coalition run by doctors.

    The subscription entitles you to some treatments or consultations that require no extra fee; and for more expensive services (surgery, long-term care, access to a specialist, etc), the subscription gives the consumer substantial discounts.

    Coalitions will offer many different subscriber plans, just as your cable or satellite TV over various tiers of service: The more you pay per month, the more services you get for "free" (fully covered by the subscription) and the greater the discount for services that require further payment.

  • Finally, the subscriber should also buy a very low cost catastrophic care policy. This would be real, honest to goodness insurance, where the insurer only pays for serious and unexpected events, like a heart attack, cancer, or severe injury, where the medical costs are bankruptcy-threatening.

Young, healthy people would buy a minimal subscription with very low monthly payments. Older people and those with chronic problems would buy robust subscriptions with much higher monthly payments, and they would get correspondingly better discounts and more coverage. But the health-care coalitions, entirely privately run, would set the monthly payments such that they would make money either way... thus the system would be self-sustaining and require no government subsidies. The goal, of course, is to get government out of the picture to the maximum extent possible.

But what about people with pre-existing conditions?

It's bad public policy to have a batch of people who cannot get medical care because coalition subscriptions are utterly out of reach; nobody wants to see the deserving poor dying in the streets because they have medical problems. But the problem of people with pre-existing conditions could be handled by an assigned risk system randomly and evenly assigning such patients to coalitions at affordable subscription rates -- much like accident-prone drivers who get assigned to auto-insurance companies. (Though the coalition assigned-risk system is more just, since most assignees did nothing to bring on their own pre-existing conditions.)

The coalitions would be required to sell subscriptions to such patients at a loss, making it up by a small premium on everybody else's subscriptions.

Note that coalitions are not tied to employment, so changing jobs would not affect one's health care. And there would be no restriction on who could buy a subscription from whom, regardless of the state or even country in which the coalition is incorporated.

And because patients are directly paying doctors without any third-party insurer, they will have a great incentive to become prudent consumers of medical care, keeping costs down.

The more Obamacare obliterates the erstwhile health-"insurance" system, the faster will health-care providers create health-care coalitions and begin offering subscriptions. Even a broken Obamacare can have at least one good effect, however serendipitously!

Hatched by Dafydd on this day, January 5, 2014, at the time of 1:22 PM | Comments (5)

December 4, 2013

Just Checked In to See What Condition My Pre-Existing Condition Is In

Health Insurance Insurrections
Hatched by Dafydd

I have had "pre-existing conditions" for as long as I've had my own health insurance, starting in the 1970s. They focus mainly on allergies, some serious enough to provoke anaphylaxis or an asthma attack that can, e.g., send my blood pressure plummeting or prevent me from breathing. I take expensive medicines that keep me asymptomatic, so I can hike and run and work out without worrying about dying from eating the wrong food or inhaling cat dander.

Much of the cost of those medicines is borne by my insurance companies... which they knew going in. Hence the term "pre-existing condition" (PEC).

In every instance where I have had to change insurance, whether a new group plan or buying individual coverage, I have had to go through a special process: For the first few months, my PECs aren't covered by insurance at all; then for a few months, my coverage goes through a "vesting" period, where coverage is phased in month by month. Finally, at the end of that vesting, I'm fully covered.

Note the timeframe -- from decades before Obamacare until now. Somehow, all these non-government insurers managed to cover me, PECs and all, for decades.

So it appears that, on the one issue that everyone was most worried about -- people with PECs who "couldn't get insurance>" -- we already had a model of how to handle that without utterly remaking health insurance. (What Man has done, Man can aspire to do.)

The General PEC Model is two-pronged:

  1. Use some kind of a vesting schedule during which insurance coverage for PECs is gradually increased until the insured has full coverage.

Now, some PECs are much more expensive for the insurance companies than others; consider somebody born with a series of medical problems that lead to many, many surgeries on the heart, liver, lungs, and so forth.

Natually, insurers would rather not cover those people; yet it would be dreadful public policy to tell everyone with a serious PEC that he should just die and reduce the surplus population. (Dickensian death panels, anyone?) Hence the second prong of the General PEC Model:

  1. Include an assigned risk element for the very small number of people whose PECs are serious enough that insurers are guaranteed to lose money on them that no rational premium could compensate. Each insurer must take a certain number of such assigned risks, just as they must in the realm of automobile liability insurance, for the public good.

This way, no one insurer gets hit too hard, and nobody gets to skate with only healthy people on its rolls. That's the model, and we know it works because it was already working for nearly everyone; nobody seriously disputed that the vast majority of uninsured pre-Obamacare comprised young, healthy people who could have afforded health coverage -- but rejected it. The few "uninsurables" could be absorbed by the rest without much cost; that is, after all, the basis of all insurance!

So if anyone, from Progressivist peon to President of the United States, tells you that we needed Obamacare because of the problem of pre-existing conditions... he's lying in his teeth.

Hatched by Dafydd on this day, December 4, 2013, at the time of 1:29 PM | Comments (2)

October 9, 2013

Shutdown Victory - a Retrospective View From 2014

Health Insurance Insurrections , Obamunism , Predictions
Hatched by Dafydd

Contrary to the gloomy predictions of most conservative "pundants" (who tend towards pessimism even in the best of times), voters who "blame Republicans" today are unlikely still to blame them as the 2014 elections loom.

So the GOP should play this "17% shutdown" hand all the way through the debt-ceiling debate next week, without the morbid fear that the party will be demolished by the Democratic spin cycle. Even if their polling is driven down now, it will rebound sharply throughout the next year, as the horrors of Obamacare and other Obamunist policies enrage the citizenry and spook the horses.

Let's review what will have happened by October 9th, 2014:

  • The "17% shutdown" will long be over, as will the "crisis" of the debt ceiling.
  • It will have affected hardly anybody in the country beyond a quarter of the federal workforce -- who will certainly get their back pay.
  • When the truth leaks out -- and it will, you can't bury it forever -- voters will discover how they have been callously, even viciously manipulated by Barack "You didn't build this" Obama.

    They will eventually discover that throughout the shutdown and debt-ceiling "crises," it was the Republicans who sent bill after bill to the Senate that would have made life under the "shutdown" much easier: authorizing spending on national parks, the NIH, vets' health care, Medicare and Medicaid, and on and on. Voters will eventually hear about the many compromise bills they passed, and how sincerely they tried to negotiation with an intransigent president who believes that, since he won reelection, that means he's the emperor, ruling by decree.

    And they will also find out that Obama and his Democrat cronies in the Senate conspired to thwart every ameliorative bill, and did everything possible to make Americans' lives as miserable as possible, in an ugly attempt to create a phony baloney crisis... just so they could blame the GOP.

    That is not going to sit well in 2014, when Obamacare really starts hitting home.

  • The national hatred of Obamacare itself, as policy, will be much stronger and deeper, as more and more people get run over by the ObamaScare express.
  • Republicans will have gotten something out of either the shutdown or out of the debt-ceiling negotiation (more likely the latter); Obama will be unable to maintain his utter intransigence for very long, especially when the debt-ceiling debate heats up, traditionally an opportunity for the opposition to negotiate a compromise. Even Democrats will begin defecting if the president maintains his mantra of "no negotiation, only abject, unconditional surrender." So the Republican fight today won't look like an utter futility next year.
  • The GOP will convincingly be able to argue that it was only because they dug in their heels that anything positive happened; that makes the GOP fight a net positive, and they can run on that in 2014: "If it wasn't for us, you wouldn't have X, Y, and Z. Think how much worse it would be!"
  • A half-dozen more scandals will have engulfed the Obama administration by the next elections; in this case, I think we can assume that past performance does predict future results. The non-issue of the shutdown will long since have been forgotten in the wake of the more immediate corruption and tyranny to come.

A year from today, despite the best efforts of the plantation media, all of these points will be well known to voters, via the most powerful communications medium ever invented: word of mouth, the gossip mill.

And a year from today, tens of millions of voters will have severe sticker shock from the staggering premium increases of Obamacare. They will look around and realize that there are fewer Americans with insurance, not more. And they will be confusticated by the bureaucratic B.S., the political looting, the rent-seeking and kickbacks that accompany every huge government program (see the New Deal, the Great Society, the War on Some Drugs).

And worst of all, Americans will witness first-hand the uncaring, anti-life nature of government medicine around the world, where ginned-up budget "crises" result in denial of health care and literal death panels... as we see in Great Britain, Japan, Canada, and everywhere else that has foolishly enacted what the Democrats admit is their ultimate goal. I think a huge swath of voters will come to see Obamacare as fundamentally unAmerican, a perverse inversion of traditional American values and beliefs.

Given the very high likelihood of such knowledge and such painful personal experience, tens of millions of voters will retroactively decide that the GOP was right all along: Republicans did good to do everything they could to stop it from happening, or delay it until we can get a new (and probably Republican) president.

Bottom line: Hardly anybody is affected by the so-called shutdown; but a majority of voters will be very adversely affected by Obamacare itself. I predict that a year from today, Obamacare will be a raging negative, while the slowdown will be seen in hindsight as a desperate and noble attempt to save America from that government nightmare.

People are always more affected by what's happening right now than what happened a year ago, and which barely touched them even at the time. Once the immediate hysteria over the "17% shutdown" subsides, Americans will be far angrier over Obamacare itself than over the GOP attempt to prevent it.

I suspect that a great many people attacking Republicans today will claim, a year from now, that they had fervently supported the shutdown all along; and they'll say, "See? I told you so!"

Hatched by Dafydd on this day, October 9, 2013, at the time of 5:42 PM | Comments (0)

August 24, 2013

...Because Usually, Something Beats Nothing

Health Insurance Insurrections
Hatched by Dafydd

Bill Kristol of the Weekly Standard claims Republicans have actually been working, in secret, on a health-insurance bill, a "big replacement package" for Obamacare.

While a large majority hates the Avoidable Scare Affordable Care Act, they might still be queasy to "replace it" with "nothing" (as liberals put it), with the status quo ante we had in 2008. The only argument the Left has in favor of Obamacare -- other than "Isn't it great that we're thiiiis close to government-run socialized medicine?" -- is to say, "Republicans just want to go back to the bad old days, when thirty million people died every year from a severe lack of government medicine!"

Sadly, such non-argument arguments still sway a disturbingly large percent of voters. But if the GOP can produce an understandable, believable plan by early 2014, one that resolves the main problems (rightly or wrongly) perceived prior to Obamacare, it might dramatically improve Republican chances in the midterm election and subsequent insurance wars.

We'll see what they come up with, but I'm hopeful: As a good-faith start, I woud like to see the following problems addressed:

  • Insurance portability from job to job -- Probably the biggest fear is that when an employee is laid off (in a bad economy like this), and he suddenly loses his health insurance too, just when he doesn't have the money to buy private insurance.
  • Pre-existing conditions -- If that's not addressed, more and more Americans will find themselves shoved completely out of the insurance regime. That would be disaster. Maybe some combination of phasing in pre-existing condition coverage and implementing "assigned risk" pools similar to those for bad drivers.
  • Insurance-plan choice -- All we are saying... is give Capitalism a chance! Stop the federales and state bureaucrats from throwing roadblocks and rent-seekers in between sellers and buyers.
  • Tort reform of medical malpractice and other health-related litigation -- This is vital to reduce the overall cost of health care. Get rid of the bogus lawsuits, the high-paid "expert" witnesses (who say whatever their plaintiff bosses tell them to say), defendants going bankrupt even when they win the lawsuit, threats against medical device manufacturers, and the skyrocketing med-mal insurance premiums, and you'll have a much cheaper health-care system. That helps everybody (except trial lawyers).
  • And the rational but problematical insurance rejection by young adults -- Offer incentives (both carrot and stick) that make it financially attractive for the young to buy some kind of high-deductable catastrophic care coupled with a medical savings account. As they age, they'll probably want more expensive and inclusive coverage.

I would love to see something like this; it would really help both those who currently have insurance and also those who don't, and who worry what might happen if they're injuried skiing or contract a devastating disease even at a young age. And when we address those issues -- which we can do piecemeal, one "issue" at a time -- that will virtually eliminate pressure to vote for a one-size-fits-none comprehensive health-care boondoggle, like Obamacare.

Then we can repeal that Obamunist monstrosity, and everybody will feel more secure. Everybody but dyed in the wool socialists, that is.

Hatched by Dafydd on this day, August 24, 2013, at the time of 2:18 AM | Comments (3)

February 9, 2012

Let's Get One Thing Perfectly Clear...

Health Insurance Insurrections , Presidential Peculiarities and Pomposities
Hatched by Dafydd

The recent order by President Barack H. Obama (and Kathleen Sebelius at the Department of Health and Human Services) -- that every employer must offer health insurance that fully covers birth control, sterilizations, and morning-after abortion pills, regardless of any religious objection employers, including faith-based employers that are not actually churches, might harbor to those procedures -- is not an "unintended consequence" of ObamaCare. Its architects are not that stupid.

Rather, that was one of the very reasons for enacting ObamaCare in the first place.

As many of us said back in 2009, the purpose of ObamaCare was never to give health insurance to needy people who couldn't afford it. First, that category was nearly empty:

  • The deserving poor were already covered by Medicaid; and if necessary, its qualification threshold could have been temporarily lowered to allow more people to benefit -- say, by expanding availability to those who had recently lost their jobs (hence health insurance) but were not yet living below the Medicaid poverty line.
  • The biggest chunk of those who did not have health insurance comprised the rich (who prefer to pay for their health care as necessary, rather than buy insurance), and the young, healthy, and shortsighted, who can afford health care but choose instead to gamble that they won't get so sick or injured that they need expensive treatment. Making such a choice, even if it turns out to be a big mistake, is part of individual liberty. The proper "solution" is to allow us that liberty, then hold individuals accountable for their own decisions; actions have consequences. (Innocents swept up in those bad decisions, such as children, can be helped separately.)
  • Finally, a small percentage of the uninsured could have afforded a cheaper, stripped-down policy, but cannot afford the "Cadillac" health-care plans whose costs are driven up by government mandates and regulations.

    For those unfortunates, the easiest fix -- which would have benefitted everyone else as well -- was to eliminate all the government meddling the caused the problem in the first place: Requiring health insurance by law to cover a littany of specialized services; policies that make it difficult for insurance companies to offer greater variety in policies, such as a medical savings account coupled with catastrophic care (which encourage more parsimony among patients, as they must pay to refill their MSA if depleted); regulations prohibiting insurance companies from offering policies cross-state and cross-border; overly plaintiff-friendly (and especially lawyer-friendly) medical malpractice laws; and so forth.

Real problems, such as people with pre-existing conditions (the faux "casus belli" for the war against private insurance), could have been handled the same way bad drivers are handled for automobile insurance: Create an "assigned risk" pool among health insurers to spread the cost; allow a reasonable increase in rates for those with such conditions, and have a reasonably short waiting period (e.g., six months) before full coverage occurs; and allow for temporary government assistance for those who truly cannot wait and incur unpayable costs. (This isn't laissez-faire Capitalism, of course; but it's a reasonable and inexpensive compromise between liberty and safety net.)

Such reforms would have cost a fraction of the trillion dollars that ObamaCare expropriated from the private sector. In fact, once the lifting of government mandates and the squelching of "jackpot justice" malpractice suits lowered actual health-care costs, insurance reform might have wound up cheaper than the original system it replaced. And in any event, it would have been a move towards greater freedom of choice for employers and individuals.

But the Obamunists had precisely the opposite purpose from the beginning; rather than freedom, their ultimate goal was to put more Americans than ever before under the iron boot-heel of the government. Never was it about health insurance for the poor and uninsured; it was always about the federal government seizing control not only of the health care of individuals but also nationalizing those state and local health programs already in place. ObamaCare was, first and last, a power grab by the federal government at the expense of states, local governments, and individual Americans.

So please, let's not imitate Captain Renault in Casablanca -- shocked, shocked to discover that Barack Obama has violated our First-Amendment right to freedom of religion! In fact, that specific mandate was at the heart of ObamaCare tyranny: a frontal assault on the Catholic church in particular, which is so virulently hated by the gay-activist and feminist wings of the Left.

The only element of this policy that should shock anyone is the unbelievably hamfisted way that Obama decreed it: A politically savvy politician would have patiently held off until after the election, giving himself two years to allow the furor to die down.

Instead, the president once again mistook unanimity among his left-liberal friends for a Progressivist "consensus" among the American people; he lives in a bubble of epistemic closure, talking only to true-blue believers on the left. I formerly gave him the nickname "Lucky Lefty," because (a) he is left handed, (b) he is left-leaning, and (c) he was extraordinarily lucky. Well he's still (a) and (b), but not so much (c) anymore, so I can no longer call him that.

Obama's new nickname is "Bubble Boy," honoring his world view.

But what's done is done and cannot be undone; Obama has ripped off the mask, and he can't put it back into the bottle. We now see ObamaCare in all its naked savagery and unAmericanism. Thank goodness for Obamunist "dumbth!"

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

Hatched by Dafydd on this day, February 9, 2012, at the time of 7:43 PM | Comments (6)

May 18, 2011

Only Obama Can Save Us

Health Insurance Insurrections
Hatched by Dafydd

The Hill reports that employers are in for a significant hit in health-care costs due to ObamaCare:

U.S. employers can expect an 8.5 percent increase in their medical costs next year due in some part to the healthcare reform law, the consulting firm PwC said in a report Wednesday.

The widely read annual report on cost trends points to three main drivers of healthcare costs, two of which are exacerbated by the new law.

But relief could be at hand... for if only President Barack H. Obama will issue enough waivers, then perhaps costs will rise only five or six percent. And if he sees fit to just go all the way and grant universal waivers to the universal health-care "reform," then we mightn't see any increase at all!

The power is in the Obamacle's hands; His will be done.

Hatched by Dafydd on this day, May 18, 2011, at the time of 2:10 PM | Comments (1)

August 2, 2010

Riddle Me This, o Argumentative Abogados

Health Insurance Insurrections
Hatched by Dafydd

(Or is that "Avocados?")

If the federal government can force me by law to purchase government-approved health insurance -- e.g., ObamaCare -- whether I want it or not... does that mean it can also force me by law to purchase cable-TV service from government-approved cable-TV operators, even if I would rather have DirecTV or Dish Network, or even (heaven forbid!) no TV at all?

If the power to command the first doesn't imply the power to command the second, then what is the legal distinction? Why couldn't Congress enact the Viewer Protection and Affordable Television Act of 2010 during its Lame Donkey session this year?

Non-lawyer minds really, really want to know.

Hatched by Dafydd on this day, August 2, 2010, at the time of 4:54 PM | Comments (2) | TrackBack

May 12, 2010

Stop Me Before I Veto Myself!

Health Insurance Insurrections , Presidential Peculiarities and Pomposities
Hatched by Dafydd

Ahem. To be filed in the "I warned you" file under C for chutzpah:

The Obama administration threatened to veto parts of its own health care bill after budget scorekeepers found that the package would add at least $115 billion more to government health care spending.

What next? If we don't give him whatever he demands, will he threaten to tell everyone that he was really born in Tierra del Fuego? But wait, there's more; President Barack H. Obama is actually using his own fabricated figures to extort something out of his own Democratic Congress:

President Obama's budget office charged Congress with finding $115 billion in spending cuts or tax increases to offset the price tag hike. The figure approached the amount of money the Congressional Budget Office previously estimated the law would save, and pushed the total 10-year cost of the package past $1 trillion. It comes after a separate Medicare office report found the bill would raise spending by about 1 percent over the next decade.

But the Office of Management and Budget stood by the administration's original claims that the law would reduce the deficit and tasked Congress with making sure that happens -- or else.

Is anybody else reminded of a bizarre scene from the Mel Brooks movie Blazing Saddles? Cleavon Little, the black sheriff sent to clean up a racist town, is about to be run out of town. So he points his pistol at his own head and says, in a deep, fake voice, "Hold it! Next man makes a move, the [pejorative deleted] gets it!"

"He's not bluffing!" shouts one of the panicky townspeople.

Aside from the surreality of Obama threatening to immolate his own odious health-care takeover, the real scandal here is the president holding his own bill hostage until he gets a big, fat tax increase. (And the casual admission that the extra amount the bill will cost is just about the amount Obama and the Dancing Democrats said it would save. Who'd a thunk it!)

But as they say on the Ginzu Knife commercial, that's not all...

Costs could go higher, because the legislation authorizes several programs without setting specific funding levels.

And that's not even counting the infamous "doc fix," the 21% "pay cut" for doctors Medicare reimbursements that was enacted as part of ObamaCare. The vaunted projections over hundreds of decades that show huge savings all relied upon slashing more than a fifth from physician reimbursements... which everybody knows is never going to happen.

In fact, the House already passed a bill to nullify the pay cuts, and the Senate will surely follow suit. The doc fix adds from $208 billion (Yahoo's prediction) to $245 billion (CBS) to the actual cost of ObamaCare, sans accounting tricks.

Add the two together, and the cost is already up by (averaging) more than $340 billion -- and deep, deep into the red. And the only solution acceptable to the Democrats will naturally be... yet more tax increases! Probably a Euro-style "value added tax," which taxes everything at every level of manufacturing, distribution, and sale... the greatest economy-buster and job-killer ever invented by the socialist mind.

We're shocked, shocked to discover there's brazen corruption at the International House of Obama. But how about this for our response: If Obama threatens to veto his own bill -- let him. Can we at least get all 41 Republicans in the Senate to agree not to rescue Obama from the veto pen he's holding against his own head?

If we can't successfully filibuster a massive tax increase -- the only purpose of which is to appease the Obamacle -- then we may as well just pack it in and return to the primordial ooze, whence we came.

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

Hatched by Dafydd on this day, May 12, 2010, at the time of 7:18 PM | Comments (2) | TrackBack

April 15, 2010

ObamaCare Media Coverage: What's In a Verb?

Health Insurance Insurrections , Media Madness
Hatched by Dafydd

At first crack, this may appear to be a meaningless cavil on my part. But I think it cuts to the very heart of the leftstream news media's coverage of the "Progressive" -- that is, national socialist -- policies of President Barack H. Obama.

I read an AP story on the surprising but charming fact that, since passage of ObamaCare, support for it and the One's handling of health care in general has plummeted. This was unexpected, since normally support for a policy rises after it becomes "the law of the land."

Of course, Squeaker of the House Nancy Pelosi (D-Haight-Ashbury, 100%) threatened that they had to pass the bill so that we could know what was in it. Well, they passed it; now we know (some but not all of) what's in it; and it's hardly surprising that with each new revelation, Americans realize anew what a huge pile of fertilizer has been dumped on their front porches.

But here is the section that jumped out at me, where AP describes the bill as enacted into law:

The nearly $1 trillion, 10-year health care remake would provide coverage to nearly all Americans while also attempting to improve quality and slow the ruinous pace of rising medical costs.

Nonpartisan congressional budget analysts say the law is fully paid for. [But see previous post. -- DaH] Its mix of Medicare cuts and tax increases, falling mainly on upper-income earners, would actually reduce the federal deficit. And people covered by large employers may even see a dip in their premiums.

The public doesn't seem to be buying it.

Whoa there, Hoss... ObamaCare provides coverage? Perhaps memory dims with age, but I seem to recall that rather than providing coverage, it mandates that everyone pay for coverage at his own expense. The only thing it provides us is yet another reason to vote Republican in November.

So AP cannot forbear cheerleading for government-controlled medicine, even in an article about Americans' rejection of government-controlled medicine! Mark Twain would be vastly entertained.

It is heartening that the public is not "buying" ObamaCare, even (especially) after passage; but to me, the great scandal is what has happened to American journalism. In many ways, it's less competent, and certainly less diverse in its bias, than at any time in America's past.

Hatched by Dafydd on this day, April 15, 2010, at the time of 12:39 PM | Comments (1) | TrackBack

March 31, 2010

"Repeal and Replace" - Filling In the Outline

Health Insurance Insurrections
Hatched by Dafydd

C.K. MacLeod of Zombie Contentions posted a fascinating discussion of the larger context of the fight against ObamaCare; his point is that we cannot win the argument to repeal ObamaCare until and unless we are prepared to argue exactly what should replace it:

As on other issues historically identified with the left, a reflexive rejection of progressive premises tends to impair any simultaneous argument for alternative solutions. This contradiction underlies tension between “Reformlicans” and “Repealicans” that will likely worsen over time. Most of us realize that “Repeal + Reform” is a much larger coalition than Repeal or Reform separately, but concessions that seem obviously rational to some, as validating aspects of the just-passed bill initially seemed to Senator John Cornyn, may leave others nonplussed. Conversely, forms of direct opposition -- such as unstinting criticism of Stupak, support for constitutional challenges, disputing the concept of health care as a “right” -- carry some risk of re-casting Republicans as “enemies of health care.” Even the persuasive argument that ObamaCare will overwhelm the system with new demand implies that millions of Americans are presently under-served on a matter of life and death, and calls into question the critic’s commitment to their welfare.

Jonathan Tobin, writing at Commentary in his Contentions blog (and quoted by Zombie Contentions) argues that the fight is not merely to overturn ObamaCare, or even the other specific manifestations of Obamunism such as Cap and Tax, Card Check, and bank seizures; rather, we must attack the entire leftist "narrative," the overarching philosophy of thuggish domestic imperialism (my phrase) that has animated government takeovers of society since the days of Otto von Bismark, creator of the modern welfare state and arguably the first European-style social democrat, in contradistinction to Socialism, Marxism, and the much later Naziism.

As Tobin puts it:

The challenge for conservatives is more than merely pointing out ObamaCare’s shortcomings, its enormous costs, and its impact on a huge American industry. The challenge is also more than demonstrating how the health care that ordinary Americans get -- and which the vast majority currently think is good -- will decline. Conservatives’ real job is to attack the liberal narrative. What they must point out is that, rather than the next inevitable step toward greater justice, Obama’s “reform” is, in fact, a move away from individual freedom and toward the same nanny welfare state that Americans thought they had put to rest. Rather than a progressive innovation, ObamaCare is a retrograde move that seeks to drag American politics and the economy back to the mistaken emphasis on government power of the mid-20th century. Like so much of the welfare economics and failed liberal policies of that era, ObamaCare has the potential to do far more harm than good. Policies that are driven merely by good intentions and a belief in expanding government power can help derail the engine of American wealth creation and freedom -- just as the devastating mistakes of “Great Society” liberalism did in the past.

The critique of these two gentlemen is vitally important; yet it tells us only the what and why, not the more important how: How do we craft a counter-narrative, an arc of fiscal liberty that resonates with the freedom-loving American people, yet clearly explains how sound government policy that encourages free-market thinking can nevertheless reduce the irreducible problems that many Americans see as inevitable under Capitalism.

I believe those "irreducible problems" are in reality category mistakes on the part of an electorate misschooled for decades by liberal educators; they believe that it's a failure on the part of Capitalism that some people go bankrupt, or lose their houses, or find themselves unable to pay for medical care after refusing to purchase medical insurance... whereas those are actually features, not bugs. Without the right to fail, there is no right to succeed; the nanny who protects you from your own stupid decisions also "protects" you from your own bold investment. Or as Dennis Prager puts it, "the bigger the government, the smaller the citizen."

But stated so starkly, that is not a winning argument, to say the least. Many people are frightened by the lack of a "safety net." So what are we to do?

Fortunately, Capitalism coupled with liberty is such a powerful engine of wealth creation that it can coexist with some degree of statism without harm; too much government control, however, will stifle creativity and innovation, causing the creation of wealth to sputter out, like a candle under airtight glass. Our challenge is to craft solutions to what most Americans see as problems that satisfy the following three conditions:

  1. Rely on free-market economics for the core resolution.
  2. Include some "safety-net" provisions to allay the fears of those Americans who do not have 100% confidence in their own ability to provide for their families in bad economic times.
  3. Design those provisions to be self-limiting, so that they cannot grow exponentially -- as leftist schemes like the New Deal, the Great Society, or Obamunism invariably do -- metastasize, and eventually overwhelm the capitalist core.

Free-market solutions to "market" failures, real and imagined

The first step is educational: The market cannot "fail;" the market is nothing but the conglomeration of all the transactions by all the buyers and sellers; it's like saying that the law of gravity failed because you caught hold of something before falling off a cliff.

But a "free market" can fail if freedom is curtailed by external force... i.e., by the government. The controlled or "fair market" that is left will be a grotesquely distorted caricature of a free market, without the ghostly power to guide buyer to seller by an invisible hand. The free market defines the standard: To the extent that government policy alters the natural outcome of a transaction, that policy has failed -- at least for the loser in that transaction; it has correspondingly succeeded wonderfully for the winner. (Watch Oskar Schindler in action in the opening minutes of Schindler's List for an excellent illustration of the principle.)

Let's step away from ObamaCare for a moment and talk about a different instance of the same dynamic. In the case of the housing collapse, the perverse government intervention driven by leftist activists like Rep. Barney Frank (D-MA, 100%) and Sen. Chris Dodd (D-CT, 100%), and by groups like ACORN and Rainbow PUSH, caused a few people became undeserving winners -- those who "bought" houses they couldn't really afford, but were shielded by overly liberal, biased laws from suffering the consequences; some became deserved winners -- everyone who was in good financial shape and was able to profit and "move up" when housing prices dropped... along with those politicians who schemed to enact the laws in the first place, then took advantage of their political odor of "good deeds;" and a whole bunch of ordinary folks on the margin became deserved or undeserved losers in the resulting financial catastrophe.

(The words deserved and undeserved are shorn of their usual moral implications in this case; I mean only that "deserved" means the person consciously took actions that led to failure or success; "undeserved" means success or failure was largely the result of external forces beyond the individual's control.)

The collapse of the housing bubble was a classic illustration of how government manipulation, even with "good intentions," generally causes a market to spin wildly out of control... and "the best-laid schemes o' mice an 'men gang aft agley," as Bobby Burns wrote; the control economy is overtaken by events.

(Speaking of appropriate classical references -- that Burns poem, "To a Mouse, on Turning Her Up In Her Nest With the Plough," is all about a "wee, sleekit, cow'rin, tim'rous beastie" who is evicted from her mousehole, despite all her careful planning, due to the unwelcome intervention of a large, unfeeling, external power beyond her control... to wit, a coulter or one of the blades of a plough.)

The lesson here is that any economic "reform" should hew as closely as possible to letting the market run its course; the collective decision of millions of intelligent people, each looking out for himself and his own, is almost always smarter than the brokered decision of a few weisenheimers in Washington. Thus on health care reform, we should restore a market that had already been terribly distorted by hamfisted government meddling long before Obama was elected:

  • Decouple insurance from employment, so that the connection between who gets the benefits of insurance and who pays for it is as close as possible. For example, the GOP plan could allow individuals to deduct insurance payments from their income for federal tax purposes, but not allow businesses to deduct as expenses any portion of an insurance policy they pay for their employees.

    Since a business can deduct salary as an expense, that would encourage employers not to pay for insurance... but instead to put that money into higher wages, and let the employees pay their own insurance out of it.

  • Dramatically reform tort law, particularly medical malpractice cases, to reduce lawsuit abuse.
  • Remove all rules restricting cross-state sales of health insurance.
  • Remove all "mandated" coverage and allow companies to offer any mix of policies they want, from bare-bones, minimalist catastrophic-care plus a medical savings account all the way up to a "Cadillac" plan, without any special government taxation or regulation to push insurers one way or another.
  • Allow insurance companies to charge more for customers with pre-existing conditions, then use some less distorting means of getting insurance for those unfortunates. (See the "safety net" section below).
  • Allow insurance companies to offer "group" health insurance based upon any set of customers they can imagine.
  • Remove all barriers to entry by smaller, specialized insurance carriers, subject only to requiring them to maintain sufficient capital to pay off their caims -- or require the insurers to carry insurance for an unexpected spate of claims (like from a natural disaster).

Once the perverse incentives foisted upon the health-care system by do-gooder liberals and control-freak liberal fascists are repealed, many more insurance customers will pick the kind of plans that require them to pay their doctors directly for most routine procedures -- introducing a market incentive to be a more careful health-care shopper. Likewise, the reduced need for "defensive medicine" will reduce the number of unnecessary tests and procedures whose only purpose is to set up a legal defense to the inevitable lawsuit if anything goes wrong... even if the patient was properly informed of that risk.

Therefore, the price of medical care, hence insurance, will drop markedly. And with cheaper insurance, more people will buy it -- supply and demand. Finally, none of these solutions even begins to approach the horrific cost of ObamaCare, both in money siphoned off by the federal goverment (from Medicare, student loans, general tax collections, and from the states) and in liberty.

A market-friendly safety net for the market

On a recent broadcast of Dennis Prager's show, his guest, a female psychologist, opined that unless a woman first feels safe, she cannot feel loving. I reckon it's similar with ordinary, non-ideological Americans: Unless they first feel safe, they cannot feel self-reliant. As self-reliance is the distilled essence of Americanism, our policies must first reassure the people that they will not be abandoned beside the road when they get into trouble, especially when due to simple bad luck.

But by the reverse of the same coin, we cannot allow a "safety net" to take the place of the free market itself; a safety net does not generate weath, nor even save money. It is, by definition, a distortion on the market, hence a drag on the system.

But while the free market work wonderfully in aggregate, it can be very cruel to many people to whom Fate deals a bad hand. A good example is a person born with a congential heart defect: He didn't do anything foolish or wrong, but what insurer would want to write him a health-care policy?

Typically, with group policies, insurers will not cover medical problems related to a known pre-existing condition for some period of time, often six months to one year; thereafter, they will. The feds could encourage this across the industry by levying a very small tax on each policy (passed along to the consumer) that would pay to subsidize the increase in premiums demanded by insurers of those customers who have pre-existing conditions; the subsidy would not apply to pre-existing conditions that are caused by damaging or risky behavior, such as smoking or excessive drinking. All proceeds of this tax must, by the law, be spent on premium subsidies; that becomes important in the third section below.

Insurers have the option to offer policies to such people or not, and to charge what they will; but since the market of people with pre-existing conditions is large, and the premium would be partially covered by the feds, there will always be some insurers willing to offer that coverage. (My guess: Every major insurer would cover them, since the higher premiums take into account the increased risk; it would be a lucrative business.)

This is clearly a distortion of the market; but it's a minor perturbance for the vast majority, and it resolves what most Americans see as a serious problem... without any "mandate" to buy coverage or government control of insurance policies or medical treatment. (No rationing, no death panels.) This is sort of "market-friendly safety net" I mean.

Limited vs. self-limiting

Finally, the safety net features must be self-limiting: The government cannot be allowed to profit or benefit from increasing the premium tax; if they do, then the feds will raise rates every time they need to cut the deficit. Even worse is when such cancerous growth is built right into the system, as with Medicare and Social Security. Thus, the bill itself must include provisions requiring all premium taxes to be used only for subsidizing the medical insurance of those with pre-existing conditions.

(It's true that Congress could change the law to suck some of that money away; but they can already do that. This bill wouldn't make it any easier, and it might make it harder -- since individuals would actually be able to see their tax rise, making them more willing to vote out the crooks who raised it.)

ObamaCare has a number of enacted limits; but it also has huge incentives for future Congresses to remove or violate those limitations, restrictions, and consumer protections; because when they do, they will be able to keep far more of the money for themselvs.

We need a new approach where the "default" is the free market, not government control.

In the final analysis...

The Republican plan to replace ObamaCare must be a free-market "solution," not a competing version of big-government Obamunism; it must include a safety net... but a market-driven one not in opposition to, but in harmony with, the free market; and its elements must be self-limiting, at all times refusing and removing any way for the United States Treasury to get rich quick, at taxpayer expense, via health reform.

Hatched by Dafydd on this day, March 31, 2010, at the time of 7:33 PM | Comments (7) | TrackBack

March 29, 2010

Mandatory Madness

Constitutional Maunderings , Health Insurance Insurrections
Hatched by Dafydd

Virginia has passed a law exempting its citizens from the federal insurance mandate contained within the ObamaCare law as enacted; in addition, twelve other states, led by their attorneys general, have banded together to file a lawsuit, also seeking to overturn the insurance mandate.

Thus there is a nonzero probability that ObamaCare's most tyrannical element -- the federal "mandate" for everyone to buy government-approved health insurance -- will be struck down. We will find out in the fullness of time which camp is accurate, the one that predicts the Court will never intervene to strike down such a "big law" passed by Congress and signed by the president -- and the camp that says the Court will be forced to make a substantive ruling because the issue is so stark, so pregnant, and so egregious.

Simply put -- which is just what Rep. Michael Burgess, R-TX, 96%, did -- if the feds can pass a law ordering citizens to purchase specific goods from particular, government-approved, private companies, it would open the door to a horrible new form of covert control to benefit specific lobbyists and donors at taxpayer expense:

[I]f the mandate in the health care law requiring individuals to purchase health insurance or be penalized is upheld by the courts, the federal government could mandate anything, such as requiring all Americans to purchase a General Motors car.

The Washington Times rolls the ball a bit farther:

Both of the state lawsuits challenge the federal government's authority under the Commerce Clause, which grants Congress the power to regulate commerce among the states. The Florida case also cites a violation of the 10th Amendment, which reserves those powers not spelled out under the federal government in the Constitution to the state governments, and argues that the health care law's expansion of state Medicaid programs threatens state sovereignty.

Among the arguments against the law is that because it does not allow for purchasing insurance across state lines - the insurance exchanges are state-based - the buying of health insurance does not constitute interstate commerce. In addition, the plaintiffs say, not purchasing health insurance does not constitute an economic activity.

"Thus far in our history, it has never been held that the Commerce Clause, even when aided by the Necessary and Proper Clause, can be used to require citizens to buy goods or services," Virginia Attorney General Kenneth T. Cuccinelli II argues in his state's lawsuit. "To depart from that history to permit the national government to require the purchase of goods or services would ... create powers indistinguishable from a general police power in total derogation of our constitutional scheme of enumerated powers."

The cases raise a profound question of constitutional balance: Should we interpret the Constitution in such a way as to ratify the Founders' principle of limited government? Or should we instead interpret it as the current administration prefers, even if that is to expand the scope of federal control tenfold, on grounds of judicial deference to the elected branches?

In other words, whether Congress is restricted only to those tasks listed in the enumeration clause (U.S. Constitution, Article I, Section 8), all else being forbidden... or whether the only restrictions are those actions specifically prohibited by the Constitution and its amendments, and anything not mentioned is an unenumerated but protected power of Congress. Which is the default position when specific areas are not mentioned in the organic documents? The courts have gone round and round on this question.

The question is not only timely, it's also timeless. It determines whether we are citizens or subjects:

"The remarkable thing about an individual insurance purchase mandate is you are not being subject to a requirement by virtue of any economic activity you engage in -- you're not doing a damn thing; you just exist," [David B. Rivkin, jr., counsel for the state plaintiffs] said. "If this is upheld, then the federal government can do everything it wants subject only to the restrictions contained in the Bill of Rights."

That really is the question here. I'm not sure about the Burgess example of mandating that everybody in America buy a car manufactured by Government Motors; but can Congress pass and the Executive enforce a law mandating that every worker in the United States pay dues to a (government approved) union? That hypothetical seems perilously close to the mandate that forms the core of ObamaCare... and the more I think about it, the less "hypothetical" it seems.

But I'm very optimistic about this particular case -- at least once it reaches the Supremes. Don't count me in that rumba that thinks the Court will never find the mandate unconstitutional because that would "interfere" in the operation of another branch, which such pessimists say violates "judicial restraint."

In fact, it's the very belligerence and in-your-face arrogance of the Pelosi-Reid Democrats that gives me such hope. The Democrats made no effort to abate their tyrannical tendencies, giving them full vent instead -- dictatorial, partisan, raw, and very, very unpopular.

Given the nature of the current Court, this is probably the best moment to bring such a case before the Nine. We currently have four reliably conservative votes -- Antonin Scalia, Clarence Thomas, Samuel Alito, and of course the Chief Justice, John Roberts -- and one somewhat squishy justice, Anthony Kennedy; Kennedy is not a solid conservative, but neither is he a solid activist.

It's true that judicial restraint gives deference to the elected branches of the government; but the philosophy has never taught that such deference requires justices to bow to the legislature or the White House, even when there is a clear constitutional violation. For example, this very Court just struck down the D.C. gun-prohibition law and looks likely to strike down even state bans on "keeping and bearing arms." This bodes well.

We cannot rely upon such a favorable ruling from the Supreme Court to save our tender loins, of course: The only thing certain about such a ruling is that it will occur some time from now, probably long after the November elections -- and maybe even after the presidential contest in 2012, depending on how long the cases kick around the district and circuit courts first. (That is, if it ever eventuates at all.) The electorate will already have passed judgment on the politics of ObamaCare and whatever else the lame-duck 111th Congress manages to jam down between now and January.

But a decision striking down the mandate on grounds of enumerated powers, the lack of applicability to interstate commerce, and the Tenth Amendment could play a major role in "repealing and replacing" ObamaCare, even while Barack H. Obama remains president, and even if the Senate Democrats retain enough votes to block cloture.

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

Hatched by Dafydd on this day, March 29, 2010, at the time of 11:43 PM | Comments (2) | TrackBack

March 26, 2010

Every Crowd Has Its Silver Lionizing

Blogomania , Health Insurance Insurrections
Hatched by Dafydd

In the midst of the eldritch, trancendental, Lovecraftian horror of ObamaCare being foisted upon us by a monomaniacal "Democratic" Congress, some pearls of great price have been unearthed as unearned grace. One such is the best column by Dennis Prager I've read in a half-dozen years or more. Bookends:

A terrible thing happened to America on Sunday, March 21, 2010.

The country took its biggest step ever down a road diametrically opposed to its original intent of keeping the state small so that the individual can be free and great.

Therefore, in this unprecedented crisis of values, this is what needs to be done....

7. Acknowledge that we are in a non-violent civil war.

I write the words "civil war" with an ache in my heart. But we are in one.

Thank God this civil war is non-violent. But the fact is that the left and the rest of the country share almost no values. The American value system and the leftist value system are irreconcilable. If the left wins, America's values lose. If American values prevail, the left loses.

After Sunday's vote, for the first time in American history, one could no longer confidently believe that the American system will prevail. And if we don't fight for it, we don't deserve it.

Dennis, who I've met many times but who wouldn't know me from Adam Ant (or Adam Schiff), succinctly presents seven positive steps we can (must!) undertake in response to this, if not unprecedented then at least obnoxious and infuriating infringement of our sacred liberties. An E-ticket ride, no bout adout it.

Then there is this impactful drawing together of many threads anent "political violence," defined in this limited case as "Democratic whinery about controlling only 99% of government power, instead of the 112% they expect and demand to control."

Offered for your approval, Wolf Howling's recent post on political violins -- sorry, violence -- allegedly directed against alleged Democrats. Here is Mr. Howling's back-of-the-thumbnail summation of the current state of play:

[The Left is] now making a concerted effort, helped by an equally "progressive" MSM, to portray that there is some new level of violence, racism and homophobia in America, and further, that this violence, racism and homophobia is synonymous with the Tea Party movement who protested Obamacare at the capitol over the weekend. There is no doubt that this is a collateral attack on all of those who protest the passage of Obamacare and an attempt to delegitimize them. It is also just so incredibly hypocritical as to be jaw dropping.

Just reading these two internicine intercourses back to back should buoy the spirits and calm fears better than trancendental meditation, chocolate, or a stiff belt of Tullamore Dew. So do be a do-bee, and read them both to their utmost.

Consider this a Big Lizards PSA.

Hatched by Dafydd on this day, March 26, 2010, at the time of 12:40 AM | Comments (2) | TrackBack

March 24, 2010

We've Only Just Begun to Pay

Democratic Culture of Corruption , Health Insurance Insurrections , Postal Disservice
Hatched by Dafydd

I see that the U.S. Postal Disservice plans to eliminate Saturday delivery; it seems they're in the hole by $3.8 billion this year, headed for $7 billion next, and this is the only way to begin to close that gap:

The Postal Service took the first formal step Wednesday toward cutting mail delivery to five days a week.

The postal governing board agreed to ask the independent Postal Regulatory Commission for an opinion on dropping Saturday delivery. That request goes to the commission next week....

The Postal Service says the delivery change would save more than $3 billion annually. It is a major part of a decade-long plan to eliminate losses and restore the agency to stability in the face of shrinking business....

The post office lost $3.8 billion last year and is facing projected losses of as much as $7 billion this year. Other proposals for cutting losses include changes in the financing of retiree health care and closing some mail handling centers and post offices.

That is, the federal government claims to be so strapped that it can't come up with $7 billion more per year to ensure Saturday delivery; but it can scrounge two trillion over ten years to seize control of American medical care.

Here's another way of looking at this signal event: Barack H. Obama wants to end Satuday mail delivery in order to (partially) pay for ObamaCare -- including the Cornhusker Kickback, the Louisiana Purchase, the Gator Aid, and the Stupak Stipend.

Good to know our national priorities.

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

Hatched by Dafydd on this day, March 24, 2010, at the time of 12:08 PM | Comments (0) | TrackBack

March 21, 2010

Stupak Caves, Euro-Style Government-Run Health Care Now a Done Deal - UPDATED

Congressional Calamities , Democratic Culture of Corruption , Health Insurance Insurrections
Hatched by Dafydd

The post title says it all... but see previous post for how we may still have a good shot at reversing the vote.

UPDATE: After all the Sturm und Drang, Rep. Bart Stupak (D-MI, 90%) settled for an executive order (EO) from President Barack H. Obama saying that federal funds would not be used for abortion.

But this is what Mary Poppins calls a "pie-crust promise, easily made and easily broken." This EO will be signed in the spotlight, with a thousand media moguls covering the "breakthrough" with hundreds of thousands of feet of tape.

But the next EO will be signed in the proverbial dead of night, probably when Congress is in recess, buried amongs a flurry of innocuous EOs declaring September "Homer Simpson appreciation month" or "recognizing the tremendous influence of peppermint-flavored dental floss on American culture."

The next EO will "clarify" the first one... it will state that in certain "emergency circumstances," the feds can fund abortion; and then it will give so broad a definition of emergency circumstances that every abortion in America will be eligible.

How do I know this? Very simple: Barack Obama truly wants the federal government to pay for abortions; and since he has the authority to get what he wants, with only a promise to hold him back, why wouldn't he? What is Bart Stupak going to do about it?

The syllogism is quite simple:

  1. Obama ultimately wants a single-payer health-care system in the United States, à la Great Britain or Japan. Nobody denies this, not even the president.
  2. Obama believes that abortion should be safe and legal.
  3. If abortion is legal, it counts as health care, obviously.
  4. Therefore, in the world that the One wants us to have, the federal government -- the "single payer" -- will necessarily pay for all abortions in the U.S.


Whether the Obamacle can bring about the millennium he desires is another question; but it's a dead cert that his desire is for the feds to pay for abortions, among other procedures, using taxpayer dollars. In fact, he also wants partial-birth abortion to be legal; so by the same syllogism, he wants you and me to pay for it with our federal taxes.

Now I'm not completely anti-abortion; but I am utterly anti-federally funding for abortion. (And I'm also utterly against partial-birth abortion -- or to be more accurate, partial-birth infanticide -- federally funded or not.)

Therefore, Stupak traded away his putative principles for a pot of message. He is a traitor to a cause he claims to have supported from long before he has been in federal office, since 1993, going all the way back to when he consciously accepted Catholicism, presumably as a child.

I reckon the aphorism is true: Liberalism, like socialism, truly does corrupt all that it touches.

Hatched by Dafydd on this day, March 21, 2010, at the time of 1:12 PM | Comments (3) | TrackBack

March 20, 2010

Does She Do or Does She Don't? A Reptile Says - She Don't

Congressional Calamities , Democratic Culture of Corruption , Health Insurance Insurrections , Predictions
Hatched by Dafydd

Bonus extra fold-out: How the Democrats hoisted themselves by their own petard

Let us once more check the Hill's newest whip count:

  • 178 Republicans are firm Nays; even Rep. Joseph Cao (R-LA, not yet rated), personally (and heavily) lobbied by President Barack H. Obama himself, doesn't look to buck the unanimity.
  • 37 Democrats are firm Nays, likely Nays, or leaning Nay.
  • 199 Democrats are firm Yeas, likely Yeas, or leaning Yea.
  • 17 Democrats are toss-ups.

A little back-of-the-thumbnail calculation gives us 215 firm, likely, or leaning Nay -- vs. 199 firm, likely, or leaning Yea; 216 is a majority in a House of Representatives that has but 431 members at the moment. Once again, the ObamaCarebears must run the table, picking up each and every undecided... while we need only a single one to break against the bill.

Of course, some in the Nay column could repent of their sinful ways and join the Democrat scamwagon; but so far, for every Nay lost to a Yea, an undecided has come out as a replacement Nay. The Nay side has stayed at 215 or 214 for several days now, despite all the queen's rubber hoses and all the queen's minions.

You gotta like our chances.

Other prognosticators agree; according to "Pessimism" Paul Mirengoff at Power Line, one of the Stupakians, Rep. Dan Lipinski (D-IL, 90%), says Pelosi is still about seven short. Paul continues, joined by "Jeremiah" John Hinderaker:

UPDATE: Jeffrey Anderson at NRO's Critical Condition blog says Pelosi is still short. He counts 208 leaning in favor, 214 leaning against, and nine undecided. At this point, though, "leaning against" may mean "waiting for an inducement" in some cases.

JOHN adds: This is consistent with what James Hohmann of Politico told us on our radio show this morning, i.e., that as of around 1:00 this afternoon, Pelosi had 206-208 "yes" votes.

So as I've said many times, in politics, the game ain't over till the last fat lady is hung. If Squeaker of the House Nancy Pelosi (D-Haight-Ashbury, 100%) postpones tomorrow's vote, that means she knew she didn't have 216; if she holds the vote, that means she thinks she has 216 -- but could be mistaken.

Bonus fold-out! It occurred to me a week or so ago that the Democrats' own corrupt scheme actually makes it much more plausible that, even if ObamaCare passes tomorrow, we can still repeal and abolish it before it destroys American medical care.

How? How?!

The Democrats were so anxious not to reveal how horribly ObamaCare adds to the deficit that they pulled a fast one on the Congressional Budget Office (CBO), which tracks those sorts of issues: They crafted a bill that "backloads" all the core elements of ObamaCare -- all the liberty-liquidating, choice-curtailing, budget-busting, death-panel debuting provisions, including the mandate -- to 2013; but the bill enacts the tax increases immediately.

What does this mean? For one thing, the bill the CBO was given to score included only seven years of spending, but a full ten years of tax increases. That made it appear actually to decrease the budget deficit -- for the exact ten-year period from fiscal year (FY) 2011 through FY 2020; but if instead one looks at the ten-year period from FY 2014 through FY 2023, ObamaCare adds about two trillion dollars to the budget deficit!

So a profligate's dream of a bill that will bust the budget wide open was artificially made to look like a fiscally responsible bill that will (slightly) reduce the deficit.

But there was a price to pay: By backloading the guts of ObamaCare, Democrats themselves insured that nothing concrete would be done to implement its most horrible parts until after the 2012 presidential election. Thus, if we can take a long stride towards recapturing the House and Senate in this year's election, then complete the job in the 2012 election; and if we can bring a candidate who defeats Barack "Spending Spree" Obama; then Congress can just vote to repeal ObamaCare, and the new (Republican) president will sign it.

And of course, if the Democrats try to filibuster that bill in the Senate, the GOP can just reach into the Democrats' own bag 'o tricks, like Felix the Cat, and pull out any of a number of techniques, fair or foul, that they pioneered to quash filibusters. If worse comes to worst, Congress has simply to fail to enact the necessary appropriations bills and starve ObamaCare to death; while the administration need only fail to enforce the law mandating insurance to strangle ObamaCare while still in the womb.

It must be infinitely easier to kill a new entitlement program that hasn't even started yet than to kill one that has been up and running for two years. The bill (even if passed) is vulnerable entirely because Pelosi couldn't face a vote with the full extent of her perfidity in plain view. Wile E. Democrat, Supergenius, strikes out again.

So let's all keep a stiff upper spine, wait for tomorrow, and see what the old biddy has up her skirts.

Hatched by Dafydd on this day, March 20, 2010, at the time of 11:59 PM | Comments (1) | TrackBack

March 15, 2010

The Hill's "Whip Count" on ObamaCare - GOP Picking Up Votes

Congressional Calamities , Health Insurance Insurrections
Hatched by Dafydd

In our last installment on Saturday, we were able to report the following:

The Hill newspaper is published daily in the nation's capital while Congress is in session, which is unfortunately true right now. They've been publishing a daily (or so) whip-count; that is, the Democratic and Republican leaders tell the Hill how many votes they think they have, and the paper makes the final judgment (presumably after talking to some of the waverers).

In the count published today, here's how we stand:

  • All 178 Republicans will vote Nay.
  • 34 of the Democrats are firm, leaning, or likely Nays; this includes eight Democrats who voted Yea the last time around in November.
  • 147 Democrats are firm, leaning, or likely Yeas.
  • The remaining 72 Democrats are "undecided."

That puts the current count at 147 Yea, 212 Nay, with 72 toss-ups. Note that a majority is currently 216, since there are only 431 members of the House right now.

In today's whip-count, we see some movement -- and astonishingly, considering all the proclamations of Obamic victory, it's in the right direction!

  • All 178 Republicans will vote Nay.
  • 37 of the Democrats are firm, leaning, or likely Nays, three more than last time.
  • 146 Democrats are firm, leaning, or likely Yeas (one fewer than Saturday).
  • The remaining 70 Democrats are "undecided" (two fewer).

That's 146 Yeas, 215 Nays, with 70 ditherers, and majority is still 216.

In other words, ObamaCare is just one vote shy of defeat in the House... with 70 votes still up for grabs. We must win over one more Democrat -- before they win over 70: If Democrats lose even one more congressman, the bill dies.

I still have full faith and confidence in the American people; we have proven ourselves to be steadfast in our rejection of a radical rewrite of all health-insurance rules. The danger is not the American people but rather the Democratic majority, which might still trample the people down with hobnail boots.

But more and more, it appears that simple self-interest will kill this wretched act; simply put, most United States Representatives like their jobs and want to keep them.

But even if the worst happens, even if the Dems suddenly reverse the momentum and end up eking out a marginal victory, I still believe that we can repeal ObamaCare -- despite the fact that (as I am reliably informed) no major new government social bureaucracy has ever been "uncreated." Think of Social Security, Medicare and Medicaid, and State Children's Health Insurance Program (SCHIP).

Why am I so positive? First, because the reliable claim is not particularly reliable; for one example, Aid to Families with Dependent Children (AFDC) was an FDR-era welfare entitlement created, as Aid to Dependent Children, as part of the Social Security Act of 1935. Yet it was repealed in 1996, to be replaced with a radically different and far more temporary welfare program titled Temporary Assistance for Needy Families (TANF).

Even the New Republic has recently hailed the repeal of AFDC and enactment of TANF instead [hat tip Wikipedia, of all sites]; TNR editorial of September 4, 2006, p. 7; the piece appears not to be available online:

A broad consensus now holds that welfare reform was certainly not a disaster--and that it may, in fact, have worked much as its designers had hoped.

But the second reason I am convinced that ObamaCare can be repealed is that it differs significantly from all other social-welfare, social-control bureaucracies enacted by Congress -- including AFDC. Unlike all the others, ObamaCare is not supported by voters; it is vehemently opposed by large margins.

If President Barack H. Obama's scheme is finally enacted, it will be over the earsplitting objections of the American people. By contrast, programs such as Social Security and Medicare were wildly popular when they were enacted -- and most retain strong majority support even today.

We have never before enacted such wholesale change in the balance between government and governed -- when the bill itself was so intensely unpopular; I daresay it's the most unheard-of thing I ever heard of. For that reason, I simply do not believe it will be passed; but even if it is, I do not believe it will survive long in the 112th Congress.

So hip hip, chin chin, and keep your welly up. Courage, Camille. This too shall pass away!

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

Hatched by Dafydd on this day, March 15, 2010, at the time of 8:44 PM | Comments (3) | TrackBack

March 13, 2010

The Hill's "Whip Count" on ObamaCare - as of Today

Congressional Calamities , Health Insurance Insurrections
Hatched by Dafydd

The Hill newspaper is published daily in the nation's capital while Congress is in session, which is unfortunately true right now. They've been publishing a daily (or so) whip-count; that is, the Democratic and Republican leaders tell the Hill how many votes they think they have, and the paper makes the final judgment (presumably after talking to some of the waverers).

In the count published today, here's how we stand:

  • All 178 Republicans will vote Nay.
  • 34 of the Democrats are firm, leaning, or likely Nays; this includes eight Democrats who voted Yea the last time around in November.
  • 147 Democrats are firm, leaning, or likely Yeas.
  • The remaining 72 Democrats are "undecided."

That puts the current count at 147 Yea, 212 Nay, with 72 toss-ups. Note that a majority is currently 216, since there are only 431 members of the House right now.

To put it in a nuthouse, Republicans must get 4 of those toss-up Dems to vote Nay, while the Democrats must get 69 of the toss-up Dems to vote Yea.

It should be obvious now why Squeaker of the House Nancy Pelosi (D-Haight-Ashbury, 100%) has not yet called the vote: The risk is too great that the Nay-sayers will get their 4 before the Yes-men get their 69. And she won't call the vote until the whip-count shows better odds for ObamaCare than against it.

Now I expect the great majority of those toss-up Dems will eventually vote for ObamaCare; but if they lose only 4 out of the 72 (6%) it goes down. Bear in mind that when the current Congress ends -- probably sometime in late November or December -- any legislation passed in one or both chambers but not signed into law dies.

The new Congress would have to start all over again with ObamaCare (if it's still controlled by Democrats); the new House cannot simply pass the previous Senate's bill and send it to President Barack H. Obama for signature.

As a more practical matter, the closer we edge to the November 2nd elections, the greater the pressure on the toss-up Dems to vote Nay, since that is the way most of their constituents want them to vote.

Note to Democratic readers: The congressional elections for your party will be held on Wednesday, November 3rd. On that date, please vote early and vote often!

I would guess that the window will firmly shut in late May or early June; after that -- with one dangerous exception -- ObamaCare cannot be enacted, for reasons of politics.

The one dangerous exception is the putative "lame-duck" period of the second session of the 111th Congress... the short interval after the elections but before the 112th Congress is seated on January 3rd (per the Twentieth Amendment to the U.S. Constitution).

During those two months, every representative in the House already knows whether he has been reelected, and the Senate bill is still in effect.

A defeated Democrat has nothing to lose by voting for ObamaCare. If enough of those currently leaning towards Nay are defeated, they may, in a fit of vindictive revenge against the constituents who fired them, vote in as perverse a manner as possible. (Though of course, it's unlikely the reconciliation side of the package could also be enacted during that period.)

This is the most likely time for ObamaCare to be enacted, since it would then have virtually no consequences on its supporters: Many of the Democrats voting for it will have already been defeated; and for those from moderate districts who were nevertheless reelected, a December vote gives them the maximal "memory-lapse" time before facing voters again in 2012.

I'm quite concerned about that interval; has the GOP given it much thought?

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

Hatched by Dafydd on this day, March 13, 2010, at the time of 11:43 AM | Comments (1) | TrackBack

March 6, 2010

Democrat Massa Resigns - to Squeaker Pelosi's Gain

Health Insurance Insurrections
Hatched by Dafydd

Alas, Squeaker of the House Nancy Pelosi (D-Haight-Ashbury, 100%) just picked up a vote for ObamaCare. Rep. Eric Massa (D-NY, not yet rated) has announced his resignation from the House effective Monday, due to ethics charges (sexual harassment). On November 7th, 2009, Massa was one of the 39 Democrats who voted against the House ObamaCare bill; see this roll-call vote.

There are two paths forward:

  • Ultra, ultra-liberal New York Gov. David Paterson might appoint a replacement, if state law permits; Paterson would unquestionably appoint a liberal who will vote for ObamaCare, converting Massa's Nay into a Yea -- a big help to Pelosi.
  • If the law does not permit, or if Paterson doesn't move quickly enough (being embroiled in his own ethics charges -- bribery), then Pelosi still gains.

    There currently are only 432 members of the House, instead of the usual 435 (two resigned and one, Jack Murtha, dropped dead); to pass the Senate version of ObamaCare in the House the Democrats need an actual majority... which is 217, because 216 is only 50%.

    But with Massa's resignation, that leaves only 431 members; and 216 is an actual majority (50.1%) of 431. Since Massa voted against ObamaCare, Pelosi needs one fewer vote from the same number of Yes-men... so she doesn't even need to convert Massa from Nay to Yea.

Either way, Speaker Pelosi has picked up one net vote since yesterday. So it goes.

However, three other House members are embroiled in their own ethics charges: Reps. Charlie Rangel (D-NY, 100%), Maxine Waters (D-CA, 100%), and Laura Richardson (D-CA, 100%); and each of this lot actually voted for the House version of ObamaCare. Thus if any of them is forced to resign in the next month or so, that would make up for Massa. (If two or three of them leave, that would put even more pressure on the Speaker, of course.)

It's up, it's down, it's a yo-yo.

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

Hatched by Dafydd on this day, March 6, 2010, at the time of 6:11 PM | Comments (1) | TrackBack

March 5, 2010

Well There's Yer Problem! part III

Health Insurance Insurrections
Hatched by Dafydd

Let's check back with the minions of Squeaker of the House Nancy Pelosi (D-Haight-Ashbury, 100%); the Squeak insists she'll either pass the bill, or she'll pass the bill. It's in the bag -- no need even to vote on it. (I wonder if -- maybe she'll... would even San Fran Nan have the huevos to try to rule that the Senate bill has passed the House by acclamation? Nah, even she wouldn't have that much chutzpah.)

But what do said minions themselves min? There are two main dissenting groups, plus one unnamed revolutionary mob that may well be larger than the other two put together.

Abort! Abort! Abort!

Let's start with the Stupakians, who have stooped to stupify the Squeaky stooges in Congress:

A dozen House of Representatives Democrats opposed to abortion are willing to kill President Barack Obama's healthcare reform plan unless it satisfies their demand for language barring the procedure, Representative Bart Stupak said on Thursday.

"Yes. We're prepared to take responsibility," Stupak said on ABC's "Good Morning America" when asked if he and his 11 Democratic allies were willing to accept the consequences for bringing down healthcare reform over abortion.

"Let's face it. I want to see healthcare. But we're not going to bypass the principles of belief that we feel strongly about," he said.

Oh, well they can always pass the Senate version of the bill (with no aboriton restriction), then just fix it in reconciliation, right?

Wrong: Reconciliation must follow the "Byrd Rule," which means (among other things), it's only available for clauses and sections that are primarily intended to reduce the budget deficit, either by cutting spending or raising taxes. There is no possible way that the Senate Parliamentarian, Alan Frumin, or anyone else Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 70%) names to that position in a fit of pique, is going to say that the primary purpose of banning federal spending on abortion coverage is simply to reduce the budget deficit.

That means the Stupakians must accept in advance of their vote the solemn assurances of liberal, pro-choice Democrats like Sen. Chuck Schumer that they will vote against funding abortion, even when they have the chance to implement what they have always dreamt of: Full funding of abortion with taxpayer money, so that every woman can get one!

I'm sure Rep. Bart Stupak (D-MI, 90%) and his likeminded colleagues have absolute trust in the Senate Left.

Green is the color of my true-love's eyeshades

The second group that has begun grumbling comprises the fiscal... well I wouldn't exactly say hawks; they are Democrats, after all. But at least fiscal woodpeckers, who might insist upon hammering off bits and pieces here and there to bring the cost down somewhat -- and who already voted against the House bill because it was too costly:

But perhaps the most overlooked section of [Barack H. Obama's] speech was his insistence that the Democratic bill will take sufficient steps to control the rise in health care costs for individuals, families and the federal government.

“We have now incorporated most of the serious ideas from across the political spectrum about how to contain the rising cost of health care -- ideas that go after the waste and abuse in our system, especially in programs like Medicare,” the president said. “But we do this while protecting Medicare benefits and extending the financial stability of the program by nearly a decade.”

Whether the legislation will tamp down rising health care expenditures is controversial; even experts who support the Democratic legislation say it could do more to control costs. Nonetheless, the president’s remarks sent a clear message to a crucial group of Congressional Democrats who voted against the health care legislation citing cost concerns: the White House and Congressional leaders will not be taking any big new steps to win them over.

This is the group that the Squeaker must target for more votes, since her coalition has already dropped to a minority due to the loss of four votes (one reversal, two retirements, and one demise). At this point, Mrs. Pelosi has only 216 from her previous 220-vote majority... and she needs 217. (I think we should at least count Bart Stupak as another defection, dropping the current count to 215, two less than she needs now.)

The only place to troll for new votes is, quite obviously, among those who voted Nay last time; and that means Nancy Pelosi must persuade the fiscal woodpeckers to switch and support the bill this time.

The problem for the Democrats is... why? Why should they switch? What can the Democratic leadership offer the 39 Democratic Nay-sayers that they didn't offer them last time? How can the deal be better, now that they're voting on the Senate bill, rather than the one they helped craft in the first place?

Nothing in the Senate bill, vice the House bill, sweetens the pot for the fiscal woodies:

  • The Senate bill adds many more taxes and "fees" on the middle class and on the medical community than the House bill.
  • The Senate bill loots Medicare for considerably more than does the House bill, $438 billion vice $396 billion over ten years.
  • The House plan raises revenues by putting a big tax on "the rich" (individuals who earn more than $500,000 per year, households which earn more than $1,000,000), perceived as being primarily Republican; contrariwise, the Senate plan raises revenues by taxing "Cadillac" health-care plans, a tax that falls disproportionately on union members, perceived as primarily Democratic.
  • Although the Senate bill supposedly spends less than the House bill ($871 billion vice $891 billion over ten years), it (equally supposedly) reduces the deficit by less than the House bill does -- $132 billion vice $138 billion over ten years.

    (This is all a fiction, of course; as Rep. Paul Ryan, R-WI, 84%, demonstrates: The CBO counted ten years of tax increases but only six years of spending, so it's hardly surprising that looks good on paper; think how good your own bottom line would look if you counted a decade of your salary, then subtracted six years of your spending.)

The distance between the bills is not great; but what few discrepencies remain tend to make the woodpeckers less likely, not more likely, to vote for the Senate bill. Certainly the gap was wide enough that the two chambers never did come to a meeting of the minds.

Pelosi might get a few votes by twisting arms; but will it be anywhere near the dozen Stupakians she's going to lose, plus the four other votes she has already lost? That drops her 220 down to 204; Speaker Pelosi needs to scavenge 13 of the 39 Democratic Nays -- a third of them! -- for a bill that is certainly no better than the last time and arguably worse... up for a vote in an undeniably worse political environment than last time.

Lotsa luck, lady.

Red state menace

Finally, we have the "hidden" group: Those representatives who actually voted for the bill the last time... and then got mugged by their own constituents with a sock full of sand. I refer here not just to congressmen from Republican-leaning districts but even the moderate or "swing" districts -- which have swung rather decisively against ObamaCare.

Remember, the House Dems must vote for the entire Senate bill; not a word, not a comma or semicolon, not a jot or tittle may be changed -- else the "new" version has to return to the Senate and be voted upon, with 60 votes required and only 59 available.

Nothing, nothing can be changed before that first vote. That means that, in addition to voting for a bill that the president pretends costs $1.3 trillion over ten years, but which everybody knows really costs closer to Ryan's estimate of $2.3 trillion; in addition to voting for a bill that allows the federal government to use taxpayer money to fund abortion; in addition to raiding Medicare of half a trillion buckaroos, increasing the cost of health insurance, drastically raising taxes, and rationing health care (yeah, "death panels"); in addition to voting for all that, our hapless Democrats must must also vote for the Louisiana Purchase, the Kornhusker Kickback, and the Gator Aid.

If those poor reps suffered howls of anguish after the first go-round, imagine the shrieks of hysterical outrage when those same clods return for Easter break with a new black mark on their record -- just as their reelection campaigns kick off in earnest!

Doom is nigh!

Michael Barone has suggested (based upon a comment by Mark Tapscott) that the Democrats may be a little shorter than folks realize:

Clever liberals in the blogosphere are still urging House Democrats to pass the Senate health care bill, with the Senate then making changes through the reconciliation process requiring only 51 votes and the Senate going along. Sounds like a clever idea. But as my Examiner colleague Mark Tapscott writes, an anonymous quote from a House Democratic leader suggests that they are 100 votes short of passing the Senate bill. I wouldn’t take that 100 votes as a precise number, but as an approximation.

Whether a particular Democratic representative is a fiscal woodpecker and voted against the bill, or a pro-life Democrat and voted for it because of the Stupak Amendment, or a scared moderate Democrat from a moderate to right-leaning district -- or even a tie-dyed liberal who thinks that without the "government option," the whole bill is worthless -- he is asked to gamble his entire political career on the desperate hope that the Senate rides to his rescue, approving all sorts of things that it rejected the last time.

...Despite the fact that many of those clauses, such as the restriction on abortion coverage, cannot possibly be shoehorned into reconciliation; therefore they would be subject to filibuster, and any 41 Senators -- liberal, conservative, or a left-right alliance -- could block their implementation.

Barone's last line sums up this entire post, explaining in a nuthouse why all the momentum is with those switching from Yea to Nay, not the other way around:

The House Democratic leadership’s problem is that it cannot credibly promise that the Senate will keep its part of the bargain.

And I would add, so what if it did? It's still a lousy bill in a lousy year. The idea that there are handfuls of Democrats in the House just itching to pass an unpopular government takeover of health care and get themselves thrown out of office as reward is just... surreal.

How many high-paying ambassadorships and top-level adminstrative positions does anyone think Obama can find -- given that he needs those open slots to bribe campaign donors?

Hatched by Dafydd on this day, March 5, 2010, at the time of 3:57 AM | Comments (1) | TrackBack

February 28, 2010

The Democrats' New Map

Elections , Health Insurance Insurrections , Liberal Lunacy
Hatched by Dafydd

Or, why I am not convinced that either Pelosi or Reid has the votes

The New York Times, of all venues, sculpts the slope the Democrats must scale to summit Mount Reconciliation:

Of the 219 Democrats who initially voted in favor of the House measure, roughly 40 did so in part because it contained the so-called Stupak amendment, intended to discourage insurers from covering abortion....

An additional 39, like Mr. Kratovil, are fiscal conservatives who voted no the first time around. Ms. Pelosi is hoping that she can get some to switch those no votes to yes in favor of Mr. Obama’s less expensive measure.

Let's run some numbers, shall we?

The House version of ObamaCare -- the Affordable Health Care for America Act (H.R. 3962) -- passed on November 7th last year in a vote of 220-215. Ordinarily, 218 Yeas are required to pass a bill in the House; but since that vote, three representatives have left Congress, one of them horizontally. With only 432 current members, the magic number for a majority is 217 (216 is only 50%, which is not a majority).

The three who left are all Democrats who voted for the House version of ObamaCare the first time around: retirees Robert Wexler (FL) and Neil Abercrombie (HI), and John Murtha (PA), who left feet first this month. In addition, Rep. Ahn "Joseph" Cao (R-LA, not yet rated), the only Republican to vote for the bill, has since repudiated that vote and says he will certainly vote against the Senate/reconciliation version of ObamaCare when that comes up for a vote. So Pelosi starts with only 216 of the necessary 217 votes.

We know for certain that unless the Senate agrees in advance to the Stupak Amendment, which bans any and all federal funding of abortion (and even funding of insurance carriers who pay for abortions), Rep. Bart Stupak (D-MI, 90%) will also vote against it; he has too much "face" bound up in that prohibition to overlook it. I consider it virtually impossible that the Senate would agree to a Stupak Amendment, so that drops the number of Yeas to 215.

Thus the real question is this: Can Squeaker of the House Nancy Pelosi (D-Haight-Ashbury, 100%) bully enough Democratic former Nays to switch to Yeas so that the total will be two higher than the number of Yeas who switch to Nays? In other words, if 20 of the 40 Stupakers vote Nay on the Senate version, then Pelosi must scrounge up 22 representatives who voted Nay last time to vote Yea instead. Otherwise, she has less than the 217 needed.

Looking ahead, it's hard to see why any representative who voted against ObamaCare before will be persuaded to vote for it this time: The cost differential between the House and Senate plans is negligible; the Senate version doesn't include the "government option," which the House Democrats liked; and in the meantime, voters have made their disgust with the government takeover of health care clear and vivid.

Scott Brown's election to the Massachusetts Senate seat formerly held by Ted Kennedy scared the bejesus out of many representatives, especially those who represent districts that went to John McCain in the 2008 presidential election; many will try to innoculate themselves from the consequences of the last vote by turning thumbs down on ObamaCare this time.

The only real hope Pelosi has is with those Democrats who voted against the bill last year, but who have decided not to run for reelection this year. However, at the moment, there are only three: Reps. John Tanner (D-TN, 89%), Bart Gordon (D-TN, 89%), and Brian Baird (D-WA, 80%). Even if all of them switch, that brings the total only to 218; if two or more representatives flip the other way, from Yea to Nay -- two out of the 40 who only voted for the bill because of the Stupak amendment, for example -- then Pelosi falls short.

My back of the thumbnail estimate is that at least 20 of the 40 Stupakers vote Nay, while only two of the lame-duck Democrats go the other way (Tanner has already said he will not switch to Yea); that would land the Squeaker into a 200-232 deficit. An AP article confirms this:

In fact, Democrats following the legislation say House Democratic support for the legislation has sunk to 200 votes or less in recent weeks, following the stunning GOP victory in last month's special Massachusetts Senate election and the bill's modest showing in polls.

Where "modest showing" has the tendentious redefinition of "catastrophic collapse." I would guess another five Democratic Yeas vote Nay when it becomes clear the votes aren't there anyway; why go down with a sinking ship?

It's hardly any better on the Senate side, where they must pass the "reconciliation" changes to the Senate bill that (they hope!) will keep some Democratic House members from desperately dog-paddling towards the shore. Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 70%) is not doing very well, despite only needing a simple majority to pass the package:

Under the Democrats’ tentative plans, the House would pass the health care bill approved in December by the Senate, and both chambers would approve a separate package of changes using a parliamentary device known as budget reconciliation.

The tactic is intended to avoid a Republican filibuster, but in the Senate, the majority leader, Harry Reid of Nevada, faces challenges if he tries to use it. He is having trouble persuading a majority of his caucus to go along.

Despite their gigantic majorities in both chambers, despite a still-personally popular Democratic president who has made this his make-or-break issue, Pelosi, Reid, and the Democratic leadership still can't seem to round up enough Yeas to spit in the voters' faces. Funny, isn't it?

The calculus is fairly simple; AP quotes a couple of members of the House Democratic caucus explaining the problem:

"People who voted 'yes' would love a second bite at the apple to vote 'no' this time, because they went home and got an unpleasant experience" because of their votes, said Rep. Jason Altmire, a moderate Democrat from Pennsylvania. "On the other hand," he added, "I don't know anybody who voted 'no' who regrets it...."

Rep. Gene Taylor, D-Miss., said he chatted at the House gym Friday morning with fellow conservative Democrats and found that Obama's session had produced no new momentum.

"I don't think it made a nickel's worth of difference," he said, adding, "It's fair to say the trend is going against the bill."

I don't believe that Scott Brown's victory alone redrew the Democrats' electoral map; but it definitely shone a spotlight upon it... and any Democrat who plans to run for reelection ignores it at his political peril.

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

Hatched by Dafydd on this day, February 28, 2010, at the time of 3:19 AM | Comments (2) | TrackBack

February 27, 2010

The Unbearable Slightness of Being Joe Klein

Health Insurance Insurrections
Hatched by Sachi

In Time Magazine, Joe Klein has a very eccentric response to the health-care summit:

[T]he tea leaves seem to indicate that Obama came out well ahead of the Republicans.

That's... unique. How does Klein score the "debate" to get that result?

[T]he President talked a lot -- actually, the President, the Congressional Democrats and Republicans each spoke an equal amount -- the Times of London found it boring and the networks turned to other programming.

Of course that ratio actually means that the Democrats talked twice as much as Republicans. But why should the number of minutes of speech, or how boring it was, determine who won the summit? The president can spout nonsense all day long (which he did) without letting the other side speak, but that doesn't mean he persuaded Americans to support ObamaCare (which he did not).

But I digress. Mr. Klein continues.

Reading between the lines, you can conclude that the Republicans had nothing very interesting, or clever, to say (and were never able to get the President's goat). And that the President was his usual, unflappable, well-informed self. You can also conclude that not much progress was made at the summit, as Karen reports here -- but that's a huge surprise, right?

Reading between what lines? The entire summit was carried on C-SPAN, and there is a lot of it now available on YouTube. If Klein actually watched the discussion, he would have known Republicans had a lot to say. For only one example, here is a six-plus-minute clip of Rep. Paul Ryan (R-WI, 84%) trying to break through Barack H. Obama's wall of separation between rhetoric and reality (hat tip to Power Line):



So, where did Joe Klein got the strange ideas that (a) the president routed the GOP, and (b) Republicans had little to say? What program was he watching anyway?

Perhaps this explains Joe Klein's take-away impression:

Shame on me. I was elsewhere yesterday and missed the health care summit. I'm catching up now, and the tea leaves seem to indicate that Obama came out well ahead of the Republicans. How do I know that? From Matt Drudge, of course.

As it turns out, Klein's entire sourcing for his conclusion comes from reading Drudge and the New York Times. ("All the news that fits -- our pre-existing story board!") In Klein's world, that trifling input is enough to justify his conclusions of who won and who had the better case.

So what other news did Klein pick up from his sketchy reading? Here's his take on how the GOP could have "won" instead:

I remain convinced that if the Republicans actually wanted to deal with this issue, they might have gotten some major concessions from the President -- malpractice reform, for sure; ....To get these things, however, the Republicans would have had to say yes at some point. As in, YES, I'll vote for the bill if you throw in malpractice and pay for it with the money you get from limiting deductability. That is what happens in a negotiation. That is what is supposed to happen in a democracy.

Joe Klein misses the central point: Republicans are not asking for a few concessions here and there. They, and majority of Americans for that matter, fundamentally reject and oppose a government take over of the health care system. There is a huge, unbridgeable gap between Democrats and Republicans. As Paul Ryan explains towards the end of the clip above:

The difference is this. We don't think all the answers lie in Washington regulating all of this. So the problem with the approach we are seeing that you're offering, which I do believe, Senator, is very different than what we're saying, is we don't want to sit in Washington and mandate all of these things....

We want to decentralize the system, give more power to small businesses, more power to individuals, and make insurers compete more. But if you federalize it and standardize it and mandate it, you do not achieve that.

Joe Klein might have understood this, had he actually watched the summit instead of reading the New York Times condensed and filtered version. (If he wasn't too busy retracting specious claims from earlier columns, I mean.)

But the obvious truth here is that the Republicans do not want any sort of health care bill to pass at all because they do not want to hand President Obama a victory.

Is Klein saying we Republicans don't even want our own health-insurance reform plan to pass? Or is he unaware that we have one? (Maybe the Times chose not to cover it, so Klein never heard of it.)

Republicans do not want to let Democrats use this artificial "crisis" to create a very real and irreversible nationalization of one-sixth of the American economy. Republicans (Americans!) do not want shockingly huge taxes, skyrocketing premiums, loss of choice, waiting lists, rationed care, and death panels... not even in a swap for unnamed (and never offered) "concessions" on a few things that might actually help ordinary people.

This isn't a game; we're talking about real people's lives, health, and liberty. We don't want fascism with the smiley face of tort reform and more catastrophic care policies, assuming ObamaCare's health-insurance exchange eventually decides to allow them.

Republicans actually have principles -- another point Joe Klein didn't pick up from the Times.

Hatched by Sachi on this day, February 27, 2010, at the time of 6:34 PM | Comments (2) | TrackBack

February 24, 2010

Sounds Good; But Can We Believe It?

Abortion Distortion , Health Insurance Insurrections
Hatched by Dafydd

House Minority Whip Eric Cantor (R-VA, 92%) makes the firm claim that Democrats "[don't] have the votes" to pass the Senate version of ObamaCare, which is the necessary first step down Reconciliation Road:

“The buzz around Washington right now is the inevitability that this healthcare bill is going to pass, that we are somehow going to go to this healthcare summit and there will be a decision on the part of Speaker Pelosi and Harry Reid to go ahead and jam this bill through,” Cantor said.

“Speaker Pelosi doesn’t have the votes in the House. That’s just where we are, and it’s indicative of the fact that the American people don’t like this healthcare bill.”

In a memo to the Republican caucus Wednesday morning, Cantor wrote that House Democrats are farther away from securing the votes to pass a government healthcare bill today than they have ever been, and that they will never be able to muster the votes needed to pass a Senate reconciliation bill in the House.

On the other side of the aisle, Rep. Bart Stupak (D-MI, 90%), he of the Stupak Amendment against federal funding of abortion, agrees that Squeaker of the House Nancy Pelosi (D-Haight-Ashbury, 100%) is woefully short of the votes she needs. In a radio clip of an interview he gave, Stupak said that "15 to 20 Democrats" have already told him that they will not vote for the Senate version because it funds abortions and insurance companies that pay for abortions, and there is no correction in the President's follow-on "fix-it" bill.

These representatives would be among those who actually voted for the previous version of ObamaCare, precisely because they first passed the Stupak Amendment. That means that if they make good their threat, that's a whopping huge hole in Pelosi's previous bare-majority victory.

It all sounds great. I hope it doesn't turn out to be "sound and fury, signifying nothing," with all these Democrats under siege bowing their heads and accepting Party discipline for the sake of the Vision.

Hatched by Dafydd on this day, February 24, 2010, at the time of 4:34 PM | Comments (6) | TrackBack

February 22, 2010

Inconsolable Differences

Health Insurance Insurrections
Hatched by Dafydd

Many Democrats now pugnaciously assert that, no matter what voters think, the Left is going to pass ObamaCare anyway... and you'll jolly well like it, see!

Under this scenario, the House will simply pass the Senate version. Then, by abusing a procedure that is little understood (even by members of Congress) -- and never intended to pass controversial legislation under the radar anyway -- they will "fix" (that is, rewrite) every faint nod towards fiscal responsibility that snuck its way into the bill, turning it into another corrupt, trillion-dollar boondoggle.

Using this technique, called "reconciliation," no fillibuster is allowed; the fixes can be enacted with a simple majority in House and Senate.

The only fly in the pudding is that the House Democratic caucus hasn't the votes. What with retirements and untimely deaths, they lose four or five votes right off the bat. Also subtract the lone Republican who voted for it last time, Rep. Anh "Joseph" Quang Cao (LA, As yet unrated); he now says he won't vote for it ever again. That brings the 220-vote majority down to a 214- or 215-vote minority.

Finally, a group of 64 Democrats (plus 176 Republicans, but they're irrelevant here), led by Rep. Stupak, voted to ban any kind of federal funding of abortions. Alack and woe are they, full federal funding for abortions is one of the late (and Catholic) Teddy Kennedy's crowning achievements, and Democratic senators aren't about to knock the rug off the feet of that legislative memorial to the Lion of the Senate. If even 10% of those Stupakers meant what they said, that means the bill falls short of passage by 10 or 11 votes.

So they appear to be Stupaked -- a portmanteau word I just created by combining "stupified" and "stuck" in a particle accelerator. Thus, now do I offer what may be the perfect end run around the new obstacle, a House of Representatives that can't find its way to 218 votes. To complement the reconciliation process, we now offer the irreconciliation process.

All the Democrats need do is enact a House rule change: Henceforth -- until January 2011 -- a majority of 38% will be sufficient to enact any controversial legislation designed to remove and replace any program supported by Republicans or created by George W. Bush. That is, when trying to undo Republican ravages against the Vision, 161 representatives will, by rule, constitute a majority of the full 435.

It's pointless to argue; it just is. Do the math, remembering to take the traditional five-finger discount for Democrats.

The time for bourgeois voting is over; we need action, action, action!

Hatched by Dafydd on this day, February 22, 2010, at the time of 9:32 PM | Comments (2) | TrackBack

January 28, 2010

Defensive Plaintiffs

Health Insurance Insurrections , Laughable Lawyers
Hatched by Dafydd

A "seminar commenter" on a previous post made an extraordinary claim; he wrote:

Tort reform is a non starter, not because Dems have no backbone, but because tort is a very small factor in health care cost issues. Unless you consider 0.01% of total health care costs an issue.

Actually, tort reform is a "non starter" because of the truly staggering level of political donations (mostly to Democrats) lawyers make to candidates who oppose tort reform; as RealClearMarkets reports:

The reason the president and congressional Democrats don't address malpractice is clear. In the 2008 election cycle, lawyers gave $233 million to political candidates: 76% went to Democrats and 23% to Republicans. Politicians know better than to bite the hand that feeds them.

That seems a more likely explanation of Congress' inaction than the explanation offered by the commenter and his trial-lawyer sources, that "tort is a very small factor in health care cost issues."

Defenders of defensive medicine

The commenter appears to get his talking points from trial lawyers (I have no idea whether he personally is one); oddly, however, he gets them wrong.

A very recent release from the American Association for Justice -- which used to call itself the Association of Trial Lawyers of America (ATLA), until they realized how most of us view John Edwards and his cronies -- claims that:

According to the National Association of Insurance Commissioners, the total spent defending claims and compensating victims of medical negligence in 2007 was $7.1 billion -- just 0.3% of health care costs.

So even the trial lawyers admit the direct costs of medical-malpractice trials are 30 times what the commenter claims. We can chalk this error up to faulty memory; however, the ATLA itself plays fast and loose with its own figures.

ATLA uses the figure of $2.2 trillion for the size of the health-care industry, comparing the $7.1 billion they claim is the direct cost of malpractice-litigation judgments, settlements, and lawyers' fees. But that total-cost figure includes many areas of health care that don't need malpractice liability insurance; they either need other types of insurance or no insurance at all.

According to a Kaiser Foundation report (source: Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group), only 52% of the $2.241 trillion goes to Physician/clinical service (21%) or Hospital care (31%); the rest comprises:

  • Investment
  • Government public health activities
  • Program administration
  • Retail - Rx drugs
  • Retail - Other products [I'm guessing medical devices -- DaH]
  • Home health care
  • Nursing home care
  • Other professional services

This pie-chart illustrates the breakdown:

National Health Expenditures Distribution 2007

National Health Expenditures Distribution 2007

So comparing apples to apples, the direct cost of malpractice judgments, settlements, and attorneys' fees on those entities that are subject to malpractice lawsuits is 0.6%, not 0.3%. That's still a small percent, of course -- but it's only the beginning of the story.

What the trial lawyers dance around (and what the commenter ignores entirely) is that the direct costs of malpractice litigation are but a tiny fraction of the total costs imposed upon the health-care system by the threat of litigation.

What are the missing components in the lawyers' calculations?

  • Skyrocketing malpractice-insurance rates
  • The costs of defensive medicine

Insurance: malpractice aforethought

The monetary cost of the risk of a huge verdict far outweigh the actual awards themselves; a high-risk litigation environment causes insurance companies to jack up their rates -- for the same reason that living on a flood plain or in "tornado alley" jacks up your insurance rates for those disasters.

Doctors pay stunning premiums for malpractice insurance, in some cases more than $200,000 annually for physicians in certain specialties, such as obstetrics or anaesthesiology -- and far more for hospitals -- even for doctors and hospitals with excellent records; see the RealClearMarkets piece linked above.

Virtually every doctor and hospital is guaranteed to be sued several times in his career... no matter how good and careful a doctor he is. This is due not only to shysters like John Edwards pushing bogus cases to force a settlement, but also to the unreasonable expectation of perfection that too many Americans hold about our admittedly wonderful health care: Even when told that a certain procedure carries a certain risk, if that risk becomes a reality, the pressure is on to go ahead and sue anyway. With a sympathetic plaintiff and a runaway jury, who knows how many millions of dollars the patient might win in "jackpot justice?"

Several estimates have found that the cost of malpractice insurance alone is about 10% of the total cost of doctor and hospital care in America, or $110 billion; again, see RealClearMarkets. This is money directly out of the pockets of doctors and hospitals... which naturally means costs directly passed along to all patients.


But the heaviest costs of malpractice litigation are indirect:

  • The actual monetary cost of "defensive medicine;"
  • The opportunity cost of overtaxing medical resources by unnecessary use of equipment and needless prescribing of scarce pharmaceuticals;
  • The doctor-patient time lost to increasingly onerous paperwork... documentation required to make a strong defense in court in response to the inevitable lawsuit;
  • Doctors refusing to accept high-risk patients, knowing they will incur far more lawsuits from such patients than from low-risk patients;
  • And worst of all, doctors abandoning entire specialties (such as obstetrics) associated with an unreasonable number of lawsuits -- and doctors fleeing states that strongly encourage malpractice lawsuits, or retiring early. Likewise students opting for another profession, one that's actually thriving... such as being a lawyer.

"Defensive medicine" comprises unnecessary tests, procedures, documentation, and hospital stays ordered, not because the doctor honestly believes they will help treat the medical problem, but rather to "immunize" doctors and hospitals from bogus malpractice lawsuits.

As far as actual money out of the system due to defensive medicine -- that is, due to the threat of malpractice litigation -- estimates range from huge ($60 billion per year) to gargantuan ($200 billion per year). Consider those the "direct" indirect costs imposed by trial lawyers.

But there are even vaster and more indirect damages caused by the congressional majority's love affair with lawyers. The first hidden cost is in resource depletion: Simply put, we have limited resources available for medical tests, such as X-rays or CAT scans. While a patient with no serious injury is being CAT scanned, just so that the doctor and hospital won't be dragged into court later, that particular sanner is unavailable to other patients with more serious injuries. From the Washington Times piece:

Medical resources are scarce In a hospital There are only so many CT scan machines and only so many radiologists to read them. When fear of lawyers causes practically every patient with a bump or bruise who enters the emergency room to get a CT scan whether it's clinically warranted or not, critically ill patients who need the scan inevitably must wait their turn.

While radiologists read unneeded tests, precious minutes tick by with patients suffering from possibly fatal conditions such as subarachnoid hemorrhage (bleeding in the brain) or septic shock (overwhelming infection) waiting quietly in the queue.

Similarly, if a doctor prescribes drugs for patients who don't really need them, because the doctor fears that some persuasive lawyer will convince a jury that he knows best, and the drug would surely have saved the patient's life -- then supplies of that vital drug will become scarce, and it may not be available for patients who really do need it. (It also drives up the price of drugs by the elementary rule of supply and demand.)

One hidden cost that few think about is that doctors must overdocument everything he does, just in order to defend himself when he's sued; all the paperwork extensively cuts into the time he can actually spend with his patients. From the Washington Times piece:

Another opportunity cost of jackpot justice is its effect on the time doctors can spend with patients. Patients often may wonder why doctors spend so little time with them in the hospital. Doctors are not out playing golf or eating bon bons. They are in back rooms writing notes, documenting everything they have done and everything they plan to do.

Every day, a detailed assessment and plan is needed to outline all actions and the reasoning behind them to protect doctors from lawsuits, acknowledging every lab value, test, consult. If nothing changes from one day to the next, doctors must take the time to write the same thing again. If it is not written down in the chart, it never happened.

While some medical cases can be quite complex and such inordinate documentation can help organize the case more clearly in the doctor's mind, often this is not the case. Primarily this degree of documentation is done out of necessity to keep the pesky lawyers at bay. In fact, by wasting valuable physician time that could be better spent actually seeing patients, it can be counterproductive to a patient's well-being.

Finally, fear of litigation produces yet another nasty effect... defensive dumping: Doctors are already refusing to accept high-risk patients, those with serious ongoing conditions or many allergies to drugs and "contrast agent" dyes, because they know a higher percent of them will have problems and complications from treatment -- and that means a corresponding increase in malpractice lawsuits, no matter how proper the treatment was.

Similarly, some medical specialties (obstetrics, for example) are inherently more legally risky; veteran doctors staring at spiraling malpractice premiums -- and especially newly minted doctors right out of residency, who haven't yet chosen a specialty -- will be driven to pick those that don't carry quite as much risk of spending several weeks (or months) in court. Worse, some potential med-school students will look at the costs and legal risks associated with being a doctor and opt for some other career entirely.

Malpractice tort costs amount to a "tax" on the practice of medicine -- and a subsidy for malpractice trial lawyers. What you tax, you get less of; and what you subsidize, you get more of; does America really want fewer doctors and more lawyers?

Finally, states that are litigation-happy, like New York and California, will watch as a flood of doctors leave and head towards states that have already enacted tort reform, like Texas. Great for citizens of Texas; bad for the rest of us. Make the pain universal enough, and we may have to start importing doctors from third-world countries, as the United Kingdom must now do.

Bottom line

It's impossible to make a precise estimate of how much money, resources, and doctor-patient face time tort reform would save; it depends upon what reform, how strong, and where the reform applies: Reform in California, where the health-care industry is virtually run by lawyers, would save a lot more money than a similar reform in Texas, which has already limited the extent to which lawyers can loot the system. But most academic estimates are in the range of $100 billion to $300 billion per year.

That makes tort reform one of the top targets for reducing the cost of medical care in the United States -- and well worth demanding in any so-called "reform" bill.

Unless the American people are willing to cough up donations in the hundreds of millions of dollars range, Democrats are not going to act on that demand; therefore the only viable strategy is to defeat those Democrats in the voting booth, where the opinion of an ordinary American voter is worth just as much as the opinion of a John Edwards clone.

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

Hatched by Dafydd on this day, January 28, 2010, at the time of 6:51 PM | Comments (5) | TrackBack

January 26, 2010

No More Health Care in America!

Health Insurance Insurrections
Hatched by Dafydd

Actually, it's just no more ObamaCare, according to the New York Times; I'm just going along with the media crowd that continually uses the term "health care" as a synonym for "mandatory, government-controlled, grotesquely expensive health insurance that leads inevitably to health-care rationing."

Here's the Times:

With no clear path forward on major health care legislation, Democratic leaders in Congress effectively slammed the brakes on President Obama’s top domestic priority on Tuesday, saying that they no longer felt pressure to move quickly on a health bill after eight months of setting deadlines and missing them....

Mr. Reid said that he and the House speaker, Nancy Pelosi of California, were working to map out a way to complete a health care overhaul in coming months. “There are a number of options being discussed,” Mr. Reid said, emphasizing “procedural aspects” of the issue.

And as we predicted last year, there will be no jam-down of ObamaCare using budget reconciliation:

At the same time, two centrist Democratic senators who are up for re-election this year, Blanche L. Lincoln of Arkansas and Evan Bayh of Indiana, said that they would resist efforts to muscle through a health care bill using a parliamentary tactic called budget reconciliation, which seemed to be the simplest way to advance the measure.

The White House has said in recent days that it would support that approach....

But a plan to win over House members by making changes to the Senate bill in the budget reconciliation process ran into substantial resistance on Tuesday.

Mrs. Lincoln, who faces one of the toughest re-election bids among Democrats, said, “I am opposed to and will fight against any attempts to push through changes to the Senate health insurance reform legislation by using budget reconciliation tactics that would allow the Senate to pass a package of changes to our original bill with 51 votes.”

Mr. Bayh said, “It would destroy the opportunity, if there is one, for any bipartisan cooperation the rest of this year on anything else.”

But they haven't given up entirely on passing something, anything, that they can call a health-care reform bill:

None of the options available to lawmakers, including the use of budget reconciliation, seems viable at the moment. Some lawmakers said they expected Congress to try to adopt a greatly pared down bill once it returns to the issue.

“Frankly, we’re trying to figure out what is possible,” Mr. Hoyer said. “Senator Reid needs to determine what is possible on his side of the aisle, you know, what kind of support he can get. And we’re trying to figure out as well what we can pass."

Sigmund Freud, the founder of modern psychoanalysis, famously expressed his perplexity with the distaff sex:

The great question that has never been answered, and which I have not yet been able to answer, despite my thirty years of research into the feminine soul, is "What does a woman want?"

The obvious rejoinder is -- why not ask her? (Freud actually posed his question in a letter to Marie Bonaparte, Napoleon Bonaparte's great-grandniece and a psychoanalyst herself; so perhaps Freud got his answer.)

Similarly, when Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 70%) asks, through his spokesman, "what kind of support he can get," he must surely be asking what kind of Republican support he can get... since the go-it-alone, Democrats-only approach failed miserably and humiliatingly.

And the obvious rejoinder is strikingly similar as above to Freud: Why doesn't Reid simply ask the Republicans what they would support?

The GOP has already offered a couple of health-insurance reform bills, which were so sooner debuted than the Democrats arrogantly flushed them. The Republican suggestions are several variations on putting more power in the hands of individual patients and doctors to decide their own treatment, thus removing much of the power that currently resides in government: both the regulatory regime of mandates and diktats and the judicial regime of medical-liability tort law:

  • Medical liability tort reform, to decrease outrageous malpractice verdicts and eliminate the need for "defensive medicine."
  • Insurance portability -- from job to job and from state to state.
  • Greater flexibility for insurance companies to create groups, coordinating small businesses, clubs, and buying blocs into pools of like-minded insurance customers.
  • Removing all government mandates on health-insurance policies, forcing them to cover every imaginable malady, condition, and the normal consequences of poor lifestyle choices. Let's make available a full range of insurance covereage, from minimalist plans to those "Cadillac" plans; you buy what you want and can afford.
  • More emphasis on catastrophic care plus medical savings accounts (MSAs), to put more treatment decisions directly in the hands of patients and their doctors and less in the hands of insurance adjusters.
  • And with all that, we can still take care of the poor by offering refundable tax credits for low-income families to be used to buy health insurance. There is no need for a "government option" and no voter desire for the government to get involved.

Governor Bobby Jindal of Louisiana already talked about these ideas in a Wall Street Journal op-ed; didn't Harry Reid read it?

Now that even the Democrats have been mugged by reality, perhaps their own sense of self preservation will triumph over their knee-jerk "progressivism" long enough to make common cause with the GOP and enact the health-insurance reform that Americans actually want.

I plan to hold my breath while waiting...

Hatched by Dafydd on this day, January 26, 2010, at the time of 8:11 PM | Comments (4) | TrackBack

January 22, 2010

California Democrats Ache for Canadian/UK Style Government Health Care

Health Insurance Insurrections , Liberal Lunacy
Hatched by Dafydd

A couple of days after Scott Brown's victory in Massachusetts -- a campaign primarily fought against ObamaCare -- the California state senate will now consider imposing a single-payer, government-run, "universal" health-care scheme on the rest of us. Again.

I rib you not; state Sen. Mark Leno decided this was the perfect time to push a massive government takeover -- in a state on the brink of fiscal collapse, whose credit rating was just lowered again in June, and already had the lowest credit rating of any state before June:

While the move came as questions arose over the prospects of Congress adopting national health care legislation, the author of the California bill, State Senator Mark Leno, said that the timing was coincidental. Mr. Leno said it was basically a long-planned reintroduction of a 2009 proposal that was effectively tabled because of its potential cost. But he did concede that Tuesday’s special Senate election in Massachusetts, in which Democrats lost their filibuster-proof 60-vote majority, was not completely lost on him.

“Scott Brown did not push me to do this,” said Mr. Leno, referring to the newly elected Republican senator from Massachusetts. But, he said, “as a result of Tuesday’s election, there is ever greater need for leadership in state legislatures to reform health care.”

This is the third time in four years that liberal fascists with totalitarian impulses have tried to seize control of all medical care in America's biggest state. Yeah, that's the kind of "leadership" we need: A governmen-run health-care bill that costs $200 billion the first year -- twice this year's total state spending, which is between $82.9 billion and $102.6 billion, depending on whether the legislature accepts various spending cuts or raises new taxes. The state already runs a $20 billion budget deficit; but I'm sure that will vanish, with the vast cost savings that always result when the government takes over a sector of the economy.

In 2006 and 2008, the lege passed and repassed SB 840, the California Universal Healthcare Act, introduced by state Sen. Sheila James Kuehl -- perhaps better known as Sheila James, "Zelda Gilroy" of the Dobie Gillis TV show. Gov. Arnold Schwarzenegger vetoed both bills (rather, the same bill twice); but even had one passed, California voters would have had to approve it in a statewide legislative initiative.

The new bill has been renumbered SB 810, this time introduced by Sen. Mark Leno (I don't think he is related to Jay, but he's just as much of a joke.) Schwarzenegger is still governor, but this is his final year; the gubernatorial election is this November, and Schwarzenegger is term-limited out. However, I have great hopes that Meg Whitman, former president and CEO of eBay, will beat former governor, current attorney general, and professional moonbat Jerry Brown.

But even if Brown is elected (again) and signs the bill, I am utterly convinced that voters here are at least as smart as voters in Massachusetts: We shall reject this boondoggle resoundingly.

I do have a suggestion, however. The name of the "new" bill is still the California Universal Healthcare Act, CUHA; but this is dull and pedestrian. Rather, I suggest it be redubbed the Better-Off Health Insurance for California Act, or BOHICA... because that's what the legislature is once again demanding Californios do.

Hatched by Dafydd on this day, January 22, 2010, at the time of 1:02 PM | Comments (0) | TrackBack

January 15, 2010

Democracy Inaction

Democratic Culture of Corruption , Health Insurance Insurrections
Hatched by Dafydd

Could this be the magic "exit strategy" for the Democrats to extract themselves from mounting voter opposition to ObamaCare from all sides? Here is my late-night, bleary-eyed scenario:

  1. The Democrats deliberately drag out discussions on the House-Senate compromise bill.
  2. They hope and pray that Republican Scott Brown beats Democrat Martha Coakley in the Massachusetts senatorial election. (Actually, the Democratic Senatorial Campaign Committee can ensure Coakley's defeat by forcing her to campaign where voters can see her, rather than in smoke-filled rooms with lobbyists.)
  3. Assuming Brown wins, the DSCC could lean hard on Massachusetts election officials to certify the election ASAP; if necessary, a couple of SEIU mafiosi can sit on Coakley's head until certification, to prevent her from trying to sue her way into the U.S. Senate.
  4. After certification and Brown's official seating in the Senate, congressional Democrats quickly finish the bill and submit it to the full Senate.
  5. Scott Brown makes good his threat to vote against cloture, becoming the 41st and determinative vote.
  6. The bill dies, everybody's face is saved -- "We did everything we could! It's those darned Republicans!" -- and Democrats can spend 2010 bemoaning the "obstructionist" GOP, rather than having to defend a government-run health-care scheme that everybody hates, Left and Right alike.

It's a win-win scenario! I wonder if the majority is already considering it?

Puckishly cross-posted on Hot Air's rogues' gallery...

Hatched by Dafydd on this day, January 15, 2010, at the time of 1:04 PM | Comments (2) | TrackBack

January 8, 2010


Health Insurance Insurrections
Hatched by Dafydd

Now we know why some prominent economists came out swinging so strongly for ObamaCare, notwithstanding its economic stupidity:

MIT economist Jonathan Gruber, one of the leading academic defenders of health care reform, is taking heat for failing to disclose consistently that he was under contract with the Department of Health and Human Services while he was touting the Democrats' health proposals in the media.

Gruber, according to federal government documents, is under a $297,600 contract until next month to provide "technical assistance" in evaluating health care reform proposals. He was under a $95,000 HHS contract before that.

But while he was being paid to provide his services to HHS, he was also fending off health care reform critics in the media. Gruber was one of the prominent analysts to rebut an insurance industry report from PricewaterhouseCoopers in October saying premiums would shoot up if a health care bill passes. And he has recently written columns defending specific provisions in the House and Senate bills, particularly the "Cadillac tax" on high-cost insurance plans.

...Funnily enough, it's the Left that began the firestorm of attacks on Sneaky Gruber, though I'm sure the rest of us will climb aboard that crazy train pretty soon:

"I have never seen it disclosed that he was a paid consultant to the Obama administration," a blogger for Firedoglake wrote Friday morning. "For months I have been angry with Gruber because I thought he was simply an exaggerator whose dangerous love of the spotlight was hurting the efforts of progressives to make sure the Senate bill adopted more progressive cost control solutions. ... Now it is clear something much more sinister was at play."

The Daily Kos declared that, given Gruber's contract, the "fix was in" for the Cadillac plan.

But that's all right; Gruber insists that his dogged defense of ObamaCare has "nothing to do" with the nearly $400,000 HHS paid him. After all, all of his comments, e-mails, editorials, and other advocacy activities "have been done on my own time."

So he's an independent-contractor shill.

Gruber notes in his defense that he told reporters about his payoffs "whenever they asked." If it didn't occur to them to ask whether he was secretly being supported by the very administation he was cheerleading -- hey, that's not Gruber's fault!

So Gruber gets greased, then Gruber becomes an ObamaCare enthusiast; I am inexplicably reminded of Sens. Mary Landrieu (D-LA, 65%) and Ben Nelson (D-NE, 75%).

It does tell us something, does it not, that the signature issue of the Obamic administration, nationalized health care, can only be advanced by out and out bribery -- of congressmen, of economists, and of sundry voting constituencies (AARP, the AMA, unions, and suchlike). But isn't that true for every issue of the Obamic administration, from Cripple and Tax to Card Check to globaloney to collateral stimulation of the economy -- or at least those portions of it run by Obamunist BFFs like Big Labor, Big Hollywood, and Big Soros?

One hopes the American people will use their votes more wisely this November and again in 2012. Perhaps the only benefit arising from the election of Barack H. Obama is the clarity he inadvertently brings to the dangers of electoral dice-rolling.

Hatched by Dafydd on this day, January 8, 2010, at the time of 2:31 PM | Comments (0) | TrackBack

January 1, 2010

"VIP" Treatment Under Nationalized Health Care

Doctor, Doctor , Health Insurance Insurrections , Mysterious Orient
Hatched by Sachi

A few days ago, my 77 year old father, who lives in Japan, fell and couldn't get up for more than an hour. He was taken to a hospital, where he still rests.

Last night my mother called to update me with a summary of his condition: He has a compressed disk, it seems (it's hard to translate from Japanese to English and from Mom-speak to ordinary human language). The condition is somewhat serious but not life threatening; he'll have to spend a few weeks in hospital. Too bad; New Year's is the biggest holiday season in Japan.

I'm sure everyone reading this post knows that Japan has socialized medicine (national health care, single-payer, however you want to call it). It's not as draconian as the NHS in the United Kingdom or the Canadian national and provincial health-care system; but it is universal -- everyone must pay for government insurance. Fortunately, those who are well off can also buy private insurance in addition... and they can use that instead of the government system (unlike in the UK or Canada).

In other words, Japan already has the system that proponents of ObamaCare eventually want to install here in America. So let's take a look at how it works in the real world.

After Mom reassured me about my father's condition, she started talking about last year around this time, when she had to have stomach surgery.

"Oh Sachi, the care I received was wonderful!" she said; "I stayed in a private room which was like in a nice hotel. It had a private bathroom. The nurses were nice. The doctors were wonderful. I spent nine days in the hospital and only paid ¥80,000!" [About 800 dollars]

"Really?" I asked; "government insurance actually covered all that?"

"Oh, of course not; I have three insurance policies," she proudly announced.

Before retirement, my father was a patent attorney. As a private business owner, he had to pay an exorbitant government insurance premium, both for himself and his three employees. But he always knew that would never be enough coverage, so he purchased two more private insurance policies. In other words, he spent more than twice as much on health insurance as a typical American spends now, pre-ObamaCare.

But even those extra policies wouldn't cover the VIP treatment my Mom got. I asked a few more questions, and she finally spilled the beans:

"I was supposed to be in a 4-person room. But I had a private room all to myself, thanks to your uncle."

Ah, my uncle the hospital administrator. I'd forgotten about him!

My mother's third or fourth youngest brother (I forget which) holds a high administrative position at a major university hospital. It seems he has a great deal of clout there, which has been a great help to our family in times of medical need.

My mother is quite the hypochondriac; she always complains about one ailment or another, usually imaginary. So whenever she is not satisfied with her general practitioner, she talks to my uncle. First thing you know, she's seeing a specialist -- skipping the long waiting list that those without such connections must endure under Japanese system.

On another occasion, Mom hurt her knee. My uncle "referred" his sister to a university hospital doctor who was Japan's most famous doctor for ligament tears. Patients from all over Kanto Plain (where Tokyo sits) would come to see him.

"He only takes 40 patients a day," mom said (only 40! Imagine that!) He doesn't accept appointments; so if you want to see him, you have to get there by 7:00 a.m, take a number, and... wait. And wait, and wait.

My mother strolled in at 9:00, the time the office officially opens; the waiting room was already full, and they had long stopped issuing any numbers. One lady told my mom that she had gotten up at four and had her daughter drive her for two hours to get to the hospital. She was lucky; she got number 38 and had waited three hours already. "There are no specialists in my city," the lady explained.

My mother-the-sister-of-one-of-the-nomenklatura presented her letter of introduction to the receptionist:

"Don’t worry, Ma'am, never mind the number. Just have a seat; we will call you."

My mother did not have to wait. The doctor was most courteous, a rarity in Japan, and he asked about my uncle. Then he gave Mom a thorough examination, spending far longer with her than other patients.

So my parents have the more expensive national health care for business owners (Dad pays higher taxes), Kokumin Hoken -- Citizens' Health Insurance; the lesser one is for ordinary salaryman, Shykai Hoken -- Society Health Insurance. In addition, they have not one but two private health insurance plans, a primary and a supplementary. On top of that, my mother's brother is a high-ranking official at a major hospital in Japan.

But Mom is not so foolish as to rely upon such insecure health-care planning as that; she has a back-up system that she also uses...

After such nice treatment as she got for her knee and her stomach, my mother never forgets to send "gifts," typically cash and premium liquor to the doctors, expensive chocolate to the nurses -- and of cours, something extra special to my uncle, her brother. She was laughing that after her hospitalization, she spent more money on gifts than the actual medical bill. That means over thousand dollars of, let's be honest, bribery.

Wonderful. The national health-care system works!

That's why my mother isn't worried about Dad's care; he's going to be treated better than anybody other than corporate CEOs and of course government officials. But even with that kind of influence, my father had to wait three days for his preliminary examination and to have X-rays taken. After all, it was a holiday week, the Emperor Akahito's birthday, and no doctor was willing to return to the hospital for anything other than a life or death situation. (And maybe not even then; how many extra private insurance plans is the fellow carrying?)

The day my father was taken to the hospital, the nurse told Mom to obtain several changes of clean pajamas, underwear, and towels for my father. Also soap, shampoo, and other toiletries, which were needed right away. Conveniently, the hospital has a kiosk that sells all kinds of items and is open 24 hours. Just a little markup over buying at a regular store, miles away... maybe 100% or so.

Oh, yes, I almost forgot, they told Mom to bring a thousand-dollar deposit. Cash.

My sister and mother take turns visiting Dad everyday. They have to pick up his dirty laundry, wash it and bring it back, because the hospital doesn't do that. But Dad's quite lucky that he stays in a nice hospital with three different insurance policies, under the auspices of his brother in law. My girlfriend’s father only had government insurance when he was hospitalized, and the hospital did not even turn on an air conditioner in the middle of August, with temperatures over a hundred degrees and humidity close to 100%.

My girlfriend visited her father as often as she could; she had to: Half the time, they didn't even empty his bedpan.

You see? National health care works great... so long as you're rich enough to afford the premium level of government insurance and to buy multiple additional private policies; so long as you have influential relatives; and so long as you're willing and able to brazenly bribe the doctors and bureaucrats who run the system.

"I am so glad we live in Japan," Mom said. "I worry about you in America, with no national health care!" Thanks, Mom, but I'm afraid "help" is on the way from President Barack H. Obama.

Are you looking forward to it as eagerly as I?

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

Hatched by Sachi on this day, January 1, 2010, at the time of 4:18 PM | Comments (3) | TrackBack

December 30, 2009

Will Big Ben Chime in Again?

Health Insurance Insurrections
Hatched by Dafydd

The release of a post-ObamaCare vote Rasmussen poll showing that Sen. Ben Nelson (D-NE, 75%) now sits 31 points (!) behind Republican Gov. Dave Heineman in a potential matchup in 2012 raises an interesting question: Will Nelson reconsider his vote for cloture when the bill comes back from the joint conference?

Given that there will likely be changes made in the bill, however slight, he has a ready-made excuse: "Oh, sure, I vote for the previous version; but the new one is soooo much worse!"

I reckon what it boils down to is whether he thinks the 31-point gap is just a statistical anomaly, or that it will naturally close itself as Nebraskans forget all their fears about ObamaCare and happy-up again... or whether he thinks the vote will linger and fester, effectively killing his political career for all time to come... unless he moves to Massachusetts or California and starts all over again.

At the moment, he's made an expensive ad buy to be aired starting tonight, during the Holiday Bowl football game between the Arizona Wildcats and the Nebraska Cornhuskers. The advert -- which sounds somewhat whiny, from the description in the Lincoln Journal-Star -- argues that ObamaCare doesn't mean a government takeover of health care; that it really, really, really does prevent any federal funds from subsidizing abortion; lowers health-insurance costs for all while mandating coverage; and (absurdly enough) that it actually does "reduce the deficit."

The problem is that nobody really believes that... not even Nelson; he relies upon the traditional Democratic catechism that voters are fools who can be led by the nose.

My guess is that the response to the ad will be vastly underwhelming; Nebraska is the Cornhusker state -- not the Cementhead state. When Nelson sees that his political sleight of hand has failed... will he then come to the obvious conclusion? Will he realize that if he is to have any hope of reelection at all, he must repudiate his cloture vote during the next bite at the apple in January or February?

I don't know. How bright is he?

Hatched by Dafydd on this day, December 30, 2009, at the time of 1:33 PM | Comments (1) | TrackBack

December 19, 2009

Never Retreat, Never Surrender

Health Insurance Insurrections
Hatched by Dafydd

Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 70%) finally snared Sen. Ben Nelson (D-NE, 75%), getting the 60 votes needed to close debate on ObamaCare and (obviously) pass it. We haven't lost entirely yet, though it's now very likely that this dreadful government seizure will become law. Still, there are a few hurdles left for the Left to surmount:

  • Democrats actually have to muster those supposed 60 votes; it's dimly possible that some extreme leftist in the Democratic caucus will balk at the compromises made to "moderates" like Nelson and Lieberman. But more likely, all Democrats will vote for cloture and the bill; the lefties expect either that the compromises will be washed away in the conference committee -- or that there are enough Trojan horses (like the mandate plus the federal definition of what constitutes an "authorized" insurance plan) to get what they want without the more grotesque elements ever appearing in any formal language in the bill.
  • Then there is the conference; it's quite possible that House Democrats won't go along with the Reid version of the bill, and that one or more of those "compromises" (the government option, abortion, the delayed implementation) will be restored... and that that will be enough to peel off a moderate or two when it comes time for the final vote -- which is still subject to fillibuster.
  • Finally, even if everything goes through, the Democrats hold together, and Barack H. Obama signs the bill... remember that the most odious parts of it don't go into effect for several years (though the taxes increase immediately). That means we still have a chance to undo them -- if the GOP picks up many seats in November.

So don't give up the ship. Make the Democrats pay for every vote, every amendment, every abrogation of our liberties. Make them pay at the ballot box for spitting in the face of the American people. Make them regret this vote for the rest of their lives (preferably in retirement).

What one Congress does, another Congress can undo. It's very difficult; I don't know if such an "entitlement" program has ever been eliminated. But if there's ever to be a first time, this vile bill is a great candidate for it: Not only is it repugnant to the huge majority of the American people, but its most evil provisions won't actually start for years (so we have some time); and it was passed in a risible mockery of democracy that even stunned liberals, including threats, tantrums, secret backroom deals, thousands of pages of provisions that not a single senator has fully read, parliamentary chicanery, and of course brazen bribery -- as the payoffs to Sen. Mary Landrieu's (D-LA, 65%) Louisiana and Ben Nelson's Nebraska exemplify.

I expect Republicans in 2010 to campaign on precisely that: Overturning ObamaCare before its medical-insurance limitations and rationing go into effect. While they won't likely win back either chamber of Congress -- and couldn't possibly enact a bill undoing ObamaCare with enough votes to override Obama's own veto -- they can make it harder to fund some of its provisions.

And of course, in 2012, we have the chance to change the president and add a few more Republican seats: That is our best shot at erasing this cancer from the books before it settles in and becomes permanent. A Republican president can do just what "Lucky Lefty" Obama did -- armtwist Democratic moderates into siding with Republicans to "amend" ObamaCare into nonexistence. By then I expect the American people to be fed up with the increased taxes and just starting to feel the bite of government control of health care; I doubt they will be any happier about the scheme then than they are right now.

Despair is a mortal sin; it saps one's will to continue fighting. The lesson of the Iraq counterinsurgency (COIN) strategy (and of Ayn Rand's Atlas Shrugged) is this: You can only be defeated if you accept defeat; you must actively conspire in your own subjugation.

So don't. Just say "No" to surrender. We lost a battle; we'll likely lose this campaign. But the war against "socialisme" will continue. The Reds will never surrender, so why should we?

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

Hatched by Dafydd on this day, December 19, 2009, at the time of 10:32 AM | Comments (2) | TrackBack

December 16, 2009

Heh - Let the Stare-Down Begin!

Health Insurance Insurrections
Hatched by Dafydd

Sen. Joe Lieberman (I-CT, 85% Dem) insists he can never vote for a version of ObamaCare that includes any kind of a public option or government-run health insurance.

And now Sen. Roland Burris (D-IL, unrated) swears that he can never vote for an ObamaCare bill that does not include a public option or government-run health insurance.

Lieberman cannot be intimidated by the Democratic leadership, because (a) he has a huge fan base in Connecticut, and (b) they already read him out of the party... and he won reelection anyway as an independent. Meet Mr. Immovable Object.

Burris cannot be intimidated by the Democratic leadership, because he is an appointee; as an appointee, he must run for reelection in 2010, if he is to stay in the Senate; yet despite having signed a candidacy statement, Burris later announced that he will not run for reelection next year. He is stepping down. Meet Mr. Irresistable Force.

I still suspect that somehow, somewhichway, one of the two will yield; but this may take longer than the few days remaining before Congress breaks for the rest of the year. When they return, it will be in an election year; and who wants to pass a massive tax and Medicare cut in an election year?

Burris may just be the tip of the ice cream; there are other very, very liberal senators in the Democratic caucus, and not all of them may be aboard the Chris Dodd express.

Keep watching the skies...

Hatched by Dafydd on this day, December 16, 2009, at the time of 9:21 AM | Comments (0) | TrackBack

December 14, 2009

News So Great, It Boggles the Mind (and Provokes Skepticism)

Health Insurance Insurrections
Hatched by Dafydd

If this news is true, then that's all she wrote.

In a flailing, last-ditch effort to save the Senate ObamaCare bill -- which is gonna be sinking soon, to draft Norah Jones into a role she would hate -- Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 75%) jettisoned the government option and replaced it with a government option. That is, he deep-sixed the direct underwriting of health-care insurance by the government, the program so hated by the American people, and replaced it in the bill with a surreal expansion of the Medicare boondoggle... which is already teetering on the brink of complete collapse (being unfunded to the tune of trillions of dollars), and is simultaneously being looted of an additional half a trillion in real money by various other parts of ObamaCare.

Elementary, my dear Reid.

As Paul Mirengoff at Power Line put it yesterday:

This is only the latest blow to "Reid-care." The Mayo Clinic has already denounced the expansion of Medicare and the American Medical Association also opposes this concept. These developments reinforce the sense that Reid threw his "compromise" proposal together in desperation and without much thought to its consequences.

In essence, Reid is treating the process as a game of "60 pick-up."

Meaning, of course, that Reid is simply throwing everything but the kitchen sink, plus the television, plus the "slavery" threat -- plus the kitchen sink after all -- at the wall, hoping something sticks. Sixty somethings, actually.

For that, Reid needs to keep each and every last Democrat (plus the two Independents) on the plantation (to continue his own metaphor), since all 40 Republicans have already voted against cloture even before debate began. And the Dear Leader's job just got infinitely tougher this evening, when a certain non-Democrat made a certain announcement:

In a surprise setback for Democratic leaders, Senator Joseph I. Lieberman, independent of Connecticut, said on Sunday that he would vote against the health care legislation in its current form.

The bill’s supporters had said earlier that they thought they had secured Mr. Lieberman’s agreement to go along with a compromise they worked out to overcome an impasse within the Democratic Party.

But on Sunday, Mr. Lieberman told the Senate majority leader, Harry Reid, to scrap the idea of expanding Medicare and abandon any new government insurance plan or lose his vote.

Exit Sen. Joe Lieberman (I-CT, 85% Democratic). Enter fat lady; warms up tonsils.

Even better, Reid is making no headway at all with Sen. Ben Nelson (D-NE, %) on the abortion issue:

On a separate issue, Mr. Reid tried over the weekend to concoct a compromise on abortion that would induce Senator Ben Nelson, Democrat of Nebraska, to vote for the bill. Mr. Nelson opposes abortion. Any provision that satisfies him risks alienating supporters of abortion rights.

In interviews on the CBS News program “Face the Nation,” Mr. Lieberman and Mr. Nelson said the bill did not have the 60 votes it would need in the Senate.

Nelson also expressed great misgivings about either version of the government option, worrying that it would lead to "the ultimate single-payer plan."

Meanwhile, Minority Leader Mitch McConnell (R-KY, 80%) strikes what I think is exactly the right tack -- what should kill ObamaCare is not politics but policy failings:

The Senate Republican leader, Mitch McConnell of Kentucky, said that passage of the bill was looking less and less inevitable. The Democrats "are in serious trouble on this," he said, "and the core problem is the American people do not want us to pass it."

Or to repeat the quote of the year about ObamaCare, from the assistant director of Quinnipiac University Polling Institute, Peter Brown:

“It’s a good thing for those pushing the health care overhaul in Congress that the American people don’t get a vote."

I said before that this monstrosity was going to collapse under its own weight, and I see no reason to withdraw or change my prediction. In fact, I almost feel like quoting "Hannibal" Smith: "I love it when a plan comes together!"

Still, my inborn Skept-O-Meter warns me that we're not out of the woods until the last dog has sung its swan song.

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

Hatched by Dafydd on this day, December 14, 2009, at the time of 1:01 AM | Comments (2) | TrackBack

December 10, 2009

Quote of the Year on ObamaCare

Health Insurance Insurrections
Hatched by Dafydd

This quote should become the centerpiece of the anti-ObamaCare activists; it's an absolute bill killer. It's from the assistant director of Quinnipiac University Polling Institute, Peter Brown:


“It’s a good thing for those pushing
the health care overhaul in Congress that
the American people don’t get a vote."


Brown was referring to the newest Quinnipiac poll of ObamaCare, which found that voters reject it by a stunning 14-point margin, 38 supporting and 52 opposing:

--Voters disapprove 52 – 38 percent of the health care reform proposal under consideration in Congress, and they disapprove 56 – 38 percent of President Obama’s handling of health care, down from 53 – 41 percent in a November 19 survey.

--American voters say 63 – 30 percent that extending health insurance to all will raise their cost of health care, although they are split 47 – 46 percent on whether they are willing to pay more to make sure everyone is covered.

--Voters split 48 – 46 percent on whether they think covering everyone will decrease the quality of their own care, but by 71 – 21 percent they do not think universal coverage is worth lower quality of care.

Oh, and by the way: Quinnipiac has President Barack H. Obama's job approval at 46% favorable, 44% unfavorable; this is below even Rasmussen -- and Quinnipiac University is certainly not considered a "conservative" pollster.

Moderate Democrats must be made to understand that by voting for cloture on this bill, they are signing their own career death warrants in 2010 or 2012. After the next election, they'll actually have to find honest work.

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

Hatched by Dafydd on this day, December 10, 2009, at the time of 3:21 PM | Comments (0) | TrackBack

December 9, 2009

The New (Old) Government Option; the Old (New) Shell Game

Health Insurance Insurrections
Hatched by Dafydd

The so-called "public option" is now out; it finally became clear even to Senate Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 75%) that there was no way in Hades that the public option could get the 60 votes needed to proceed on the Senate version of ObamaCare.

So he has swapped in a ringer: In Reid's new (old) proposal, he excises the government-run health care, and replaces it with government-run health care:

A much-courted moderate - Connecticut independent Sen. Joe Lieberman - signaled he might be able to live with a compromise to offer private insurance plans under the auspices of the federal employee health program while also allowing middle-aged people to buy into Medicare. Liberal Democrats also spoke out in favor of the idea....

However, as the Senate continued to debate, the American Hospital Association and the American Medical Association -- both groups that have been generally supportive of Congress' health overhaul efforts thus far -- raised red flags. Both groups are concerned about adding more patients to Medicare, because the program pays providers significantly lower rates than private insurers do....

A powerful small business group also swung into opposition. The National Federation of Independent Business, which was instrumental in defeating then-President Bill Clinton's health care bill in the 1990s, said the Democratic bill would raise costs and make it harder to create jobs....

Nonetheless Reid, D-Nev., was upbeat about the bill's prospects.

Patients currently must be 65 or older to sign up for Medicare, except in a few special circumstances; allowing people aged 55 and up to join could nearly double the number of people drawing on Medicare funds for their medical care... a government program that right now teeters on the economic abyss.

So let's see; the new (old) Reid plan would:

  • All but double the number of people relying upon Medicare, which is on the brink of insolvency already;
  • Drastically cut how much doctors and hospitals are reimbursed for treating those quasi-seniors;
  • Raise premiums for all those who aren't on Medicare or some other government "option";
  • Ration medical care, particularly for those dumb enough -- or desperate enough -- to sign up for expanded Medicare;
  • Kill Medicare Advantage; no more private health insurance option with the government program;
  • Jack up taxes for everyone, young and old, rich and poor, and probably higher than any previous tax increase;
  • Kill jobs throughout the country;
  • Leave at least 23 million uninsured -- despite the old (new) shell game of the Medicare option;
  • Oh, and I almost forgot... loot Medicare by half a trillion dollars, in addition to all the other stresses on that program.



What could possibly go wrong?

Road Warrior apocalypse

Hatched by Dafydd on this day, December 9, 2009, at the time of 4:43 PM | Comments (2) | TrackBack

December 6, 2009

Does ObamaCare Teeter on the Brink of Collapse?

Congressional Calamities , Health Insurance Insurrections , Presidential Peculiarities and Pomposities
Hatched by Dafydd

There are two possible explanations for President Barack H. Obama's sudden rush to personally lobby and exhort senators to vote for ObamaCare:

  • It's scant days from passage, and Obama wants to be there for the kill;
  • Or just the opposite: The fragile coalition is breaking apart, and this is a last, desperate lunge for the brass ring, as Obama topples off the painted, wooden horse.

I vote for the latter, as the former doesn't match the observed facts:

Democrats met throughout yesterday to seek an alternative to Senate Majority Harry Reid’s plan to create the new national program to cover the uninsured. Opposition within his party leaves Reid at risk of falling four votes short of the 60 he needs to pass the legislation, the most sweeping overhaul of the nation’s health-care system in more than four decades.

Four is a lot more than opponents need to kill the bill at the next cloture vote. And if there are four, more will probably jump aboard the bandwagon; any senator worried about reelection in 2010 or 2012 because his state is more conservative than he (that's a lot more than the usual formulation) would probably take advantage of a "free roll" to pander to the moderates. If the bill is already going down on a cloture vote anyway, it doesn't matter under the rules whether it falls four votes short -- or nine.

And the fissures are the same as they ever were: abortion, the public option, taxes, the looting of Medicare, and health-care rationing. As an example of the last, here's news about how the bill Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 70%) introduced in the Senate guts home health-care:

Republicans, unified in opposition, forced the Democrats yesterday to reiterate their support for cutting more than $40 billion in home health-care services funding under Medicare. It was the latest Republican effort to highlight the bill’s potential impact on the elderly....

The Senate also turned back a Republican bid to restore the home health services funding. The Republicans are trying to draw attention to the impact on the elderly from some $400 billion in proposed Medicare savings.

To boil it down, if Bloomberg is to be believed, Reid has made no progress whatsoever on persuading opponents, including some Democrats who voted to start debate, to come over to the dark side. Nobody has budged yet.

Therefore, if the Obamacle is personally involved at this late date, the only explanation that jibes with the facts is that his hands-off approach, leaving it to the Senate Democratic leadership, has not worked. But with Obama's own lagging poll numbers, he really hasn't the clout to bully the wavering into voting for ObamaCare: The more he tightens his grip, the more star systems will slip through his fingers.

If the Senate passes anything this year, it will be after an "amendment" jacks up the title and runs a whole new bill underneath... one that does little more than what the conservatives and moderates demand. Such a bill would be supported by Republicans, red-state Democrats, and even some leftist Democrats who cannot face the humiliation of returning to Berkeley or Austin or Manhattan empty handed; it would pass with well over 60 votes.

Barack Obama has managed the nearly impossible: After less than a year in office, he has already transformed himself into a lame duck.

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

Hatched by Dafydd on this day, December 6, 2009, at the time of 4:10 PM | Comments (2) | TrackBack

December 2, 2009

I Have a Dream...

Congressional Calamities , Health Insurance Insurrections
Hatched by Dafydd

Dear American Left;

Can we all agree on one result of the debate over ObamaCare, the latest attempt to wrench the United States over to the failed national health systems of Europe?

Can't we sign some kind of Medical Contract with America that:

  • After we voters rise up in fear and fury over the attempt to cripple our medical care, push doctors out of the business, and (to further insult us) make us pay more for degraded medical service;
  • After ObamaCare is squelched in the next cloture vote;
  • After many of those who voted for it (or to "move the process forward") find themselves pressing the flesh... not looking for votes but looking for a new job;
  • After Barack H. Obama takes the big political hit, turning him into a lame duck halfway through his first (and only) term...
  • After fear, uncertainty, doubt, and destruction of the very liberals who pushed it -- you guys...

After all those negative consequences for you, personally, not just this time but the last time as well (HillaryCare), can't we simply make a pact that -- we never, ever have to go through this again? Aren't two devastating defeats for medical Socialism in just fifteen years enough to put a stake through the heart of this leftist utopian scheme?


It can't possibly be good for America's health to raise everybody's blood pressure and anxiety level every few years. Give us a break; just leave it alone.


Dafydd ab Hugh
Consarned citizen

Hatched by Dafydd on this day, December 2, 2009, at the time of 5:42 PM | Comments (0) | TrackBack

November 29, 2009

Crass Warfare

Health Insurance Insurrections , Media Madness
Hatched by Dafydd

We haven't posted since Thursday because for us, Thanksgiving hasn't happened yet; it's a complicated dance involving my sister's in-laws and trying to juggle two Thanksgivings at two different locations, coupled with several other family members having made commitments for Friday and Saturday -- don't ask! So we're doing our Thanksgiving today. (And we personally are the ones who make the turkey, stuffings, gravy, cornbread, pies, baklava, and such; so we've been busy cooking.)

But I have a quick post before I must go make the giblet gravy from the turkey drippings...

AP has a story up essentially recapitulating what you all already know if you read Big Lizards -- or Power Line, Patterico's Pontifications, Hot Air, our dearest Michelle, or pretty much any other political blog. I'm sure even Daily Kos has discussed it, the fact that, while there were sixty votes (barely!) in the Senate to kick off debate, there are nowhere near sixty votes to finish debate and move to a vote; I doubt there are even fifty:

The 60 votes aren't there any more.

With the Senate set to begin debate Monday on health care overhaul, the all-hands-on-deck Democratic coalition that allowed the bill to advance is fracturing already. Yet majority Democrats will need 60 votes again to finish.

Some Democratic senators say they'll jump ship from the bill without tighter restrictions on abortion coverage. Others say they'll go unless a government plan to compete with private insurance companies gets tossed overboard. Such concessions would enrage liberals, the heart and soul of the party.

There's no clear course for Senate Majority Leader Harry Reid, D-Nev., to steer legislation through Congress to President Barack Obama. You can't make history unless you reach 60 votes, and don't count on Republicans helping him.

Yes, yes, we already know that; but for those poor schlimazels who get their news from the daily newspaper, this story will be a stunner. However, here is the part that caught my attention:

But Reid is determined to avoid being remembered as another Democrat who tried and failed to make health care access for the middle class a part of America's social safety net.


When did an attempt to extend health insurance to the deserving poor -- and force, under threat of prison time, everyone else to buy health insurance, even if they don't think they need it (perhaps they have a medical savings account and catastrophic care coverage) -- when did AP drop the pretense and admit that this boondoggle was really an entitlement program for the entire "middle class," whatever that is?

I know that's what it always secretly was; but I mean to ask, When did Democrats and their press accessories after the fact decide to openly acknowledge that the poor have nothing to do with it?

There are more buried nuggets in this story, starting with the casual truculence of this attack on Capitalism:

[ObamaCare] would ban onerous insurance industry practices such as denying coverage or charging higher premiums because of someone's poor health.

"Onerous" means burdensome, unfair, oppressive; since people already in "poor health" before signing up for insurance will cost Aetna or Blue Cross much more money, why shouldn't they have to pay somewhat higher premiums? Again, I thought the problem arose when folks with pre-existing conditions were flatly denied coverage... because that would force them into already overtaxed trauma centers for the most minor of medical treatments.

Of course we cognoscenti already knew the bill includes a sneaky provision to stop insurance companies from charging even slightly more for those with pre-existing conditions; but I hadn't seen before, in the health-insurance debate, such a buck-naked presentation of "from each according to his ability to each according to his needs!" I thank the Associated Press for finally fessing up and letting their cards fall on the table.

By the way, AP gives us some new statistics:

The public is ambivalent about the Democrats' legislation. While 58 percent want elected officials to tackle health care now, about half of those supporters say they don't like what they're hearing about the plans, according to a new Kaiser Family Foundation poll.

Half of 58% is 29%; so if we add together those supporters of health-insurance "reform" who reject the specifics of ObamaCare and the 42% who don't think we should even be monkeying with it right now -- instead of doing something about the wars or jobs or somesuch -- that appears to make around 71% not in favor of the bill, submitted to the Senate by Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 70%). A 70-30 split against ObamaCare among the electorate doesn't augur well for the bill's passage.

There is no new information about the content of Reid's radical revisionism; but the revelation that the major media are finally turning somewhat honest in the debate, letting people know a least a few of the "onerous" details (they still won't mention the staggering taxes), makes it distinctly less likely that "PinkyCare" will ultimately pass: Silence was always key to success.

Sorry, Harry; I'm afraid you're going to be remembered as the Democratic senator who screwed up ObamaCare. Or to be more precise, the former Democratic senator.

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

Hatched by Dafydd on this day, November 29, 2009, at the time of 1:55 PM | Comments (0) | TrackBack

November 25, 2009

Unplugging Grandma

Health Insurance Insurrections
Hatched by Sachi

When we accused Democrats of trying to unplug Grandma from life-support to save a few bucks, they called us fear-mongers. They called Sarah Palin "delusional" when she rightly pointed out that medical rationing would amount to a "death panel." But a recent airing of CBS's 60 Minutes offers a textbook example of what is going to happen all across the nation if we let ObamaCare pass.

Radio talk-show host Mike Gallagher alerted his listeners to this chilling segment that aired last week, titled The Cost of Dying. Correspondent Steve Kroft noted the enormous cost of end-of-life medical care -- then blamed that expense for bankrupting Medicare:

Every medical study ever conducted has concluded that 100 percent of all Americans will eventually die. This comes as no great surprise, but the amount of money being spent at the very end of people's lives probably will.

Last year, Medicare paid $50 billion just for doctor and hospital bills during the last two months of patients' lives -- that's more than the budget of the Department of Homeland Security or the Department of Education.

And it has been estimated that 20 to 30 percent of these medical expenditures may have had no meaningful impact. [Tell that to Grandma. -- SY] Most of the bills are paid for by the federal government with few or no questions asked.

You might think this would be an obvious thing for Congress and the president to address as they try to reform health care. But what used to be a bipartisan issue has become a politically explosive one -- a perfect example of the costs that threaten to bankrupt the country and how hard it's going to be to rein them in.

The message was crystal: Medicare is spending too much money keeping useless old people alive. Codgers are burning up precious money the government could use for something more important, like protecting endangered species or insuring street bums. The mantra is, "Grandma, shut up and die already."

All right; granted that end-of-life care costs a lot of money. But why? What would it take to "rein in" these costs?

First, it's easier for doctors to manage patient care if the patients are all together in a hospital. Second, Doctors are paid based on the number of patients they see or procedures they order, and hospitals get paid by the number of beds they fill and tests and procedures they perform... this creates financial incentives to hospitalize patients, as opposed to dealing with them as outpatients spread all over a city.

Then once hospitalized, the patient will probably be examined by numerous resident specialists, and each will put the patient through a great many tests, many of which are conducted purely defensively, to ward off malpractice lawsuits. One 85-year-old mother discussed in the 60 Minutes program was seen by twenty-five specialists in the last two months of her life:

"You think they were running up the bill to make money? Or running up the bill or giving her all these tests because they really thought it might help her? Or to cover their…rear?" [Steve] Kroft asked.

"Yeah, to cover their rear," [the patient's daughter] replied.

Finally, there are exhorbitant costs associated with the structure of Medicare itself. It covers the entire cost of medical care, and doctors and hospitals are obliged to accept what Medicare gives them. The patient often does not even know how much the taxpayers are paying. "No cost to the patient" equals no incentive to be frugal about unnecessary tests:

In almost every business, cost-conscious customers and consumers help keep prices down. But not with health care. That's because the customers and consumers who are receiving the care aren't the ones paying the bill.

These are obvious problems, but there are equally obvious solutions:

  • If doctors and hospitals were protected from frivolous lawsuits by strong tort reform, they would not be driven to order a ridiculous number of oddball tests just to guard against litigation that results in "jackpot justice."
  • If Medicare operated more like normal, private insurance -- scrutinizing specific costs, covering only a certain percent of the cost of medical procedures, and requiring patient co-pays -- beneficiaries would probably be more skeptical about authorizing multiple testing regimes. (This is the idea behind Medicare Advantage... which the Barack H. Obama administration is intent upon killing.)
  • And if more procedures could legally be performed by nurses, medical technicians, pharmacists, and other providers below the level of doctor, there would be less incentive for patients to enter the hospital or linger there, since they would have more alternatives.

But, that's too easy -- and it doesn't allow for a complete government takeover of health care, which is the hidden purpose of ObamaCare.

So what is the major goal of a national health service -- as Great Britain has? It certainly doesn't cost less than a private system, nor is the health care itself better, or even as good. None of the reasons given logically make the case for nationalized health care.

But there is another power that governments can only obtain by implementing government health care, national health service, single-payer health care, socialized medicine, or whatever else the government chooses to call it: It gives the national government life-and-death control over every citizen. Every resident is in the same boat as murderers; the government gets to decide, thumbs up or thumbs down.

Under a national health service, the taxpayers foot the bill; which gives the government its hook to demand "regulation and oversight" of how much they spend. This, in practice, means complete control over who gets medical treatment.

The government can set up a "death panel" -- in Medicare, it's called MedPAC, the Medicare Payment Advisory Commission -- that tells us when we're allowed to receive treatment and survive, and when we've outlived our usefulness to the State and must be denied care, so we can hurry up and "decrease the surplus population."

MedPAC doesn't decide on the basis of individual worth or the patient's politics (at least not directly); but by declaring what procedures can be performed on which groups of patients, and having no effective competition, the feds find themselves with the power to decide who gets treated and who gets thrown under the bus, all in the name of cost cutting and protecting the taxpayers (the same ones they plan to soak with huge tax-rate increases):

Charlie Haggart is 68 years old and suffering from liver and kidney failure. He wants a double transplant, which would cost about $450,000. But doctors have told him he's currently too weak to be a candidate for the procedure.

At a meeting with Haggart's family and his doctors, Dr. Byock raised the awkward question of what should be done if he got worse and his heart or lungs were to give out.

He said that all of the available data showed that CPR very rarely works on someone in Haggart's condition, and that it could lead to a drawn out death in the ICU.

"Either way you decide, we will honor your choice, and that's the truth," Byock reassured Haggart. "Should we do CPR if your heart were to suddenly stop?"

Sounds reasonable enough; Dr. Byock is just engaging in end-of-life counseling. But is he really the neutral arbiter, trying to explain all of Charlie Haggart's options? Read on:

"Either way you decide, we will honor your choice, and that's the truth," Byock reassured Haggart. "Should we do CPR if your heart were to suddenly stop?"

"Yes," he replied.

"You'd be okay with being in the ICU again?" Byock asked.

"Yes," Haggart said.

"I know it's an awkward conversation," Byock said.

"It beats second place," Haggart joked, laughing.

"You don't think it makes any sense?" [Steve] Kroft asked the doctor.

"It wouldn't be my choice. It's not what I advise people. At the present time, it's their right to request it. And Medicare pays for it," Byock said....

"I think you cannot make these decisions on a case-by-case basis," Byock said. "It would be much easier for us to say 'We simply do not put defibrillators into people in this condition.' Meaning your age, your functional status, the ability to make full benefit of the defibrillator. Now that's going to outrage a lot of people."

"But you think that should happen?" Kroft asked.

"I think at some point it has to happen," Byock said.

Easier for whom, the patient or the doctor? And how long does Dr. Byock expect each patient still to have the right to be resuscitated if his heart stops? Byock sounds as though he expects "hope and change" to come very soon now for the aged and their cockamamie idea that they might be worth saving.

Dr. Byock's answer seems to have distrubed Steve Kroft, the 60 Minutes correspondent:

"Well, this is a version then of pulling Grandma off the machine?" Kroft asked.

That is exactly what conservatives have been saying; evidently, Sarah Palin isn't the only person who is "delusional."

But here is where it truly strikes home to every American, not just senior citizens on Medicare:

"Every other major industrialized nation but the United States has a budget for how much taxpayer funds are allocated to health care, because they've all recognized that you could bankrupt your country without it," David Walker told Kroft.

Asked if he is talking about rationing, Walker said, "Listen, we ration now. We just don't ration rationally. There's no question that there's gonna have to be some form of rationing. Let me be clear: Individuals and employers ought to be able to spend as much money as they want to have things done. But when you're talking about taxpayer resources, there's a limit as to how much resources we have."

Yes, that's true. But when you're talking about ObamaCare, there is no limit on the number of Americans who will be pushed into a taxpayer-funded system.

Once we all receive our health care at public expense, then we can all be subject to the same rationing that Dr. Byock proposes. "Equality" will reign: Everybody will be equally bankrupt, equally unemployed, and equally short-lived.

Again, the answer is clear; but it's the exact opposite of the direction the Obama administration is taking us: The solution to this dilemma is to reduce the number of people receiving government-run health care, not multiply it by a hundred! That's like trying to cure a flood by sending a tidal wave.

[A]nd the life of man, solitary, poor, nasty, brutish, and short.

Did Thomas Hobbes (1588-1679) have something like ObamaCare in mind?

Hatched by Sachi on this day, November 25, 2009, at the time of 4:36 AM | Comments (1) | TrackBack

November 24, 2009

Yes On Dr. No!

Health Insurance Insurrections
Hatched by Dafydd

Sen. Joseph "Smilin' Joe" Lieberman (I-CT, 85% Democratic) has drawn his foot in the sand:

Sen. Joseph Lieberman, speaking in that trademark sonorous baritone, utters a simple statement that translates into real trouble for Democratic leaders: "I'm going to be stubborn on this."

Stubborn, he means, in opposing any health-care overhaul that includes a "public option," or government-run health-insurance plan, as the current bill does. His opposition is strong enough that Mr. Lieberman says he won't vote to let a bill come to a final vote if a public option is included.

I don't believe he can ever back away from that absolutely flat statement, and he is not the kind of politician who blithely flips and flops: He will vote against cloture at the end of debate unless the government "option" is stripped from the bill; he insists he'll do so even if the government option comes with "opt out" or a trigger:

So any version of a public option will compel Mr. Lieberman to vote against bringing a bill to a final vote? "Correct," he says.

And when Lieberman makes it plain he's doing so, he will be joined by more or less moderate Sens. Blanche Lincoln (D-AK, 80%), Mary Landrieu (D-LA, 65%), and Ben Nelson (D-NE, 75%). They've already expressed very public reservations against the bill; why should they piss off their constituents and damage their reelection chances if ObamaCare is going to be blocked anyway? It's all pain and no gain.

And if those four go, I suspect others might follow: Sens. Evan Bayh (D-IN, 70%), Max Baucus (D-MT, 80%), and Tim Johnson (D-SD, 80%) are all possible defectors -- if others have previously defected, making their own defections irrelevant to the bill's survival.

To put it bluntly, Lieberman's adamant refusal to vote for cloture is the first hole in the Democratic dike; it will very likely lead to more.

Unsurprisingly, Sen. Lieberman focuses on a very different worry than do Republican conseratives:

[Lieberman] insists his objection isn't based on the oft-expressed conservative fear that a public option would lead to a government takeover of health care. He says he doubts this or any subsequent Congress would allow that.

Rather, his objection is based on fiscal risk: "Once the government creates an insurance company or plan, the government or the taxpayers are liable for any deficit that government plan runs, really without limit," he says. "With our debt heading over $21 trillion within the next 10 years...we've got to start saying no to some things like this."

Fine with me; it's a perfectly valid argument. I really don't care why he opposes the government option so strongly, so long as he does!

Mind, Lieberman does want health-insurance reform; he just rejects ObamaCare as currently constituted. He still supports increasing insurance coverage (I don't know if he supports a mandate) and doing something about people being denied insurance because of pre-existing conditions.

But this leads right back to where I began: I believe the Democrats will manage to pass something which they will label health-insurance reform; it just won't be the massive government takeover that liberal fascists long to impose.

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

Hatched by Dafydd on this day, November 24, 2009, at the time of 2:05 PM | Comments (0) | TrackBack

November 21, 2009

Don't Have a Seizure Over the ObamaCare Cloture Vote...

Congressional Calamities , Health Insurance Insurrections
Hatched by Dafydd

...You'd only have to rely upon ObamaCare to cure you!

This post by John Hinderaker at Power Line is fairly typical of what I've been reading:

Mary Landrieu announced today that she will vote for cloture on the Democrats' government medicine bill tonight. The Democrats now have 60 votes and will be able to pass their version of government medicine.

By great good forture, this is a cross between a crocodile and an abalone *: All that this means is that the Democrats have sufficient votes to invoke cloture on beginning the debate on ObamaCare; it does not imply they will have the votes to end debate and actually vote:

Senate Democrats said they had clinched the votes needed on Saturday to propel major health care legislation to the floor for weeks of full debate, as the majority party’s two last holdouts said that they would not block consideration of President Obama’s top domestic initiative.

Some Democrats and one of the two Independents (Sen. Joe Lieberman, I-CT, 85% Democrat) have committed only to the former and not the latter; Lieberman has emphatically stated that unless there are very significant changes, he will not vote for cloture to end debate and vote.

UPDATE from Politico:

“I believe it is going to be very clear at some point very soon that there are not 60 votes for the current provision in the bill and that the leader and the leadership will have to make a decision, and I trust they will figure out how to do that,” Landrieu said....

Two of those planning to vote yes today – Sen. Ben Nelson (D-Neb.) and Sen. Joseph Lieberman (I-Conn.) have already said they’d join a filibuster of the bill, Nelson to strengthen its abortion restrictions and Lieberman to stop the public option. Lieberman has said he believes other Democrats would do the same, though none warned of that in remarks Saturday.

Landrieu announced her vote earlier in the day. "My vote today to move forward on this important debate should in no way to be construed as . . .an indication of how I might vote as this debate comes to an end," she warned. "It is a vote to move forward. … But much more work needs to be done.”

That should make it quite clear what today's vote means -- and what it does not mean.

It was practically a foregone conclusion that the Democrats would get enough votes to start the debate; even if a Democrat or Indie planned all along to vote against cloture at the end, thus not allowing it to come to an up-or-down final vote (that the Democrats would be guaranteed to win), he would almost certainly vote to begin the debate: Not to do so would make him look utterly intransigent. A Republican can get away with that because the bill is so lopsidedly partisan, but a Democrat has to seem more open to its consideration.

Everything now depends upon the debate itself -- in particular, which amendments are passed and which voted down. I'm still confident that if the liberals manage to retain any of the following in the final bill:

  • Abortion funding
  • The new marriage penalty, encouraging Americans to shack up instead
  • The massive, unprecedented tax increases during a recession and with double-digit unemployment
  • The half-trillion dollar raid on Medicare
  • The obvious rationing of medical care (already starting with the heavy hand of the government stopping doctors from advising mammograms for women aged 40-50)
  • The legal mandate to buy expensive health insurance (with those who refuse facing prison time yet!)
  • Or of course the public option that will simply detonate all private health insurance

...Then several so-called "Blue Dog" Democrats (plus Joe Lieberman) will revisit the question of cloture at the end.

Be of good cheer; this isn't the end of the fight but only the beginning. If the Republicans can stay unified, then we will only need one, single senator who supports cloture today to oppose it at the end, and we will have stopped this dreadful monstrosity.

And even if they all hold firm, and PinkyCare passes the Senate -- it still must be reconciled with the House version, and that too will be subject to cloture requiring 60 votes.

Finally, I am nowhere near as pessimistic as others on the inevitability of some version of ObamaCare being implemented, even if it passes both chambers and is signed by the president. If the Republicans can take over even a single chamber -- a possibility made much more likely by the passage of a staggering tax, the looting of Medicare, and looming medical-care rationing -- then the GOP can stop the actual implementation of ObamaCare simply by refusing to fund it... and that cannot even be vetoed by Barack H. Obama, because it would be a negative act: They can fail to vote for funding, and that effectively kills it. (In fact, Republicans can even run on a "reverse the vote!' platform.)

So put on your manly gown, gird your loins, and pull up your socks; we still have many bites left at the apple, quite a few more chances to strangle this serpent in the grass. Stopping debate from beginning was always the least likely of all possible ways to kill ObamaCare.

Man up -- we've still got a fight on our hands!


* A "crockabalone," of course!

Hatched by Dafydd on this day, November 21, 2009, at the time of 3:03 PM | Comments (10) | TrackBack

November 20, 2009

Maritalphobic Democrats Strike Again!

Congressional Calamities , Health Insurance Insurrections , Matrimonial Madness
Hatched by Dafydd

Generally we use the "Matrimonial Madness" category for discussions of same-sex marriage; but not this time. Today, in a bolt from the blue (staters), the Senate Democrats have snuck a ringer into Majority Leader Harry "Pinky" Reid's (D-NV, 70%) version of ObamaCare... they created a new tax with a nasty "marriage penalty" to punish dopes who actually tie the knot, instead of simply living together (evidently the Democrat preferred option):

Senate Democrats' health care bill would create a new marriage penalty by imposing a tax on individuals who make $200,000 annually but hitting married couples making just $50,000 more....

"Yes, this structure can create a 'marriage penalty' for some couples. It also creates a 'marriage bonus' for others," [Jim Manley, a Reid spokesman] said. "A married couple with one wage earner can earn up to $250,000 without facing this higher tax, whereas a single person in the same job with the same pay would be hit by it."

But a married couple in which each earner makes $150,000 would be hit with the tax, whereas an unmarried couple living together with the same incomes would not.

Ryan Ellis, tax policy director at Americans for Tax Reform, said the new marriage penalty comes on top of an existing one that's always been part of the payroll tax, which funds Social Security and Medicare.

Say what they will, it appears that Democrats simply cannot abide the institution of marriage. They seek to destroy it any way they can:

  • "No-fault" divorce;
  • Enacting adoption laws that don't "discriminate" against unmarried adoptive parents;
  • Altering the very definition of marriage willy-nilly;
  • And now by heavily taxing marriage -- but not shacking up.

Senate Minority Leader Mitch McConnell (R-KY, 80%) is beside himself:

"If you have insurance, you get taxed. If you don't have insurance, you get taxed. If you need a life-saving medical device, you get taxed. If you need prescription medicines, you get taxed," said Senate Minority Leader Mitch McConnell, Kentucky Republican, who is leading the fight against the bill.

And now, if you get married, you get taxed.

But it's not just marriage that Democrats hate and fear; they also despise patients who want to control their own medical care:

Several relatively small tax increases will be aimed at health savings accounts and medical savings accounts. One will change the definitions for medical expenses that qualify as itemized deductions. Another will raise the penalties for withdrawing funds from these vehicles. A third would limit health-related flexible spending arrangements.

"All of these changes are designed to make health savings accounts less attractive and cripple consumer-directed health care plans," said Michael Cannon, director of Health Policy Studies at the Cato Institute. Altogether, they would raise about $20 billion through 2019.

Take that, you villains trying to decrease your own health-insurance premiums via MSAs and catastrophic care! We can add a couple more to McConnell's collection: If you have an expensive health-insurance plan, you get taxed. If you have a cheap health-insurance plan... you get taxed.

Liberals and Democrats: They're nothing if not consistent in their hatred of every traditional American virtue, from self-reliance to traditional marriage to fiscal sobriety to self-defense to American exceptionalism.

Say... let's put them in charge of all energy production, all financial transactions, defending the nation against the Iran/al-Qaeda axis, and the medical care of every individual American. What could possibly go wrong?

Hatched by Dafydd on this day, November 20, 2009, at the time of 4:52 AM | Comments (2) | TrackBack

November 7, 2009

Only One GOPsmacked Fool!

Congressional Calamities , Health Insurance Insurrections
Hatched by Dafydd

Today, the House of Representatives passed the aptly named SqueakerCare bill... "aptly named" for two reasons:

  • It was introduced, and the favorable vote extorted, by Squeaker of the House Nancy Pelosi (D-Haight-Ashbury, 100%);
  • It squeaked by with 220 Ayes to 215 Nays... 218 being the bare minimum needed for passage.

The bill stalled out until Pelosi was forced to allow a vote on the Stupak Amendment, which stripped funding for abortions from the bill (possibly); that amendment prevailed by 240-194 -- much stronger support than for SqueakerCare itself. This may not be the last word on the abortion issue, however:

Democrats were forced to make major concessions on insurance coverage for abortions to attract the final votes to secure passage, a wrenching compromise for the numerous abortion-rights advocates in their ranks.

Many of them hope to make changes to the amendment during negotiations with the Senate, which will now become the main battleground in the health care fight as Democrats there ready their own bill for what is likely to be extensive floor debate.

No word in either the New York Times article or the AP article on whether there was any resolution of the controversy over covering illegal aliens.

(The Republican plan was dismissed by Democrats -- even the Blue Dogs -- in a near party-line vote; only Rep. Tim Johnson, RINO-IL, 68% crossed party lines to vote against the GOP substitute health-care reform plan.)

Every dog has his silver lining, and the bright spot of this bill was that out of 177 Republicans voting (I think that's all of them), the total number who voted for SqueakerCare was... one: Rep. Joseph Cao (R-LA, not yet rated). By contrast, 39 Democrats voted against the bill, with 219 in favor, of course.

That means Republican defectors did not hand the Democrats the victory, as I had feared they might; it would still have passed without the vote of the sacred Cao. Thank goodness for pitifully small favors!

Amusingly, one Democrat who voted for the bill was newly minted Rep. Bill Owens (D-NY, not yet rated)... despite the fact that the bill contains numerous provisions that Owens swore during his election campaign he would never support. It took Owens all of eleven hours and sixteen minutes to toss those promises into the dustbin of liberalism.

I'm certain that Conservative (and soon to be Republican) candidate Doug Hoffman is cataloging all such InstaLies for his rematch next year.

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

Hatched by Dafydd on this day, November 7, 2009, at the time of 11:37 PM | Comments (1) | TrackBack

November 6, 2009

Squirmer of the House Nancy Pelosi Doesn't Have the Votes... Yet

Congressional Calamities , Democratic Culture of Corruption , Health Insurance Insurrections
Hatched by Dafydd

I picture Speaker of the House Nancy Pelosi (D-Haight-Ashbury, 100%) writhing and twisting in frustration; with all those Democrats, surely she can scrape together 218 to vote for SqueakerCare!

Surely not, at least not yet:

House Democrats acknowledged they don't yet have the votes to pass a sweeping overhaul of the nation's health care system, and signaled they may push back the vote until Sunday or early next week.

Majority Leader Steny Hoyer, D-Md., told reporters in a conference call Friday that the make-or-break vote on President Barack Obama's push to make health coverage part of the social safety net could face delay. Democrats were originally hoping to pass the bill on Saturday_and officially, that's still the plan....

Hoyer acknowledged that Democrats are still short of the 218 votes they need to pass the bill. "There are many people who are still trying to get a comfort level that this is the right thing to do," he said. "We're very close."

So what's the hold up? Yep, the same old overreaching -- our secret weapon against the Left! Evidently, Democrats still can't agree on coverage for abortions and of illegal immigrants:

But Democrats have yet to resolve a intraparty disputes over abortion funding and illegal immigrants' access to medical coverage. They cleared one hurdle Friday when liberals supporting a government-run Medicare-for-all system withdrew their demand for a floor vote.

Translation: some Democrats demand SqueakerCare pay for abortions -- and demand it cover illegal aliens. If there was no power faction insisting on such coverage, it would be easy to insert language banning it.

Here's a point that hasn't gotten enough coverage, I think: La Casa Blanca has endorsed the House version of the bill; which means that President Barack H. Obama has formally renounced his earlier pledge to keep the cost below $900 billion over ten years. Even by the Congressional Budget Office's reckoning, SqueakerCare would cost $1.2 trillion; and the CBO is obliged to accept all the economic premises of Congress, however ludicrous they may be... for example, that Congress will be able to loot half a trillion dollars from Medicare, that they'll be able to raise vast taxes in an election year, that those taxes won't cause a recession, and so forth.

Evidently, each and every solemn oath that eructates from the Obamacle's mouth is what Mary Poppins would call a "pie-crust promise: easily made and easily broken."

Anent the abortion and illegal immigrant controversies, Democrats have run straight into the fundamental buzzsaw of nationalizing health care: There are many things that a private company can do but the government cannot. So what happens under liberal fascism, where the federal government takes control of the private sector? Here is the dilemma in a nuthouse:

  1. A private insurance company in a Capitalist system can offer coverage for abortions if it chooses; a great many do so.
  2. A private company can choose not to demand proof of legal residency before insuring a subscriber; many insurance companies follow this route.
  3. But when the federal government operates its own insurance plan -- and especially when it rigs the game to force more and more people into that government plan -- then there are only two options for those particularly controversial issues:

    1. The government plan can cover them; in which case you have the federal government funding abortion and paying for coverage of illegal aliens;
    2. Or the government plan can refuse to cover them; in which case, hundreds of thousands of women forced into the government plan can no longer get their insurance to pay for their abortions; and millions of illegal aliens will lose the insurance they currently pay for and rely upon.

Thus in the House and Senate, either you have moderate Democrats up in arms about federally funded abortions and a free health-care ride for illegals -- in which case the bill goes up in smoke, because there are too many Blue Dogs to ignore; or else fewer women get abortions and fewer illegals get medical insurance -- and the ultra-liberal mainstream of the Democratic Party jumps ship, leaving the bill in even worse trouble.

The only solution would be to bribe three or four Blue Dogs to go ahead and vote for the bill, knowing they will likely lose their seats in 2010. For example, the One can offer lucrative positions in the administration to any Democrat who loses reelection next year; or the Democratic leadership can offer specific Blue Dogs powerful committee chairmanships if they betray their constituents -- plus a ton of campaign cash in 2010, in both the primary and the general elections.

I assume that's what is going on; and Squeaker Pelosi's insistance that she will have the votes represents her certainty that at least that many moderate Democrats are eager to be bribed.

But the fact that she does not yet have the votes indicates either that they're holding out for a super-duper bribe... or else that Pelosi's fundamental axiom -- that all Democrats are enthusiastic participants in the Democratic culture of corruption -- is a misapprehension based upon projecting her own ethos onto other people.

The next few days will tell us which. Since we're talking about Democrats, I suspect the Squeaker's scheme will ultimately bear fruit; she'll find three or four Blue Dogs corrupt enough to accept money and power in exchange for selling their constituents down the river. But I'm always open to persuasion by hard data.

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

Hatched by Dafydd on this day, November 6, 2009, at the time of 3:42 PM | Comments (0) | TrackBack

November 5, 2009

House to Vote on SqueakerCare Saturday

Health Insurance Insurrections , Predictions
Hatched by Dafydd

I have an annoying feeling about this. It's almost a cead cert that the Democrats will find enough votes this Saturday, November 7th, to pass Squeaker of the House Nancy Pelosi's (D-Haight-Ashbury, 100%) version of ObamaCare.

I hereby dub thee SqueakerCare, to distinguish thee from Senate Majority Leader Harry Reid's (D-NV, 70%) version, PinkyCare.

But it's the way I suspect it will happen that irks me. Darn this precognition!

Here is my Nostradamus-like prophecy:

  1. San Fran Nan needs 218 votes (50.1% of 435 representatives) to pass SqueakerCare out of the House.
  2. There will probably be 256 Democrats in the House on Saturday.
  3. So when the roll is called, and if no Republican votes for SqueakerCare, the Democrats can lose no more than 38 of their members and still pass the bill with 218 Dems.
  4. Therefore, I predict that at least forty of the Democrats will defect...

Good news? No -- lousy news!

  1. Yet the bill will pass anyway -- because two or three Republicans are sure to vote for it, thus saving the day for the Democrats -- and even allowing Pelosi to claim it's a "bipartisan" victory.

Why? Because they're Republicans, and there are always a handful who just can't contain themselves when they see a chance to betray their party, betray their principles, and betray their constituents.

See, they prove their "independence" by slavishly voting the Democratic line, just to demonstrate that they're not bound by party loyalty. (This of course makes them just as robotic as if they were; only they robotically gainsay anything the conservatives say.)

Net effect: The bill passes, but more Democrats are able to distance themselves from it and therefore maintain a veneer of respectable independence, so they might get reelected in 2010.

Bloody contrarian boneheads.

Hatched by Dafydd on this day, November 5, 2009, at the time of 1:40 AM | Comments (0) | TrackBack

November 4, 2009

A Tale of Two Birds - the Vulture and the Eagle

Health Insurance Insurrections
Hatched by Dafydd

Let's sing a tale of two pieces of legislation. First, Squeaker of the House Nancy Pelosi (D-Haight-Ashbury, 100%) offered up her take on ObamaCare. SqueakerCare on a nutshell:

  • Puts virtually all decisions about medical care in the hands, not of the patient, the doctor, or even the insurer, but in the iron fist of the federal government.
  • Outlaws competition between insurance carriers:

    • Must accept all applicants;
    • Cannot charge more for subscribers with pre-existing medical conditions;
    • All carriers must offer the same gold-plated plans;
    • Carriers cannot sell outside their own states -- yet they will also be subject to antitrust regulation; thus they must be completely governed by the federal government to avoid being sued (or indicted).
  • Forces medical-care rationing:

    • Rationing by waiting list (the "death queue"), where the feds hope that if they delay your treatment long enough, you will either go to some other country and pay for it -- or better yet, just die;
    • And rationing by the ObamaCare Payment Advisory Commission, or whatever they'll cal it -- that is, a "death panel" -- just as the Medicare Payment Advisory Commission decides how much the feds will pay for any Medicare procedure, or whether to cover it at all. No coverage, no care... unless you had the good sense to become a multi-millionaire.
  • Mandates that all Americans buy a very expensive policy, like it or not.
  • Includes a strong government-run health-care component.
  • Rigs the game so that employers are virtually forced by economic necessity to dump their health-insurance programs and force employees into the mandatory government option. Most Americans will lose their current health insurance in favor of the government plan, whether they want to switch or not.
  • Raises taxes by many hundreds of billions of dollars, not just on medical care but on pharmaceuticals and even medical devices.
  • Dramatically raises the cost of medical care and prescription drugs for everyone. Except for members of Congress and senior White House staff, including the president; top government officials are all exempted from the restrictions and rationing of SqueakerCare.
  • Speaking of that program, the Pelosi bill loots Medicare to the tune of half a trillion dollars -- or more.
  • Costs in excess of $1.2 trillion... and that's just the amount Democrats are willing to admit!

That's the obverse of the coin; a vulture is stamped on that face, for the Democratic bill of Nancy Pelosi is a carrion creature, feeding off the death of American medical care -- and off the dead bodies of those who don't survive the waiting lists, the payment advisory commissions, and the collapse of the prescription drug market.

But every coin has a reverse side as well. An eagle adorns the Republican face of the health-insurance reform coin. Here are the highlights of the bill just introduced by House Minority Leader John Boehner (R-OH, 92%):

  • Incentives for more subscribers to shift to a health savings account (HSA) and catastrophic-care insurance alternative; this puts health-care decisions back into the hands of patients and doctors, since all routine procedures and tests would be paid directly by the patient using his HSA, not by the insurance company. Every financial expert who has studied the issue agrees that the biggest cause of the rise in the cost of medical care is that "somebody else" pays for your treatment. When patients pay for themselves, they exercise more financial responsibility.
  • GOPCare includes tort reform; it "caps non-economic jury awards in medical malpractice cases at $250,000," thus reducing the hundreds of billions of dollars spent in "defensive medicine" -- tests and procedures that are not medically warranted, whose only purpose is to stave off John Edwards, lawyers who turn the legal system into "jackpot justice."
  • The Boener plan "allows health insurance to be sold across state lines," yet another cost-saving measure.
  • It includes a permanent ban on federally funded abortions, except for cases of rape, incest, and to save the life of the mother.
  • No mandates on employer, employee, or other American to offer or buy health insurance; no restriction on policies that companies can write (thus encouraging competition); and no regulation of what companies can charge for applicants with pre-existing conditions or whether they cover them at all.

Simple. Clean. Inexpensive. And above all, a plan that relies upon liberty, choice, Capitalism, and the American way of life... rather than the centrally controlled, authoritarian, liberal fascist approach written by congressional Democrats and egged on by the president.

The fundamental GOP philosophy is that if you make health care cheaper, then insurance will likewise become cheaper (Capitalism); and if insurance is cheaper, more people will buy it (Econ. 101). Everything in this bill is designed with that end in mind: Make health care cheaper by removing the perverse incentives of the "invisible foot" of government, driving costs up:

"As Leader Boehner has made clear, our proposal will focus on the No. 1 concern of the American people - reducing health care costs, and we do it at a price tag our nation can afford," said spokeswoman Antonia Ferrier, though Republicans have not said how much their bill would cost.

"Our proposal will help struggling middle-class families and small businesses by increasing access to affordable, high-quality health care," Ferrier said.

Everyone says a picture is worth a thousand words. Personally, I think a thousand words is a couple of good-sized paragraphs, but let's not discuss my fiction here. Just for eye-candy, take a look at this, which I, er, borrowed from Jason Simon's Farcebook page:

PelosiCare And GOPCare Side By Side

GOP bill (230 pages) vs. PelosiCare (1990 pages)

Pretty much says it all. (Reckon that means I can delete one my thousand-word paragraphs...)

Hip hip, chin chin.

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

Hatched by Dafydd on this day, November 4, 2009, at the time of 6:34 PM | Comments (3) | TrackBack

October 30, 2009

Health Insurance Question...

Health Insurance Insurrections
Hatched by Dafydd

I was reading a blogpost by my favorite blogger on my favorite blog, and what appears to be a revelation just bit me right in my damascus.

The most significant objection that the vast majority of Americans have anent health insurance involves how it treats people with pre-existing conditions, particularly those that are completely outside individual control. For example, people with genetic conditions, or who have had heart attacks, or who have severe allergies and asthma, and so forth. We rightly say there is something unAmerican about telling a child born with juvenile diabetes that he's just going to have to go without insurance -- and when he gets sick, he just has to die and decrease the surplus population. It sounds so... mediaeval.

But I just thought of what appears to be a much cheaper solution to that problem, one that does very little damage to the American capitalist system, comparatively speaking. I'd like to see what you all think.

The Pre-Existing Lizard Plan

The plan is of course a compromise between a completely free-market system -- in which we don't concern ourselves with what happens to those who, through no fault of their own, have prohibitively high medical-insurance premiums -- and a completely regulated system, à la mode d'ObamaCare.

Note, this plan does not apply to Medicare, Medicaid, SCHIP, or military health care or insurance, nor does it require any of these programs be looted for cash, as all versions of ObamaCare do:

  1. Require insurance companies to accept all applicants, regardless of pre-existing conditions.
  2. Allow insurance plans to charge any premium they want for such applicants. Bear in mind, they will be competing with other plans; so if they charge absurd premiums, they'll lose business to their competitors.
  3. Allow insurance companies to deny coverage for treatment of such pre-existing conditions for up to six months after the policy begins (such "exclusion periods" are fairly common in group plans). Insurers can, of course, start coverage earlier, if they think that will give them a competitive edge.
  4. Because it's good public policy for people to be insured, even if they already have medical problems, the federal government offers a defined-contribution subsidy for patients with pre-existing medical problems. The subsidy consists of a refundable tax credit in a specified amount, the same for everyone who has that particular pre-existing condition.
  5. Because it's bad public policy to encourage bad health habits, there is no subsidy for increased rates due to risky or damaging behavior -- such as smoking, drinking to excess, using drugs illegally, becoming a skyboarder or NASCAR driver -- or for patients who are not following their doctor's advice.
  6. The tax credit is entirely voluntary; nobody is obliged to file for it. If a person chooses to file for it, he must sign a waiver saying that he understands that his private medical information will be sent to the federal government for consideration in deciding to grant or withhold the tax credit.

Note several points:

  • The plan is completely separate from any other reform; we can do this in addition to allowing cross-state competition, tort reform, tax incentives for switching to a combination medical-savings account (MSA) and catastrophic care, prohibiting insurance companies from using DNA testing to set rates, or any other reform we ultimately decide to enact.
  • The plan adds no government mandate that anybody buy insurance. Any reforms to close the "free rider" loophole are separate from this plan.
  • The insurance companies are forced to accept bad-risk customers, but they can charge them extra to make up for it.
  • They can set their own rates, compete with each other, and administer their plans as they choose. They can offer discounts for healthy lifestyles, offer any kind of policy they want, and so forth. This is not creeping socialism.
  • Most employer health-care plans would be unaffected, since most are group plans... and most group plans don't charge individual members of the group extra money for pre-existing conditions anyway; that's one of the selling points for group plans.
  • Because the tax credit is calculated on the basis of the average premium increase for that particular pre-existing condition, everybody with that condition gets the same credit, regardless of how expensive his particular insurance is. Thus there is very little market distortion: Expensive insurance will still be more expensive and cheap insurance will still be cheaper, even with the subsidy.
  • The plan would be much cheaper and vastly less tyrannical than ObamaCare.

On that last, according to the census, as of 2005, the percent of Americans who had employer-sponsored health insurance was 59.5%, and the number with individually purchased health insurance was 9.1%. That adds to 68.6%.

Assuming we have about 300 million people, that would mean 205.8 million people are covered by private-company insurance. Let's get wild and suppose that 15% of those people have pre-existing conditions for which they sought treatment in the six months prior to enrollment, the usual standard; this is probably a gross overestimate. That would mean 30.9 million of the insured might have pre-existing conditions.

Assume every last one of these people is eligible for, and applies for the subsidy -- again an overestimate; many would not qualify for various reasons, and many would not apply. Assume the average premium increase is $100 per month per insured. That works out to a total premium increase for the whole kit and kaboodle of $37 billion per year. If the subsidy is calculated to cover 75% of that amount, the feds would be on the hook for considerably less than $28 billion per year.

And that would actually be the ceiling: There is no incentive for people trying to fake pre-existing conditions to get the subsidy, since it's less than 100% of the increased premium cost; and the market will prevent companies from declaring everything from slight overweight to breathing to be a "pre-existing condition."

Administrative costs would be very low, since it's just a tax credit you can apply for when you file your 1040, and decisions are fairly automatic based on data supplied by the insurers. Enforcement of the regulations is by the IRS. And some of that money would be recaptured by taxes paid by the insurance companies on the profits from the increased premiums.

Is this a workable substitute for the monstrosity of ObamaCare? Or is there some hidden trap that I have missed?

Hatched by Dafydd on this day, October 30, 2009, at the time of 4:26 PM | Comments (6) | TrackBack

October 14, 2009

ObamaCare in a Nuthouse

Health Insurance Insurrections , Ubertweets
Hatched by Dafydd

Since I hope that a few more people think about this point than read my Twitter feed (I have seventeen follows*, ooh-rah!), here's my latest tweet:

ObamaCare: Mandates every health plan cover everything -- then taxes the hell out of all those "gold-plated" policies. Kill it at cloture.

I live in California, so this will be an intensely personal issue with me: The state and federal governments between them mandate that our health-care plans cover everything you can imagine; and there are other states even more demanding. I reckon that means that all of us "wealthy" people will be paying a hefty tax for the privilege of obeying the stupid legal mandates.

Thank you, mask man.



* My previous tweet was two months ago. Perhaps I would have more followers if I tweetied -- twitted -- tooted? -- a bit more frequently. Of course, if I actually tooted more often, it might not affect my readers, but I bet I'd have fewer face-to-face conversations!

Hatched by Dafydd on this day, October 14, 2009, at the time of 6:37 PM | Comments (2) | TrackBack

October 12, 2009

Extree, Extree, Getcher Your DMV Health Care!

Health Insurance Insurrections
Hatched by Dafydd

This is an utterly brilliant parody advert, lampooning the asinine Will Ferrell ad. (Which itself was meant to be a parody; so this ad is a parody of a parody -- of the original parody, ObamaCare itself!)

The difference between these two offerings is manifest:

  • The advert below attacks government-run health care, while the Will Ferrell ad applauds it;
  • The Will Ferrell ad was supposed to be funny; this one actually is...



For reference (and exercise in eye-rolling), here's the original propaganda piece for your perusal...




Just another clear indication that the primary ingredient for a joke to be funny -- is that it actually have a grain or more of truth at its core. Hence, Hollywood lefty "parody" adverts, Michael Moore movies, and anything done or said by Al Franken in the last few decades is un-funny, because it's about as truthful as any statement from Barack H. Obama that begins with the words "In all sincerity..."

Hatched by Dafydd on this day, October 12, 2009, at the time of 2:35 AM | Comments (0) | TrackBack

September 29, 2009

Life Without Defensive Medicine

Books2Read , Health Insurance Insurrections
Hatched by Dafydd

Back in 1996, Philip K. Howard wrote one of the most extraordinary books I've ever read: the Death of Common Sense: How Law is Suffocating America. This year, he published Life Without Lawyers: Liberating Americans from Too Much Law (he has written books in between those, too).

Howard has an opinion piece in today's Wall Street Journal (I don't believe a subscription is required) revealing the dark secret behind the adamant refusal of Democrats even to consider any significant curtailing of medical-malpractice lawsuits. Of course, it's not really a secret; it's just "common sense": The Democrats' most reliable fundraising allies in the nation are the trial lawyers; and to a man (or woman), it seems, trial lawyers like the current system of vaguely written "jackpot justice" just fine:

Eliminating defensive medicine could save upwards of $200 billion in health-care costs annually, according to estimates by the American Medical Association and others. The cure is a reliable medical malpractice system that patients, doctors and the general public can trust.

But this is the one reform Washington will not seriously consider. That's because the trial lawyers, among the largest contributors to the Democratic Party, thrive on the unreliable justice system we have now.

It's a spectacular column, just as the Death of Common Sense is spectacular (I haven't read Life Without Lawyers yet). I urge you all to click through immediately and read the whole thing... gosh, I've always wanted to say that! Since I began by quoting the lede, I'll conclude by quoting the final paragraph, which sums up the in-depth article quite succinctly:

Trial lawyers often claim that any alternative to the current medical malpractice justice system, such as specialized health courts, will only make it more difficult for injured patients to seek justice. But that's why you start with a pilot project. If these courts are unfair they will be rejected. But if they succeed -- that is, are fairer to patients and doctors -- they could provide a solid foundation for rebuilding an effective, less costly health-care system than we have today.

Now if only we had a president and majority party honestly interested in lowering the staggering cost of health care, rather than using the high price (and some number of people unable to get insurance) as the "crisis" that Rahm Emanuel urges them not to let go to waste.

Hatched by Dafydd on this day, September 29, 2009, at the time of 7:55 PM | Comments (0) | TrackBack

September 25, 2009

Yes, Virginia, It Really Is a Tax

Health Insurance Insurrections , Tax Attax , Ubertweets
Hatched by Dafydd

Yesterday, Sen. John Ensign (R-NV, 92%) interrogated one Thomas Barthold, chief of staff for the Joint Committee on Taxation; Ensign wanted to know whether the Internal Revenue Service was responsible for enforcing the ObamaCare provision requiring individuals to pay a "penalty" of $1,900 if they fail to purchase an "approved" health-care plan.

Why is this important? Because if it falls to the IRS to enforce that rule, then both the requirement to purchase and the penalty if you don't are indeed "taxes." Failure to pay the $1,900 penalty gets you a fine of up to $25,000.

(I'm not sure which ObamaCare plan this refers to; the House plan is the only one where a completed bill was actually voted on -- it passed in the House, of course.)

Barthold confirmed that indeed, the IRS will enforce payment of the nineteen hundred smackeroos -- and if you fail to pay it, the IRS will prosecute... and you could even be sent to jail for failing to pay, just as if you failed to pay any other tax. From the first Political post linked above:

Ensign pursued the line of questioning because he said a lot of Americans don't believe the Constitution allows the government to mandate the purchase of insurance.

"We could be subjecting those very people who conscientiously, because they believe in the U.S. Constitution, we could be subjecting them to fines or the interpretation of a judge, all the way up to imprisonment," Ensign said. "That seems to me to be a problem."

I presume the IRS will also enforce the similar provision mandating businesses, including small businesses (even Mom & Pop stores), to offer "approved" health insurance to their employees; I don't know what the penalties are for failing to do so.

In a follow-up Politico post, Barthold confirmed to Ensign that indeed, the possible penalties included jail time:

Violators could be charged with a misdemeanor and could face up to a year in jail or a $25,000 penalty, Barthold wrote on JCT letterhead. He signed it "Sincerely, Thomas A. Barthold."

The Joint Committee on Taxation has both senators and representatives (which is why they call it a "joint" committee); it's chaired by Rep. Charlie Rangel (D-NY, 100%) and vice-chaired by Sen. Max Baucus (D-MT, 80%); the committee comprises three each Democratic senators and representatives, and two each Republican senators and reps.

So the next time some chowderheaded clown -- or the president -- denies that the individual and employer mandates in ObamaCare are massive middle-class tax increases, shove this post in his face and make him read it!

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

Hatched by Dafydd on this day, September 25, 2009, at the time of 1:11 PM | Comments (0) | TrackBack

September 21, 2009

Obama Has a Mandate - but with Whom?

Health Insurance Insurrections
Hatched by Dafydd

President Barack H. Obama was all over the broadcast map yesterday, reading the usual litany of whoppers, floppers, and gobstoppers that flows from the Teleprompter of the United States. (TOTUS -- I picture an object like a Dalek from Dr. Who... "Exterminate! Exterminate!")

Having nothing better to do (I mislaid my toenail clipper), I read an article quoting some of what our august president said this September.

Hot cars and health czars

Here is one of my favorites, where Obama argues in favor of an individual mandate for every American to have health insurance:

"What it's saying is, is that we're not going to have other people carrying your burdens for you any more than the fact that right now everybody in America, just about, has to get auto insurance," Mr. Obama said on ABC's "This Week." "People say to themselves, that is a fair way to make sure that, if you hit my car, that I'm not covering all the costs."

I have already accepted the arguments against such an individual mandate; but even back when I reluctantly accepted it, I never made an argument as foolish as this one. How dumb is it? Let me count just a few of the ways:

  • No, Mr. President; it's not true that "everybody in America, just about, has to get auto insurance." Only those people who (a) drive, (b) drive on the public roads, and (c) own a car have to buy auto insurance; that constitutes a lot less than ("everybody" minus "just about"). The remainder (children, non-drivers, those that drive only on private land, those that only borrow other people's cars because they can't afford one of their own) do not have to buy automobile insurance.

    But under ObamaCare, everybody in America must buy insurance (or have it bought for them), no exceptions.

  • Even when you are required to buy auto insurance, you don't have to buy insurance to protect yourself, unless you live in a state that requires vile and disgusting "no fault" insurance. In any other state, you only need to buy insurance for damage you cause to other people. If you don't want to insure against damage to your own car -- or your own body -- that's up to you.

    But under ObamaCare, the mandate applies entirely to insurance to protect you, yourself from damage to you, yourself. It wouldn't cover any damage you cause to someone else... just yourself.

  • Even in states that "require" insurance, you generally can opt out of the insurance mandate by posting a bond of some certain amount.

    But under ObamaCare -- fugeddaboudit. You won't be able to opt out of the mandate just by posting a bond... or having a medical savings account (MSA), or catastrophic care, or what have you. In fact, you (or your employer) will almost certainly have to buy a gold-plated health insurance policy that covers everything, including abortions, fertility treatments, STD treatment, homeopathic treatment, acupuncture, colon cleansing, tooth whitening, and mental health care (which you may need after paying your premium each month).

Note, you won't be able to use any of that stuff, or any other specialized care (including anesthesiology -- what could go wrong?), because of rationing -- cf. Canada. But by golly, at least you'll be covered!

Tax fax

Here's the next burst of risible rhetoric:

And now, the insurance mandate is being criticized by lawmakers and Americans who say that the cost of coverage will amount to a new tax that would violate the president's campaign pledge against imposing new taxes on Americans who make under $250,000....

"My critics say everything is a tax increase," Mr. Obama said on "This Week." "For us to say that you've got to take a responsibility to get health insurance is absolutely not a tax increase."

Huh; it'll sure feel like a tax. The feds will say, "Either you spend several hundred dollars per year buying the insurance we tell you to buy, or else you pay a fine of several hundred dollars." If it walks and squawks like a tax...

Technically, it's not extortion if Guido says, "You got a nice place here; sure would be a shame if anything happened to it." But I think everybody knows what Guido (and his capo) really mean.

Debates and mandates

Here's the last. It's not exactly an argument about health-care reform but rather about criticism of health-care reform; and it masquerades as a defense of such critics. But its absurdity lies not in the actual words but in the hidden meaning behind them:

Mr. Obama also said Sunday that he doesn't agree with recent comments from former President Jimmy Carter that "an overwhelming portion" of the criticism over health care is based on the president's race.

"This debate that is taking place is not about race. It's about people being worried about how our government should operate," he said. "I do think we all have an obligation to try to conduct this conversation in a very civil way."

Allow me to quote from a very much more reliable narrator, Michael Barone:

I would submit that the president's call for an end to "bickering" and the charges of racism by some of his supporters are the natural reflex of people who are not used to hearing people disagree with them and who are determined to shut them up.

This comes naturally to liberals educated in our great colleges and universities, so many of which have speech codes whose primary aim is to prevent the expression of certain conservative ideas and which are commonly deployed for that purpose....

Similarly, the "mainstream media" -- the old-line broadcast networks, The New York Times, etc. -- present a politically correct picture of the world. The result is that liberals can live in a cocoon, an America in which seldom is heard a discouraging word....

Speaker Nancy Pelosi has warned us that there's a danger that intense rhetoric can provoke violence, and no decent person wants to see harm come to our president or other leaders. But it's interesting that the two most violent incidents at this summer's town hall meetings came when a union thug beat up a 65-year-old black conservative in Missouri and when a liberal protester bit off part of a man's finger in California.

The absurdity of Obama's argument above is that he still maintains the fiction -- delusion? -- that both sides are equally responsible for the "incivility;" I dispute that utterly. One side is saying, "Hey, let's debate this revolutionary rewrite of the entire American health-care system... before Congress votes on it."

The other side is saying something very different: "Shut up," he explained.

Jokeses and hoaxes

It amazes me just how many truly, deeply unintelligent things this alleged genius says -- says and defends, to the bitter end. If I didn't know better, having been instructed by so many important people in government, in the Democrat Party, and in the sundry elite liberal media, I could almost begin to believe that we may not have as bright an Obamacle as we ordered.

Does Amazon have a refund policy on presidential elections?

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

Hatched by Dafydd on this day, September 21, 2009, at the time of 4:38 PM | Comments (2) | TrackBack

September 16, 2009

Barack H. Obama: Mr. Meter Mover?

Health Insurance Insurrections , Polling Keeps a-Rolling , Predictions
Hatched by Dafydd

On Thursday last, September 10th, the day after President Barack H. Obama's grand ObamaCare speech to a session of joint congressmen -- or whatever that was -- I made a bold prediction:

John Hinderaker at Power Line helpfully reports that before President Barack H. Obama's grand address on ObamaCare, the Rasmussen tally stood at 44% of likely voters supporting, 53% opposing....

He makes no predictions, but I'm not gunshy; I say No, Obama's speech last night did not move the meter; we won't see any jump outside the statistical margin of error....

The people have awakened to the fact that there's no "there" there in ObamaCare, and there never was; the drums of August proved that. There are no new arguments or facts under the sun that will help push it; the more people learn about it, the more they hate it; and the president himself has flat run out of charisma-gas.

It's still possible the Democrats will manage a jam-down (though I increasingly think they never will); but if they do, it will not be due to popular demand.

Barack Obama's final, desperate, make-or-break play to stir a populist uprising in favor of ObamaCare has failed. The numbers will not move significantly towards ObamaCare because of this or any future speech.

Well, the numbers are in. It is now exactly a week since the Obamacle spake from on high to the assembled cardinals and bishops -- also broadcast as an extraordinary dispensation to the huddled masses, yearning to breath the government option. During that se'en-night, what happened anent popular support for the plot scheme conspiracy proposal?

Well, on those rare occasions where it's necessary, I'm always big enough to admit I was wrong. I predicted that Obama would not significantly "move the meter" on Rasmussen, but in fact he did; he moved it quite a bit, actually, much more than I thought he could.


As of the Rasmussen release of the 10th, you'll recall -- with all polling conducted before the speech aired -- ObamaCare was supported by 44% of likely voters, with 53% opposing; thus it was losing by 9 points.

Yesterday's release, Tuesday September 15th, shows 42% supporting with 55% opposed, with ObamaCare losing in the poll by 13 points. That's a jump of 4 points, or 44% over the previous gap.

During the interim, support crept up to as high as 51% four days after the speech, with forty six percent opposed; at that momentary peak, ObamaCare was winning by 4 points. But support utterly collapsed in the very next day's release, to 45% support, 52% opposition, with ObamaCare losing by 7 points. That spread worsened in yesterday's release to its current position.

As of now, I'd say my prediction was quite accurate: I of course meant that the speech wouldn't move the meter towards support of ObamaCare (I assume everyone understood that). That it seems to have significantly increased opposition instead (or failed to prevent the increase) is just a bonus.

But it's not just those "right-wing racists" at Rasmussen, who are doubtless straddling the pockets of Rupert Murdoch, Rush Limbaugh, Rep. Joe Wilson (R-SC, 92%), and the entire Fox News Channel (which must be a very uncomfortable straddle spread). Checking the Gallup poll released today, we see no significant movement at all in the unforced opinion, compared to the same poll conducted Aug 31st - September 2nd; and what insignificant movement it shows is, in fact, against ObamaCare.

Bottom line: The Obamic encyclical did absolutely nothing to move the meter towards ObamaCare. POTUS (and TOTUS) utterly failed.

Under the circumstances, I hereby repudiate all my previous begging and pleading for Barack Obama to just shut up about health-care reform (and to shut up shuttin' up, too). Instead, I now encourage him to continue on his "speech a day keeps ObamaCare away" tour. Please be my guest, Mr. President; and... bon appétit!

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

Hatched by Dafydd on this day, September 16, 2009, at the time of 4:39 PM | Comments (1) | TrackBack

The Utlimate Democratic Failure

Health Insurance Insurrections
Hatched by Dafydd

The Hill reports that not a single Republican supports the version of ObamaCare crafted by Senate Finance Committee Chairman Max Baucus (D-MT, 80%)... not even Sens. Olympia Snowe (R-ME, 12%), Chuck Grassley (R-IA, 76%), and Mike Enzi (R-WY, 96%), the three "moderate" Republican Finance Committee members (Grassley is Ranking Minority Member) who form the Republican half of the "Gang of Six," set up by Baucus to try to find a bipartisan alternative to the House ObamaCare bill. (Hat tip to Paul at Power Line.)

(Actually, Mike Enzi is fairly conservative with a 96% rating from the ACU; for some reason, Baucus chose to include him in the pod.)

Baucus' failure to get even one of his three Finance Committee pals to go along with his "bipartisan compromise" augurs badly for the Democrats' ability to pick up even a single Republican in the full Senate to gain the 60 votes required for cloture; thus, the only way they have a chance of passing ObamaCare is to resort to the despicable maneuver of abusing reconciliation -- whose purpose is to hold down spending to reduce the deficit -- to jam through a wholesale rewrite of the entire relationship between doctors, patients, insurers, and government bureaucrats... and to blow the budget deficit through the roof, to boot. We discussed the unlikelihood of success in As the Byrd Rule Flies.

Even more humiliating than not being able to win a cloture vote (and then deciding not to try to ride reconciliation into passage) would be if they did try the reconciliation route -- then actually lost the vote, not being able to get even 50 Democratic senators to vote for it. What are the odds of that happening?

On paper, it's not plausible; the Democratic caucus in the Senate is much more liberal than the Republican conference is conservative; there are no Olympia Snowes or Chuck Grassleys on the left. Even Sen. Joe Lieberman (I-CT, 85%) is far more liberal than most Senate Republicans are conservative.

The lowest ADA rating for a Democratic senator is 65% -- Mary Landrieu of Louisiana. Other than she, there are only four Democrats with ratings in the 70s... and one of them is Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 70%), whose defection to the Republican side is dubious at best. Even if Sens. Robert Byrd (D-WV, 78%), Ben Nelson (D-NE, 75%), and Evan Bayh (D-IN, 70%) all flip, and even assuming that Lieberman votes against the bill, that would still leave the Democrats with a 55 to 44 majority in favor.

But there is also the possibility that some liberal Democrats might vote against it, on the grounds that it lets a good crisis go to waste by not cramming true single-payer, government-run health care down America's esophagus. For example:

[Baucus'] effort to woo Republicans, however, has alienated liberals. At least one prominent liberal on his committee, Sen. Jay Rockefeller (D-W.Va.), plans to vote against Baucus’s plan.

“There is no way in its present form that I will vote for it,” Rockefeller said during a conference call.

But of course, if no Republican is going to vote for it anyway, why not make it full-blown ObamaCare -- perhaps by simply introducing the House version of the bill into the Senate? That would certain resolve the leftist rebellion... but at what cost? I can see even quite liberal-voting Democrats voting against a bill that (a) is a wild, liberal, tax and spend monstrosity in a era of mounting opposition among ordinary Americans, doctors, and townhall attendees; and (b) was brought up for a vote in such a cynical way. It would also make it easy for the three moderate Democrats plus Joe Lieberman to vote against the bill.

All it would take is six more Democrats voting against for varying reasons to drop the vote down to 49 yea, 50 nay, and the bill fails.

What a dilemma for the not quite so liberal Democrats: Either they suck it up, vote for ObamaCare under reconciliation, and have a very good chance of being voted out of office at the next opportunity... or else getting frisky, voting against the bill (and killing it), and then seeing their entire side the aisle taking a walloping in November 2010.

The best outcome for the Democrats would probably be for the bill to fail to break cloture, and then get spiked by Reid. That would be embarassing -- but at least it wouldn't be humiliating, and it wouldn't be enraging.

Hatched by Dafydd on this day, September 16, 2009, at the time of 12:06 AM | Comments (0) | TrackBack

September 15, 2009

Mailed Fist in Lizard-Skin Glove: Lizardian Alternative to Individual Health-Insurance Mandate

Health Insurance Insurrections
Hatched by Dafydd

The more I mull the arguments against the individual health-insurance mandate (hence, I-HIM), the more merit I see in them: It's inevitable that any such mandate, no matter how light the requirement begins, will eventually become a rigid rule that everyone must buy gold-plated ObamaPlans... which themselves are unsustainable and will quickly dissolve into full-blown, United Kingdom style National Health Service, with all the insane medical rationing and treatment denial that entails.

Even if the original mandate is merely for an HSA plus catastrophic care, Big Insurance will push and push, lobby and lobby for mandated coverage for this, required coverage for that; and soon you have the NHS. (The NHS as currently constituted didn't arise overnight either.)

So I bent my mighty reptilian brain -- about the size of a pomegranate seed -- and came up with an alternative that seems more free market, less statist than the I-HIM.

My sticking point in the past has always been the free-rider problem, which I explicated in a previous post. Here's how I described it:

In economics, [we have something] called the "free rider" problem; the classic example is a streetcar with a single driver who is also the ticket-taker, so he really has no ability to extract fares from riders not honest enough to pay voluntarily. These moochers start hopping on the streetcar without buying a ticket; eventually, as more and more people see others riding for free, even ordinarily honest riders start feeling like suckers. When they, too, begin doing the same, the streetcar line goes bankrupt. Then nobody gets the service.

In this case, if we have an unenforced system of health insurance, what happens when somebody without any insurance gets terribly sick or injured -- or worse, his child does. Given that Americans will not stand by and watch someone die from an easily treated disease or injury, the reality is that those free riders will, in fact, be treated. Maybe they'll be billed afterwards, but they can declare bankruptcy and weasel out of even that small bit of personal responsibility.

Similarly, Americans will never countenance senior citizens living on the streets or children growing up illiterate or otherwise uneducated: We have no stomach for willfully forcing people to pay a draconian, perhaps even fatal, price for stupidity... even less for making children pay the price of their parents' stupidity.

Without some solution to the free-rider problem, we cannot move to a system of full liberty. (I'm not saying it's insoluble, only that I personally don't know any solution.) But we can at least significantly pare back government intrusion to the least extent required to still leave nearly everyone covered for old-age health care, retirement, and some standard minimum level of education.

All right; I think I may have, if not a complete solution the free-rider problem (which I believe to be insoluble as a general paradox), then at least something that may mitigate it considerably -- perhaps desisively. I call it the mailed fist in the lizard-skin glove approach:

The problem is in one clause of one sentence above. "Given that Americans will not stand by and watch someone die from an easily treated disease or injury, the reality is that those free riders will, in fact, be treated. Maybe they'll be billed afterwards, but they can declare bankruptcy and weasel out of even that small bit of personal responsibility."

So here's the suggestion:

  1. Amend the bankruptcy rules so that only a certain dollar value of health-care debt, X dollars, can be eliminated via bankruptcy;
  2. Set X high enough to cover the deductable of any reasonable insurance;
  3. But also set X far too low to allow an uninsured patient to shield himself from the consequences of health-care debt by using bankruptcy to wipe it away.

For example, if a typical catastrophic health-care insurance policy had a $5,000 deductable -- normally paid by your health savings account (HSA) -- then X, the dollars of health-care debt you can discharge via bankruptcy, could be set to $5,000. If you have insurance, you're covered; if you only have catastrophic care, but your HSA is depleted (or non-existent), you can declare bankruptcy and discharge $5,000... which is your deductable. That way you won't be socked with life-altering bills, if you're at least somewhat responsible.

But if you've taken no insurance at all -- you're a smart-ass kid who thought he would never need it -- then you may end up with $90,000 of treatment debt, of which only $5,000 can be discharged under bankruptcy. That means you're going to have to agree to some payment plan for the other $85,000, or be taken to court and lose everything you own.

When word got around that you could be absolutely wiped out if you don't get health insurance, perhaps that would get through enough young, thick skulls that most of the free-rider problem would solve itself. As always, the deserving poor who literally cannot pay for health insurance could get federal, state, and local health-insurance subsidies (maybe a Medicaid Advantage program similar to the Medicare Advantage program that Democrats want to destroy).

At least it's something we can offer in place of the I-HIM, to be added to the other market-oriented reforms to produce a solid plan, which we can call the Health Reform Contract With America:

  • Attaching health insurance to the individual, not the employer, so it will be fully portable (and encouraging employers to offer defined contributions towards paying the premiums, if they want);
  • Removing all barriers to insurance companies selling policies of any kind to anybody anywhere;
  • Requiring insurance companies to accept people with pre-existing conditions from an "assigned-risk" pool -- perhaps they don't cover the pre-existing condition for the first six months after coverage begins, and thereafter they do, as with many group plans;
  • Allowing groups to be formed in many different creative ways, from members of a professional guild to subscribers to a particular magazine to membership in a service organization to being active-duty military, in the reserves, in the National Guard, or in the Merchant Marine, and so forth;
  • Allowing tax deductions for much larger HSAs than currently;
  • Allowing all individuals to deduct their health-insurance payments from their taxable income, even if they take the standard deduction (and allowing companies to deduct any payments they make to their employees' personal health-insurance plans);
  • Offering subsidies for the deserving poor to buy health insurance;
  • Amending the bankruptcy law to prevent free-riders from deliberately not buying insurance, gambling that even if they get sick, they'll be treated anyway... then declare bankruptcy to avoid paying for it even after the fact.

Workable? If not, why not? How can it be fixed better?

Hatched by Dafydd on this day, September 15, 2009, at the time of 6:16 PM | Comments (3) | TrackBack

September 11, 2009

"Reconciliation!" Gushes The Hill

Congressional Calamities , Health Insurance Insurrections , Media Madness
Hatched by Dafydd

It's an article remarkable for its straightforward boosterism of the most extreme congressional tactic Democrats might use to pass ObamaCare.

Today in the Hill -- the largest circulation newspaper written for (and about) Congress -- we read an article (bylined Sam Youngman) that is so enthusiastic about the mounting likelihood that Democrats will try to pass ObamaCare by abusing the reconciliation process, bypassing the Byrd Rule, that -- well, as the title of this post says, the paper positively gushes over the prospect:

By offering Republicans olive branches during his address to Congress on Wednesday, Obama has set up a win-win situation. If GOP lawmakers embrace compromise [by which Youngman means "surrender" -- DaH], a healthcare bill would pass Congress easily. But the more likely scenario is that Republicans will continue to oppose Obama’s plan, and the president later this fall will be able to note he tried to strike a deal with the GOP but could not.

Darn Republicans, refusing to compromise on their "principles" even for the sake of the president! But hey, at least he tried.

Republicans contend that the use of reconciliation would be at odds with Obama’s call for bipartisanship during his 2008 presidential campaign. But Obama has countered that argument in recent days by forcefully resurrecting the anti-Washington rhetoric that got him elected.

He's winning -- he's winning -- he countered their argument!

"The time for bickering is over. The time for games has passed," Obama said. "Now is the season for action."

And there's the rallying cry, baldly stated without comment. Why not go whole hog? Liberté, égalité, fraternité!

The Hill notes not a single substantive reason why reconciliation should not be used in this case; but there are several, as everyone at the paper knows well:

  • It's supposed to be used for noncontroversial changes made to programs to keep them within the bounds set by the budget resolution. But ObamaCare is a wildly controversial, radical rewrite of the entire American health-care system
  • On a related argument, it's unprecedented to use the reconciliation process to establish a huge new government agency -- or series of agencies. That's not what it's for at all, at all.
  • It's not to be used for programs that will add more to the deficit that what is already accounted for in the current budget resolution, which calls for deficit neutral health-care reform; but the non-partisan Congressional Budget Office (CBO) and even estimates by the administration of President Barack H. Obama have admitted that it's likely to add hundreds of billions to more than a trillion dollars to the ten-year deficit. (Obama now says it won't, but that doesn't change the fact that the CBO says it will.)

    Unless the budget resolution instructs the committees to bankrupt the nation, that violates at least two tests of the Byrd Rule prohibiting using reconciliation to sneak budget-busting bills through the Senate without allowing a filibuster.

  • Almost certainly, the combination of Republicans and moderate to conservative Democrats will force a promise from the leadership in both chambers not to use reconciliation to radicalize the program beyond what was sent them. Thus the leadership would have to brazenly deceive its own party members, as well as the opposition, and lie like a dead mongoose as it makes promises it has no intention of keeping.
  • Its use would require a ruling by the Senate parliamentarian that was utterly mendacious: He would have to rule that none of the above was true, knowing his own ruling was as false as a Bernie Madoff investment. Either that, or the Presiding Officer would have to tell the Parliamentarian to go fly a hike on a short pier; then the P.O. just rules however the Democrats want.

Yet the only argument against the reconciliation jam-down that The Hill prints is the feeble, amorphous claim that it would be "at odds with Obama’s call for bipartisanship during his 2008 presidential campaign," which call everyone and his unkey's moncle knows is "no longer operative," as a previous liberal president's aides were fond of saying. The Hill, in other words, is not-so-subtlely implying that (a) the GOP is the only group on Capitol Hill that opposes the idea of abusing reconciliation, and (b) that they have no substantive argument whatsoever against it.

This is a classic technique of supporting one side while paying lip service to bilateralism: "It's not our fault that Republicans have nothing to say in their own defense (that we see fit to print)."

If anyone still thinks The Hill is just telling it like it is, they tip their hand with this one-sentence graf:

Rep. Joe Wilson’s (R-S.C.) outburst on Wednesday was an unexpected gift to the White House, accentuating Obama’s point that bitter politics is getting in the way of improving the healthcare of Americans.

Let's review the bidding:

  • Obama said that the government plan would not apply to illegal immigrants.
  • But Wilson (R-SC, 92%) remembers well how he and his Republican colleagues in the House tried several times to enact provisions to ensure that only legal residents received the benefits of the government plan.
  • But House Democrats shot down each and every attempt. So now there is no way, in the House plan that Obama supports, to distinguish or discriminate between those here legally and those here illegally: The Democrats closed off all avenues of enforcement.
  • Thus it is a certainty that illegal immigrants will receive health-care benefits from the government plan, and probably (by law) from all approved private plans as well, if those plans are restricted to the same screening process as the government plan
  • .

  • And it's also a certainty that the president himself knows this. He is certainly keeping close tabs on the progress of ObamaCare through Congress.
  • Thus, regardless of whether it was impudent of Rep. Wilson to point it out during the speech, Barack Obama is, in fact, lying when he says the plan won't cover illegal immigrants; Joe Wilson was rude but right.

The Hill could have noted this rather important point, since it saw fit to bring up Wilson's cri de coeur in the first place; the newspaper, too, could not possibly be unaware of the House Democrats' actions. Yet it failed even to mention Wilson's side, as if he had none and was simply an unruly child making a big noise.

More gushing and ardent support:

The president also said that the White House has made every effort to include Republicans and their ideas in the process, but blamed "unyielding partisanship" for the absence of compromise.

“Part of the frustration I have is, is that on the Republican side there are wonderful people who really operated on the basis of pragmatism and common sense and getting things done,” Obama said. “Those voices have been -- been, I think, shouted down on that side.”

The Hill allows Republicans no defense; had they done so, the GOP -- and Democrats who don't call themselves "progressives," the forgotten members of the anti-ObamaCare alliance -- might have invoked principle as a reason to go against the popular will... even if ObamaCare were according to the popular will, which polling indicates is actually just a liberal fantasy and Obamic talking point.

Pragmatically speaking, we could nationalize all the industries in the United States, sell them to foreign investors, and use the proceeds to mail checks to everyone below the poverty line; it's just common sense! But it would still be a monstrous evil, because of the vital principle of property rights.

And that is one of the very same principles opposing ObamaCare: It would force all responsible Americans to pay a great price in order to benefit a bunch of irresponsible dopes who don't want to buy health insurance, even though they can well afford it... yet who expect still to be given medical treatment if they fall ill or injure themselves. (And pragmatically speaking, their expectation is reasonable, because we've always done so and probably always will.)

But besides property rights, there is also the principle of liberty: People should have the greatest freedom possible within the constrains of living in a society. Even when a problem exists that can only be solved with some degree of collectivism -- for example, those born with pre-existing medical infirmities, such as a congenital heart defect, that would prevent them from being able to buy medical insurance -- the collectivist policy we pursue should be the one that least interferes with the market, allowing the greatest number of Americans to keep as much freedom of choice as possible.

In this case, liberty demands that we either subsidize those deserving unfortunates, or else create an "assigned risk" pool, from which every insurer must accept some money-losing bad risks; rather than radically recreate the entire system with the government controlled (and ultimately government run) scheme of ObamaCare.

But again, The Hill is uninterested in any principled arguments that opponents of ObamaCare care to make; the time for bickering and game-playing is over... we need action, action, action! Pragmatic common sense dictates that we need to get things done.

The president went so far as to warn Republicans that he "will not waste time with those who have made the calculation that it's better politics to kill this plan than improve it."

No comment; I mean that The Hill offers "no comment" on the One's angry dismissal of any dissent to his plan as mere dog-in-the-manger partisanship. The article doesn't even mention another article in Wednesday's The Hill, in which House Minority Leader John Boehner (R-OH, 92%) says Obama has refused even to meet with Republicans on health-care reform since April:

Boehner told reporters that the president has not invited House GOP leaders to the White House for meetings on healthcare reform since the end of April.

Earlier this year, GOP leaders sent a letter to the president in May stating that they would like to work with the administration to find "common ground" on healthcare reform.

But the administration responded with a tersely worded letter indicating that they had healthcare reform under control.

How might that comport with Obama's accusation that the GOP "have made the calculation that it's better politics to kill this plan than improve it?" The article not only doesn't essay an answer, it doesn't even trouble to raise the question.

But to the fair to the article, it does make one weak-tea attempt to allow Republicans to speak for themselves, rather than be interpreted (into nonexistence) by the president. I'm certain it's only the vicissitudes of fate that the GOP side is relegated to the last two paragraphs of the article:

Republicans, predictably wary of Obama's maneuvering, said if Obama is setting up a defense of reconciliation, it will do little to blunt the blowback from both Congress and the American people.

“If Democrats use controversial insider tactics to force a proposal that the majority of Americans disagree with, not only would they guarantee bipartisan opposition, but they would also spark a new level of outrage among a huge majority of people in this country," said a Senate Republican leadership aide.

The same has been said by numerous prominent Republicans who would be only too happy to be named. But I reckon it's easier to dismiss an "anonymous" warning. (Actually, we don't even know whether the aide demanded anonymity; that might have been entirely the decision of the putative journalist, Sam Youngman.)

All in all, this is a disgraceful performance from a newspaper I've always held in high regard. Alas, The Hill is just another casualty in the "progressive" Kulturkampf, where every least element of life must be politicized and partisan-ized. In particular, all sources of information and argument must be squeezed through a totalitarian tunnel, filtering out all opposition thoughts and words, silencing one side and then claiming they have nothing to say.

Or as Robert Anton Wilson wrote once, channeling Lemuel Gulliver:

And so these Learned Men, having Inquir'd into the Case for the Opposition, discover'd that the Opposition had no Case and were Devoid of Merit, which was what they Suspected all along, and they arriv'd at this Happy Conclusion by the most Economical and Nice of all Methods of Enquiry, which was that they did not Invite the Opposition to confuse Matters by Participating in the Discussion.

In other words, "Shut up," he explained.

Hatched by Dafydd on this day, September 11, 2009, at the time of 5:08 PM | Comments (3) | TrackBack

September 10, 2009

Did Obama Move the Meter?

Health Insurance Insurrections , Polling Keeps a-Rolling , Predictions
Hatched by Dafydd

John Hinderaker at Power Line helpfully reports that before President Barack H. Obama's grand address on ObamaCare, the Rasmussen tally stood at 44% of likely voters supporting, 53% opposing. John concludes:

Those numbers have been pretty much stable for a while; it will be interesting to see whether and how they move over the next week or two.

He makes no predictions, but I'm not gunshy; I say No, Obama's speech last night did not move the meter; we won't see any jump outside the statistical margin of error. Here's why I so predict:

Self-selected, partisan audience

First, as the enigmatic and mercurial "Karl" reports on Patterico's Pontifications and on Hot Air's rogues' gallery, nobody but diehard Obamaniacs and weed-dwelling political junkies was likely to watch the speech in the first place.

In today's followup, Karl notes how easy it was to predict the media response:

Sure enough, CNN did a flash poll showing that ObamaCare a 14-point gain among speech-watchers. Buried at the end of the story is the fact that the sample of speech-watchers in the poll was 45% Democratic and 18% Republican. For comparison, consider that the most recent Gallup survey of party ID among adults had 35% of Americans as Democrats and 28% as Republicans. A 14-point swing among a sample that skewed to the left is not surprising. Regular tracking polls are unlikely to show anything near it.

If the viewership was heavily skewed towards those who already support Obama, hence likely support ObamaCare as well, that dramatically limits any impact it can have on the real polling. It might increase the enthusiasm of ObamaCare supporters (though I doubt it, considering how little information, how few new arguments he offered); but it's difficult for a speech to Obama's own cheerleaders to increase the number of people who support him.

(Contrariwise, it is always possible to decrease the number who support you, by saying something stupid that alienates your base. I don't believe Obama did so, so don't look for the speech to turn more people against ObamaCare.)

A highly partisan speech

Despite repeated protestations by Obamic apologists that the One "reached out to Republicans," the tone was obvious early in the address:

But what we have also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have toward their own government. Instead of honest debate, we have seen scare tactics. Some have dug into unyielding ideological camps that offer no hope of compromise. Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge. And out of this blizzard of charges and counter-charges, confusion has reigned.

Well the time for bickering is over. The time for games has passed. Now is the season for action. [As another famous leader was fond of remarking, "no more debate, we need action, action, action!" B.M. would be proud of B.O. --DaH]

Any guess who the Obamacle means by "some?" The partisan nature was set in quick-dry cement by the halfway point:

Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost. The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens. Such a charge would be laughable if it weren't so cynical and irresponsible. It is a lie, plain and simple.

Obama did include a few feeble nods towards the right:

Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do. Now is the time to deliver on health care....

Finally, many in this chamber -- particularly on the Republican side of the aisle -- have long insisted that reforming our medical malpractice laws can help bring down the cost of health care. I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. So I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine. I know that the Bush Administration considered authorizing demonstration projects in individual states to test these issues. It's a good idea, and I am directing my Secretary of Health and Human Services to move forward on this initiative today.

But nothing definite, no actual promises, veto threats, or lines in the sand. And of course, again and again, when the TOTUS invites members of Congress to la Casa Blanca to hash out language, he invites only Democrats -- and "progressive" Democrats to boot.

Liberal Democrats might perceive the speech to be even handed; but they already support ObamaCare. Where Obama desperately needs help is among moderate to conservative Democrats and among Republicans; so it's their perceptions that count... and as House Republican Whip Eric Cantor (R-VA, 92%) demonstrates, the latter, at least, perceive the speech as entirely unilateral:

CANTOR: Well, listen, I mean, obviously, this was, for an Obama speech, something that I was taken aback by in the partisan nature of the speech. I mean, listen, we all know that the status quo is unacceptable, and the president says the status quo is unacceptable. But when he goes and starts pointing fingers and casting blame, I think it's just a smokescreen, Sean.

Listen, it's not just special interests or Republicans that stand in his way. The Democrats are firmly in control of both bodies in Congress. He's the president. They've just been unable to lead in terms of the type of reform that the American people want to see....

HANNITY: All right, at one point in the president's speech tonight, Congressman, he says, "Instead of honest debate, we've seen scare tactics." And then later in the speech, he goes on to say -- and this is specifically -- "Everyone in this room knows what will happen if we do nothing, that the deficit will grow, families will go bankrupt, businesses will close, more Americans will lose their coverage when they need it most, and more will die as a result."

Is that a scare tactic by the president?

CANTOR: I mean, you know, again, I really sat there aghast with those kind of claims and the hyperbole that was used. I mean, we need some adult sense of responsibility here. We need to try and produce the reforms that we know that the American people want.

Republicans and probably non-liberal Democrats tend to tune out when they hear red-meat partisanship for the leftest of the Left.

Logical lacunae

Regardless of the two points above, it might be possible to gain support by such a speech if new arguments or data were presented that were tough to refute. "Facts are stubborn things," as John Adams insisted; and so are valid, compelling conclusions drawn from those stubborn facts.

But Obama presented no new data -- or at least no new accurate data; what data he did offer is ambiguous, to say the least... and a bushel of utter falsehoods, to more accurately characterize. And the arguments that went with the "facts" are disingenuous to the point of being loony. Several examples summed up by National Review Online:

Neither the government-heavy substance nor the dishonest and demagogic tactics have changed. The president denounced "scare tactics" -- in a speech that warned that failure to go along with his plans would cause people to die. He pretended that preventive care will "save money," even though this claim has been authoritatively and repeatedly debunked. He claimed, in defiance of every independent assessment, that the legislation before Congress will reduce costs. He denied that the legislation he supports will spend federal dollars on abortion, which can be true only if he has some private and novel definition of "federal dollars." He denied that it will cover illegal immigrants, even though Democratic congressmen have specifically voted not to require verification of legal residence.

Obama told people with insurance that "nothing in our plan requires you to change what you have." Note the careful formulation, which is technically true but deliberately misleading. The president knows full well that his plan will cause millions of people to lose their current coverage and that they are not going to catch the fact that his statement does not quite deny it. Obama said that "what Americans who have health insurance can expect from this plan" is "more security and stability." Many of them can, in fact, expect to lose their coverage while paying higher premiums and taxes. Many other Americans can expect to lose their jobs thanks to Obama’s "employer mandate."

It should be clear to all that you cannot persuade those who don't already agree with you if they consider your arguments ignorant, mendacious, and laughable. Ronald Reagan succeeded in bringing many people into his camp who had previously been ardent foes of Republicans and conservatives precisely because he was so good at making arguments that even many on the Left found unanswerable.

For example, with the Soviet Union installing thousands of new missiles in Europe, it's tough to argue that it's somehow "destabilizing" for the United States to follow suit. And with America's economy struggling under a Carter-induced malaise, it was hard for even liberals to resist Reagan's call for loosening restrictions, lowering taxes and interest rates, and allowing American ingenuity, creativity, and industry to lead us out of stagflation and recession.

Reagan's arguments compelled because they were (a) logical, and (b) based upon sound evidence that anyone could verify: Was the Soviet Union an evil empire? Was the economy in terrible trouble? Who could deny it, other than those ideologically committed to America's decline and fall?

But Barack Obama's "arguments" for more government control of health care -- and beyond that, for the "fierce urgency of now" (whatever Ted Kennedy meant by that endorsement of Obama last year) that requires Congress to pass ObamaCare so fast they haven't even time to read the bill -- is (a) paralogical, and (b) so dependent upon the fabrication of surreal factoids, invented for the sole purpose of foisting ObamaCare on the American people, that it will drive supporters away, if they have a lick of intelligence and honesty.

Of course, if they had a lick of intelligence and honesty, they wouldn't be ObamaCare supporters, would they?

The messenger is the massage

Finally, a truly charismatic speaker can lull people's good sense and lure them into supporting that which they would ordinarily recoil from in a heartbeat. A "rock star" can overcome all the previous obstacles and still make headway for his cause.

But as all polls show, the president's magical charm is already wearing thin after just eight months in office. He no longer has charisma to squander on a health-reform scheme that most Americans emphatically reject. He is no longer the rock star that some had supposed him... which means he never was one in the first place.

The main criterion for rock stardom is durability: No matter how many missteps, he can still command an audience and lead it into temptation. But when a supposed star flames out so quickly, it's clear he was actually just a one-hit wonder, yesterday's cold pizza: Some may still like it, but it just hasn't the sizzle it had when chef brought it fresh from the oven on a big metal plate.

Obama alone can no longer move mountains; he must rely on more quotidian paths to conversion... paths that are rapidly being reclaimed by the jungle of politics.


The people have awakened to the fact that there's no "there" there in ObamaCare, and there never was; the drums of August proved that. There are no new arguments or facts under the sun that will help push it; the more people learn about it, the more they hate it; and the president himself has flat run out of charisma-gas.

It's still possible the Democrats will manage a jam-down (though I increasingly think they never will); but if they do, it will not be due to popular demand.

Barack Obama's final, desperate, make-or-break play to stir a populist uprising in favor of ObamaCare has failed. The numbers will not move significantly towards ObamaCare because of this or any future speech.

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

Hatched by Dafydd on this day, September 10, 2009, at the time of 3:03 PM | Comments (3) | TrackBack

September 7, 2009

Sure, Doc... If'n You Cancel Both Sides of It!

Health Insurance Insurrections , Liberal Lunacy
Hatched by Dafydd

Another snide liberal who is too clever by half; this one is a doctor who argues that anyone who opposes ObamaCare should have to forgo Medicare -- hey, that's a government insurance "option," isn't it?

Oppose a government health care plan? A Jackson, Miss., doctor wants you to put your convictions on the line by burning your mother's Medicare card.

It's the reverse of the challenge many citizens have been issuing to their own members of Congress to forgo the health care plans they get by dint of working for the government and buy into the "public option" plan instead.

"I want to have a demonstration -- Boston Tea Party-like -- and burn those cards," said Dr. Aaron Shirley, who has done extensive work in trying to extend health care to the uninsured.

Shirley, you can't be serious, Doc... I would jump on that deal faster than you can cheer a tax increase -- provided, Doc, that in addition to rendering me ineligible for Medicare, you also return all the FICA money and SE tax I've paid into the system since my very first paycheck in 1976 (selling candy and popcorn in the Egyptian movie theater in Hollywood) -- returned with interest, naturally. (I'm willing to accept the normal interest that would have accrued had those dollars been shunted into United States Treasury Bonds all these decades.)

Should be easy to calculate.

In addition to Medicare, the deal would have to apply to all taxes taken from me to pay for Medicaid, SCHIP, and (the biggie) Social Security as well. Give it all back, Mr. Dr. Shirley, with the modest interest I demand above. Then you're welcome to wipe me from the rolls of future beneficiaries forever and a day.

And naturally, I would also be exempt from all future FICA taxation.

Say, Doc; what percentage of Americans do you think would take that same offer you make to me, to wipe them off the books -- and return all the money looted from them over the years, and never to take any more for any of those four programs? 25% perhaps? Maybe 50%? As much as 75%?

You might be shocked, Uncle Aaron; but I sure wouldn't be. Unlike you, I actually know just what a horrible "investment" all those programs have been.

Of course, you would never really make that offer, even if your pal Barack H. Obama appointed you Federal Tax Ponzi Scheme Refund Czar, because the entire country would be bankrupt... the federal treasury no longer has any of that money. It's all been spent, and what hasn't been spent has already been promised. Heck, even what has been spent has also been promised! There's no wherewithal there with all those IOUs.

Nope; all that you're really offering, Doc, is that those of us who are tired of being fleeced by those of you should abstain from all benefits, while still paying all the taxes -- and letting the government keep what it has already stolen. That's the usual liberal counteroffer, isn't it? If we don't like your product, we don't have to buy it... we just have to pay for it.

Shirley, you jest.

Hatched by Dafydd on this day, September 7, 2009, at the time of 9:20 PM | Comments (1) | TrackBack

September 5, 2009

Raucous Baucus Caucus

Confusticated Conservatives , Congressional Calamities , Health Insurance Insurrections , Liberal Lunacy
Hatched by Dafydd

In a sure sign of a looming crackup in the health-care reform debacle, Sen Max Baucus (D-MT, 80%) says that he is sick of the deadlock among the putative "Bipartisan Six" senators, and that he is going to circulate a more or less final compromise position; if it fails to get four of the six votes -- as I suspect it will -- it will prove that "further bipartisan negotiations would be futile."

If that happens, I believe it will be the end of any significant health-insurance overhaul, as the Senate does not have sixty Democratic senators willing to vote for a Democrats-only ObamaCare bill; and all the Republicans will vote against cloture (including the Maine twins).

Finally, I do not believe, in the end, that the Democratic leadership will be able to pull off the "reconciliation" trick, where they enact a bill in the Senate that doesn't have, say, the government "option," but then add it in during reconciliation -- and claim that they only need 51 votes to pass the reconciled bill. The Byrd Rule would preclude that; and I believe Sen. Robert Byrd (D-WV, 79%) himself would rail against it. A bunch of Blue Dogs would be outraged... particularly since they would be tarred by the bill even if they voted against it. The damage such a maneuver would do to the Democratic caucus itself would shred the party. Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 70%) won't fire that Rubicon.

I think that liberal Democrats and Baucus himself have concluded that there will be no bipartisan compromise: Republicans have no incentive to take the electoral heat off Democrats pushing a wildly unpopular bill that will bankrupt Medicare and put an onerous health-care mandate on all Americans without any significant reforms to lower the costs, such as tort reform, removing barriers on cross-state competition for insurance companies, expanded medical savings accounts (MSAs), health-insurance portability (attaching insurance to the person, not the job), and so forth.

On the other hand, liberal Democrats in safe seats have no incentive to take the heat off their more moderate colleagues to pass a radical government takeover of health care. Instead, both the GOP and the Progressive Caucus see more gain to themselves in blowing up the negotiations than finding a "compromise" that everybody hates: Republicans expect the collapse to hurt Democrats in 2010, while liberals believe that if they agree to a compromise, their radical constituents will abandon them in the election -- whereas their own personal reelection is guaranteed if they hold firm to "progressive" principles, even if that means ObamaCare dies an ugly death.

Baucus sounds desperate:

The chairman, Senator Max Baucus, Democrat of Montana, signaled his intentions in a telephone conference call with five other committee members who have been struggling for months to forge a bipartisan bill and break a partisan stalemate in Congress, an official familiar with the call said.

The official said Mr. Baucus had told the group that he would circulate a detailed proposal as early as Saturday. In doing so, he would be taking a big step toward forcing a final decision by the group as to whether it sees any realistic prospect of a deal.

Many of the ideas expected to be included in the Baucus plan have been aired for weeks among the negotiators and by other lawmakers. But if Mr. Baucus follows through, it would be the first time he had assembled a complete package, an indication of the pressure he is under to produce an agreement.

It was ever thus: Republicans see American health insurance as mostly in good shape with a few problems that can be handled with minor tweaks; liberal Democrats see a "crisis," whether real or fabricated, that can be whipped into an opportunity to do what they have dreamt of for decades: nationalize American health care, à la the British National Health Service... and they are pushing the Democratic moderates to hold firm, even if it costs them their jobs, to principles they don't even fully support. The negotiators are thus speaking at cross purposes; there is no "meeting of the minds," hence no "contract" is likely.

The Baucus compromise in the Senate Banking Committee gives neither side any of its bottom-line essentials:

  • There is nothing to strengthen or expand the invisible hand of the free market in health insurance, so Republicans will reject it;
  • There is nothing to stick the invisible foot of government into the Capitalist system, so the "progressives" have nothing to gain and everything to lose by supporting it.
  • Thus, only a small handful of actual moderates would support the bowdlerized "compromise."

As I wrote last Tuesday:

Compromise is a great strategy when negotiating the price of a new car, but it makes lousy politics; usually nobody likes the result, and all the collaborators end up running for cover. Far better to compete instead of collaborate... to put our own vision of health reform out there, then let the people decide.

Note that this syllogism applies equally well to the GOP and the Progressive Caucus: Each side is better off rejecting an unworkable sausage of a compromise and instead pushing its own alternative plan, heading into next year's campaign.

La Casa Blanca agrees with this assessment -- gloomy to them, bright and sunny to me and anyone else who supports liberty, Americanism, Capitalism, and the market:

For all the interest on all sides of the debate about what occurred in Friday’s conference call, the White House and Congressional Democrats have already concluded that a bipartisan alternative is probably doomed after recent public attacks from Mr. Grassley and Mr. Enzi.

That leaves the administration with a new and highly charged political dynamic -- balancing the conflicting desires of liberals and moderates in the president’s own party -- as he tries to pass a bill with Democrats’ votes alone, perhaps, and at best one Senate Republican, Ms. Snowe.

But Sen. Olympia Snowe (R-ME, 12%) supports only a potential government option that would be triggered by absolute private-insurance company intransigence, which is unlikely in the extreme; much more probable is that under such a plan, insurance companies would make some appearance of cooperation, thus avoiding triggering the entrance of government health insurance.

All sides understand that a government option hinging on a trigger is either (a) the same as no government option at all, or (b) equivalent to a full-time public option from Day-0. There will be no "in between" state in which we're already not certain whether the trigger will or will not be squeezed. But the lefties in the Democratic Party won't accept (a), while Snowe and the other moderate Republicans will not accept the latter.

Further, the progressives demand an actual government "option" for health insurance from the git-go; anything less will not allow the destruction of private insurance... thus allowing a good crisis to go to waste. The Left has too much power within the Democratic Party now to be rolled into a compromise that even Snowe could live with.

Similarly, moderate Democrats are balking at the Left's demands:

The president must reach out to moderate-to-conservative Democrats like Senators Mary L. Landrieu of Louisiana, Evan Bayh of Indiana and Ben Nelson of Nebraska, who will continue to push for a measure that spends less and does not include a public insurance option as liberal Democrats demand. The same is true for the Blue Dog Democrats in the House.

But liberal Democrats, who dominate in the House and include Speaker Nancy Pelosi, have become emboldened by the prospect of passing a bill solely with Democratic support.

Bottom line:

  • Moderates may want a compromise, but there aren't enough of them to pass it;
  • Conservatives and liberals alike would much rather have a head to head competition than "compromise" their principles by agreeing to a compromise;
  • Thus never the twain shall meet.

I predict there will be no compromise; rather, one side will win, and the other will lose. And given the mounting skepticism and even downright fear among the electorate about the specifics of radical health-care "reform," there's no doubt in my mind that the winner will be the GOP, the minor loser will be the Progressive Caucus -- and the big, fat, hairy loser will be Barack Obama himself, whose presidency will be gutted in his very first year in office.

Hatched by Dafydd on this day, September 5, 2009, at the time of 9:10 PM | Comments (2) | TrackBack

September 1, 2009


Health Insurance Insurrections , Politics 101
Hatched by Dafydd

Leonard Burman, writing in the Washington Times, warns Republicans that they cannot petulantly shoot down health reform and offer nothing in its place.

Well, that's true... but which Republican jackass is doing that? All the Republicans I've seen are pushing various reforms of their own, "to get universal access to health insurance that harnesses market forces to slow the growth of health care costs" -- exactly the attempt at bipartisanship that Burman hectors them for rejecting.

He's pointing his finger at the wrong miscreant.

Burman's thesis appears to be that the Democrats are aching for real, honest compromise with the GOP; but in fact, it's the Democratic supermajority that smirks it can go it alone; that refuses to allow Republican alternatives even to be presented for a vote in Congress; and it's the Democratic president's own very "progressive" Chief of Staff who said -- in a moment of candor he surely regrets -- that "You never want a serious crisis to go to waste."

So why is Burman directing his ire at the Right instead of the Left? Probably because he realizes at some deeper level of beingness that it is the Left that rejects any collaboration... including the sort urged by Mr. Burman. So why bother talking to people who announce in advance they won't listen?

Instead, Burman turns to the one side that might listen to him, might even take his suggestions seriously; he gives the Democrats a pass for their bullying and swagger, and shouts at the only side that won't just laugh at him... which happens to be the side that is innocent of the charges he hurls. Thus, just like the Palestinians, absolute intransigence is rewarded, while no good deed goes unpunished.

I completely disagree that this is the time for Republicans to become beggars at the banquet, bowing and scraping before their liberal masters, hoping to be noticed, maybe even patted on the head and thrown a Scooby Snack. That was never the approach of Ronald Reagan, whom Burman cites quite indirectly.

Reagan used an entirely different strategy: He crafted a great alternative to the "default liberal" position, one that resolved the problem without accepting any more lashings of socialism... and then he took his case directly to the people.

Let the Left squirm for a change. Let Democrats rush to jump on the caboose as the train chugs out of the station. It worked for Reagan (again and again), and there is no reason to suppose it won't work for today's GOP, if it has but the huevos to give it a try.

Instead of Republicans trying to wheedle their way to a booster seat at the big kids' table -- offering token amendments to ObamaCare so they can get their grimy "fingerprints" (as Burman puts it) onto a bill that the American people despise -- why not caucus by themselves, agree upon an alternative bill that will get nearly unanimous Republican support in both chambers of Congress, and then take that bill to the American voters as the new Health Reform Contract with America?

They could barnstorm the country with stacks of detailed (but readable) 4-page pamphlets, with a few charts and graphs, but mostly just describing the plan in bold, primary colors. Take them to townhall meetings. Mail them to anyone who asks. Put them up on the web. Deputize twenty or fifty Republican pols who can actually hold an audience when they speak and send them on speaking tours across America. Constantly refer to it as the "Health Reform Contract with America" -- and always contrast it to "ObamaCare," to drive home the point that it's Barack H. Obama vs. America.

Compromise is a great strategy when negotiating the price of a new car, but it makes lousy politics; usually nobody likes the result, and all the collaborators end up running for cover. Far better to compete instead of collaborate... to put our own vision of health reform out there, then let the people decide.

I mean, this is a democratic republic, is it not? And Republicans do trust the innate good sense of people... don't they? Or have they learned nothing from two successive spankings?

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

Hatched by Dafydd on this day, September 1, 2009, at the time of 5:06 AM | Comments (6) | TrackBack

August 27, 2009

It's a Dead Man's Party

Follies and Foibles , Health Insurance Insurrections , Liberal Lunacy
Hatched by Dafydd

Well that didn't take long.

All right, I made a crass prediction yesterday. I writ:

Please pardon my irreverance (blasphemy?), but I wonder how many days will pass before Chris Dodd says, "If the Republicans had allowed us to pass a public option in the Senate, Ted Kennedy would be alive today!"

Then a few moments ago, I looked on Drudge to see that the Democrats have decided to rebrand ObamaCare as -- KennedyCare!

To infuse Kennedy into the health-care debate, Democrats are planning to affix the former senator's name to the health-care legislation that emerges from Congress.

The idea of naming the legislation for Kennedy has been quietly circulating for months but was given a new push today by Sen. Robert Byrd, D-W.Va., the only person who served with Kennedy for all his 47 years in the Senate.

I say that's as near as makes no difference to my quasi-unofficial prediction: It took but a few hours for the Left to decide, almost unanimously, to work a grisly version of Weekend at Teddy's, dragging the old man's corpse to political rallies like Dracula in his coffin. (I could get truly Clive Barker-esque on you all by making sly references to Green Helmet Guy instead, but I have too much class.)

It is hard to avoid the eerie coincidence, however: Tedro's brother got elected president on dead men's votes in Texas and Illinois; and now the Democrats want to ride the coat-tails of Dead Ted into a government takeover of health care. "Complete the sequence, Mr. President!"

Do I seem boorishly insensitive, insufficiently respectful, a little too little de mortuis nil nisi bonum dicendum est? No apologies; I think the Democrats are being a thousand times more disrespectful of the DKs by drafting Teddy into the cause posthumously... even though he himself would love it.

It's the most vile of emotional appeals; but worse than a crime against seemliness, it's a terrific blunder by liberals: They have, once again, mistaken their looking-glass fantasy for the real world, as they honestly believe that the rest of the country is heartbroken by the not exactly untimely death (he was a very old 77) of Sen. Edward Moore Kennedy.

They seem to think that the outpouring of grief and wailing noises will so overwhelm America, that the townhall shouters will fall to their knees, beg forgiveness of Sen. Chris Dodd (D-CT, 100%) and Squeaker of the House Nancy Pelosi (D-Haight-Ashbury, 100%), and go and sin no more against Obamunism.

It's a dead man's party
Who could ask for more
Everybody's coming
Leave your body at the door
Leave your body and soul at the door

I rather suspect that this will be seen instead as the most disgusting political hijacking since the "memorial" for Sen. Paul Wellstone of Minnesota, which was turned into a foam-at-the-mouth, three-ring political circus of anti-Republican hatemongering -- led by Wellstone's sons and by former Vice President Walter Mondale, as if the Republican candidate, Norm Coleman, had personally shot down Wellstone's plane with a Stinger.

And the voters indeed responded to that emotional emesis: They responded by shifting decisively in Coleman's favor... simultaneously electing Coleman to the U.S. Senate and also turning Mondale into the only man to have lost a national election in all fifty states.

(Alas, Coleman was on the chopping block himself in 2008, ultimately being replaced by -- Al "Big Boy" Franken.)

Democrats have two great mottos: Never let a good crisis go to waste, and never miss an opportunity to egregiously underestimate the intelligence of the American voter. Sometimes, as with the election of Barack H. Obama, the electorate lives down to expectations; but most of the time, they know all along what the Democrats really think of them, and they resent the hell out it.

Hatched by Dafydd on this day, August 27, 2009, at the time of 12:36 AM | Comments (2) | TrackBack

August 23, 2009

Health Care: When "the Worst" Is Enemy of "Bad Enough"

Health Insurance Insurrections , Ubertweets
Hatched by Dafydd

Let's see if we can follow the logic here. According to AP

One of the most widely accepted arguments against a government medical plan for the middle class is that it would quash competition -- just what private insurers seem to be doing themselves in many parts of the U.S.

Several studies show that in lots of places, one or two companies dominate the market. Critics say monopolistic conditions drive up premiums paid by employers and individuals.

For Democrats, the answer is a public plan that would compete with private insurers.

Translation for those unschooled in libspeak:

  1. Competition is good for health care.
  2. Some insurance companies are so big, they're almost like governments.
  3. They can dominate small insurance markets.
  4. Ergo, we should introduce an actual government "competitor" to undercut those big insurers.
  5. That way, we can drive them out of business... which will create much more competition in the insurance market!

Okay. I'm not sure how that scenario is supposed to unfold, but it must be something like this: When the government "option" drives Blue Cross, Aetna, and Wellpoint out of business, then smaller insurers can gobble up that suddenly available market share -- because naturally, the underpricing tactics of Obama Insurance Inc. that drove the big insurers into insolvency and bankruptcy would never, ever do the same to smaller, poorly funded insurers.

Do I have the argument straight?

Proponents of a government plan say it could restore a competitive balance and lead to lower costs. For one thing, it wouldn't have to turn a profit.

All right, let's think this one through. You own a grocery store, and you have one major competitor: You sell 20% fat hamburger for $2 a pound, and your competitor sells it for about the same. It costs you $1.85 a pound, taking everything into account (the wholesale beef price, labor, your facilities lease, your maintenance and utilities cost, and of course that big, hefty tax burden). Thus, you make a profit of 15¢ per $2 of gross hamburger revenue, or 7.5%.

Suddenly, Bill Gates decides to open a grocery store right across the street from you. Because he's Bill Freaking Gates and is worth $56 billion, and because he decides prices are too high, he starts selling his 20% fat hamburger for $1.00 a pound.

Bill Gates has the same costs as you; but he can afford to operate at a huge loss for year after year -- because he has all the money in the world.

Your choices are:

  • Take the loss (85¢ per dollar of gross hamburger revenue, or a loss of 85%) -- multiplied by all the other products that Gatesmart is likewise selling at a staggering loss... and go broke in a few months;
  • Refuse to be sucked into that game... and see all your customers flow very quickly to Gatesmart, forcing you to go broke in a few months;
  • Fire most of your staff, stop paying your lease, and turn off all the power to the refrigerated bins, letting all or your meat rot... forcing the local Health Department to shut you down;
  • Offer to sell your store to Gatesmart and just get out of the grocery business altogether.

Yes, I can certainly see why that would foster competition... among all the different divisions of Gatesmart. That is, shifting back from our analogy to the real proposal, intense competition among all the different branches of government, to see which can drive more private insurers out of business entirely, leaving only that dad-blamed government plan.

It's a scenario that gives pause even to traditional adversaries of the insurance companies.

"The fear and concern is that the public plan could become the market-dominant plan," said Dr. James Rohack, president of the American Medical Association. "When you've got the federal government involved, it can infuse money into a plan to keep it solvent even if the premiums are lower than its actual costs."

Gee... you think?

Here is the real problem with libthink:

[Sen. Olympia] Snowe [RINO-ME, 12% -- !!], among the few Republican senators still trying to come up with a bipartisan compromise, wants to hold back on creating a public plan for now and give insurers one last chance to show if they can keep costs in check.

That's doesn't go far enough for liberals, who are loath to give the insurance industry tens of millions of new customers supported by taxpayer subsidies.

"It would give the industry a windfall without any countervailing force to require them to lower their costs," said Richard Kirsch, national campaign manager for the advocacy group Health Care for America Now. "The insurance companies could continue to jack up premiums while getting a whole new market."

(Note the tacit admission that insuring the uninsured requires "taxpayer subsidies;" in other words, it's not economically viable.)

Liberals utterly reject the fundamental theorem of Capitalism: If all insurance companies are charging premiums out of line with costs, some insurers will lower their premiums to steal away market share, since they can do so and still make a profit. The other insurers will have to lower their own premiums to avoid losing market share -- and the cycle repeats until premiums are as low as they can go while still yielding a barely adequate profit to the insurers (just enough to allow the insurance companies to stay solvent).

Rather, liberals believe the insurance companies will form a cartel, exercise superhuman discipline, and maintain an artificially inflated schedul of premiums. After all, you see how well that has worked out for OPEC; nobody ever cheats!

How about this for a plan to increase competition?

  1. Competition is good for health care.
  2. Some insurance companies are so big, they're almost like governments.
  3. They can dominate small insurance markets.
  4. Ergo, we should find all the barriers to true competition in the market -- and eliminate them, one by one, until there are no impediments left to a true, free market in health insurance.
  5. This will allow smaller competitors to compete more effectively with Big Health, offering smaller, cheaper plans for middle-income folks -- or alternatively, gilt-edged super-expensive plans for rich people... just like the automobile industry, the boat industry, and the housing market.

I realize this isn't as sexy as creating a whole new government entitlement program and spending three or four trillion dollars of somebody else's money... but at least my plan as the virtue of simplicity!

I don't know how this argument could be made any simpler to persuade the simpletons in Congress. Anybody else have an even more elementary formulation?

Hatched by Dafydd on this day, August 23, 2009, at the time of 7:13 AM | Comments (4) | TrackBack

August 19, 2009

The Private Option: Consistency Is Sauce for the Gander

Educational Elucidations , Health Insurance Insurrections
Hatched by Dafydd

Several pundits (I can no longer write "pundants," with Mr. Bush being gone from the scene) have quipped that if the Democrats are so anxious for a public (government) option in health-insurance reform, arguing that allowing the government to "compete" with private industry reduces cost without damaging quality, then why do they reject a "private option" for Medicare, Medicaid, Social Security, and schooling?

It's a grand idea; let's play with it a bit.

The putative government "option" works by allowing employers and perhaps private individuals who buy their own insurance to elect instead to buy the government insurance plan. All right... at the moment, while there are a few private insurance plans contained within Medicare, ordinary people have no option of paying for a private health-insurance plan for their sunset years instead of Medicare; if somebody wants such a plan, it must be supplemental coverage in addition to Medicare, which they also must fund via involuntary taxation -- part of the FICA taxes, which you can examine by looking at your W-2. (The self-employed must pay the entire amount directly, as SE tax.)

The same is certainly true for Social Security, paid for by the other part of FICA: You are not allowed, in general, to cease paying your FICA taxes. (There may be some exceptions for people already on government health care or retirement plans.)

Half the FICA tax is automatically deducted from your paycheck; the other half is "paid" by your employer -- but in reality, it passes that cost along to you, in the form of reduced salary. Employers certainly count that half of FICA as part of total compensation, just as they count the health insurance they offer; if they didn't need to make those payments, they would be free to offer that much more to lure the best candidates away from competing businesses.

So if Democrats really like public-private competition, how about this?

  • Allow citizens to opt out of public Medicare, instead directing their employers to deduct the amount of their Medicare taxes, 2.9% total of all income -- and pay it as a defined contribution to a health-insurance plan, selected by the employee, that will pay for medical care in old age. Those who pay SE tax could also opt out, paying that same amount instead into the same kind of plan.
  • Allow workers to opt out of public Social Security entirely -- all 12.4% of taxable wages, not just 4%, as President Bush proposed -- by instead having their employers direct the amount of the total FICA tax into a qualified IRA investment plan (same deal for SE tax). The plans would be offered by any broker willing to set them up... which of course would mean all of them, because every major broker already offers such plans.
  • And of course, allow parents to opt out of paying the portion of their federal taxes that go to government schooling, instead having a tax credit for that amount, which they can put into a special, qualified investment fund -- chosen by the taxpayer -- that could only be used to pay for non-government schools or for home-schooling. (Because the government would not directly be paying schools, the problem of whether to "fund" religious schools does not even arise, as it does with a voucher system.)

    This liberty is trickier, because people must continue to pay these taxes even after their kids are all grown and out of government schooling. Should the opt-outers continue to receive a tax credit for life, based upon what portion of their children's schooling was supplied by government schools (that is, when they chose to opt out)? Or should the tax credit diminish over time? These questions would be negotiating points to try to gain votes in Congress.

First, each of these is obviously an interim step between the current system of government monopoly and a system of actual liberty and personal responsibility; but we still must take into account that pesky First Rule:

[G]overnments conclude that it's very bad public policy -- political suicide, in fact -- to allow people to die of easily treatable injuries, illnesses, and conditions....

Let's call this the First Rule of Health-Policy Political Reality: If voters have to step over dead bodies to get to the polling place, it affects their vote.

In addition to health care, this rule also applies to standing by and allowing seniors to live in grinding, third-world level poverty, or allowing some parents to refuse to educate their children at all.

In economics, it's called the "free rider" problem; the classic example is a streetcar with a single driver who is also the ticket-taker, so he really has no ability to extract fares from riders not honest enough to pay voluntarily. These moochers start hopping on the streetcar without buying a ticket; eventually, as more and more people see others riding for free, even ordinarily honest riders start feeling like suckers. When they, too, begin doing the same, the streetcar line goes bankrupt. Then nobody gets the service.

In this case, if we have an unenforced system of health insurance, what happens when somebody without any insurance gets terribly sick or injured -- or worse, his child does. Given that Americans will not stand by and watch someone die from an easily treated disease or injury, the reality is that those free riders will, in fact, be treated. Maybe they'll be billed afterwards, but they can declare bankruptcy and weasel out of even that small bit of personal responsibility.

Similarly, Americans will never countenance senior citizens living on the streets or children growing up illiterate or otherwise uneducated: We have no stomach for willfully forcing people to pay a draconian, perhaps even fatal, price for stupidity... even less for making children pay the price of their parents' stupidity.

Without some solution to the free-rider problem, we cannot move to a system of full liberty. (I'm not saying it's insoluble, only that I personally don't know any solution.) But we can at least significantly pare back government intrusion to the least extent required to still leave nearly everyone covered for old-age health care, retirement, and some standard minimum level of education.

Second, these "private options" would naturally have to take into account that there are three groups of people:

  1. Those who have already retired (Medicare and Social Security) or whose children have finished secondary schooling, thus cannot choose not to partake of the private option.
  2. Those who have not yet begun to pay into the system -- primarily children -- who have the cleanest choice possible.
  3. And a vast remainder, including those who have already paid taxes for some number of years but haven't yet used any Social Security or Medicare, or who have children who are part-way through school, or various other combinations.

Group 3 is the toughest, of course; but all that is needed is a reasonable compromise, how much of taxes already collected would be returned to the taxpayer as a "start-up" balance in his account... because it would not be mandatory to switch to the private option. Every individual (or family) in Group 3 would have to decide which choice is best for him (them).

And of course, Congress will see a battle royal about how to fund the transition. But heck, the Democrats seem to be happy with only the least bit of hand-waving about how to pay for the government option -- ultimately, the full government control -- of health care; so why should they kick at any temporary transition cost of allowing people to opt out of Medicare, Social Security, and the government-run school system?

In any event, the cost saving of a private option is much more easily calculated than the cost of ObamaCare: Fewer people in Medicare and Social Security mean less money spent; fewer kids attending government schools mean states can consolodate and close some of them. And in both cases, a bunch of bureaucrats at all levels of government can be told to find honest work instead. Not that any of this would happen -- but that's a separate issue, the tragedy of immortal bureaucracy.

However, there is one killer argument that would persuade every Democrat in Congress, even the Blue Dogs, to vote against the private option: Demand for such a private option would eventually overwhelm the public programs, which would eventually dissipate into desuetude: Eventually, nobody in his right mind would stick with the lousy government plan, when he has the option of a much better private plan for the same money.

But of course, accepting that argument means accepting the corollary: The only way that a government option in health care could "complete" with private health-insurance (group or individual) would be for the government "option" to cheat... to take unfair advantage of the fact that the federal plan gets to write the rules for its competitors -- and it gets to operate at a loss so catastrophic, it would bankrupt any private company.

So Democrats have shot themselves in their own petard. Let's call their bluff by proposing an increase of liberty in areas of government monopoly to balance out the Democrats' demand for more totalitarianism in areas dominated by the private sector. Fair enough?

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

Hatched by Dafydd on this day, August 19, 2009, at the time of 6:18 PM | Comments (5) | TrackBack

August 16, 2009

Co-Opting the Government "Option"

Health Insurance Insurrections
Hatched by Dafydd

It's a signal victory, though more symbolic than substantive: President Barack H. Obama has reportedly backed down from his government "option" plan for ObamaCare. But what is already being flogged in its place, health-insurance "cooperatives," may end up nearly as bad.

The key question is whether they will be subsidized by the government (federal, state, or local) -- either directly by continual funding or by the Amtrak mechanism of repeated bailouts every time they fall short of break-even. If they end up government funded, they'll still have the government-option effect of forcibly shifting employees from private to co-op:

Bowing to Republican pressure and an uneasy public, President Barack Obama's administration signaled Sunday it is ready to abandon the idea of giving Americans the option of government-run insurance as part of a new health care system.

Facing mounting opposition to the overhaul, administration officials left open the chance for a compromise with Republicans that would include health insurance cooperatives instead of a government-run plan....

Under a proposal by Sen. Kent Conrad, D-N.D., consumer-owned nonprofit cooperatives would sell insurance in competition with private industry, not unlike the way electric and agriculture co-ops operate, especially in rural states such as his own.

With $3 billion to $4 billion in initial support from the government, the co-ops would operate under a national structure with state affiliates, but independent of the government. They would be required to maintain the type of financial reserves that private companies are required to keep in case of unexpectedly high claims.

The problem is structurally similar to the government option: If co-ops are allowed by law to operate at a loss or subsidized whenever they lose money, they can always undercut any private health-care plan; thus, employers will feel irresistable pressure to force all employees into the co-op plan... and in effect, you have a mandatory government "option" by proxy.

As a thought experiment, take the very example AP cites above: Imagine if food co-ops were allowed to operate at a loss and were continually replentished by tax money; this would give them cover to sell food at such artificially low prices that the free market could never compete. Eventually, private grocers would be driven out of business, and the government -- operating through its stalking-horse co-ops -- would be the sole provider of provender... a situation fraught with peril: Whenever government gains a monopoly, it introduces political considerations into the decision of who is allowed access to that product or service, whether food or health care.

However, if the health-insurance co-ops are not subsidized, and especially if mismanagers are allowed to go bankrupt and disappear, that would be a huge improvement in the bill. That change would likely prevent the wholesale destruction of private insurance that the government "option" would otherwise work.

That said, it bodes ill that these co-ops are already set to receive subsidies right at the very beginning, with "$3 billion to $4 billion in initial support from the government." Alas, I suspect this is non-negotiable by the Left; but if it's limited to just that one time -- if! -- the market distortion would not be insurmountable.

Under the government option, continual subsidy is guaranteed, because the federal government cannot "go out of business." It remains to be seen if the Democrats are serious about allowing a private, market-based insurance industry to flourish, or whether they see co-ops as just a ruse to trick the notoriously gullible (and frequently craven) Republicans into supporting a stinkweed by any other name. Therefore, this too bodes ill:

"I think there will be a competitor to private insurers," [Health and Human Services Secretary Kathleen] Sebelius said. "That's really the essential part, is you don't turn over the whole new marketplace to private insurance companies and trust them to do the right thing."

Sebelius, a Democrat and the former governor of Kansas, is not even one of the more rabid members of the Obama administration; yet her attitude clearly seems to be that government control of health care is the default position, whence she reluctantly allows some private participation -- if we really have to. After all, we certainly can't turn the free market over to private companies! How can we trust them to "do the right thing" -- that is, to kow-tow to the same political considerations that drive the federal government? (For example, how could we trust private insurance companies to mandate coverage for late-term abortions, "gender reassignment surgery," drug-addiction treatment, Octomom fertility treatment, and of course, copious donations to Democratic candidates?)

This is 180-degrees (or π radians) off what we need; the default should always be a pure free market, with only occasional and slight deviations when absolutely necessary... for example, to avoid violating the First Rule of Health-Policy Political Reality: "If voters have to step over dead bodies to get to the polling place, it affects their vote."

What we desperately need now is for GOP senators to show enough spine to insist, as a deal-breaker, that the co-ops be real not-for-profit corporations; that they receive no subsidies, directly or indirectly, from the government (after startup); and most important, no government protection from bankrupcy: If a health-insurance co-op cannot stay afloat -- we let it sink. Outstanding claims can be handled as they would in the case of a for-profit insurance company that goes out of business.

Co-ops already enjoy the heavy advantage of not having to show a profit; the way that private companies compete is by offering a wider range of plans, so that the co-op becomes the insurer of last resort... not the insurer of first resort. If they are turned into de facto conduits for full federal funding, they will be every bit as bad as the government option.

In fact, they may even be worse; the co-ops will have the forged "nihil obstat" of the free market. When things deteriorate rather than improve, Capitalism will be blamed -- leading to anti-market hysteria and even more repressive statism.

We already have a model for that vicious circle: Massive government intervention into the airline, telephone, and energy production industries, sailing under the false flag of "deregulation," usually fails spectacularly; when it does, that failure is invariably used as ammunition for a massive government clampdown to "fix" the problem that government itself created.

We dare not let such a spasm of statism drive us into the loving tentacles of government-controlled health care.

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

Hatched by Dafydd on this day, August 16, 2009, at the time of 4:38 PM | Comments (5) | TrackBack

August 14, 2009

When the Joker Hits the Fan

From Bad to Verse , Health Insurance Insurrections , Liberal Lunacy , Obama Nation
Hatched by Dafydd

Say, maybe this can be the marching song of the New Sons and Daughters of Health-Care Liberty...!

When the Joker Hits the Fan

by Dafydd ab Hugh

(Can be sung to the tune of "Bad Moon Rising")

I see Obama Jokers risin’
I see those posters all around
Sure seems politically surprisin’
Must mean approval’s hitting ground

Don’t think I’m the man
For your socialistic plan
When the Joker hits the fan

Health care is something quite important
Health care is something we all need
Town halls, if they’re a potent portent,
Folks hate ObamaCare indeed!

Don’t think I’m the man
For your socialistic plan
When the Joker hits the fan

Looks like quite a change in weather
Must be the winds of liberty
Liberals are blowin’ round like feathers
Town halls have speech that’s finally free

Don’t think I’m the man
For your socialistic plan
When the Joker hits the fan

Take back your governmental mandates
Taxes that sink us like a stone
Don’t think we’re all a bunch of ingrates
We just prefer to choose our own

Don’t think I’m the man
For your socialistic plan
When the Joker hits the fan

We don’t need government to guide us
We’re not just “public option” cogs
We don’t need senators to chide us
We won’t throw Granny to the dogs

Don’t think I’m the man
For your socialistic plan
When the Joker hits the fan...

When the Joker hits the fan

© 2009 by Dafydd ab Hugh

Hatched by Dafydd on this day, August 14, 2009, at the time of 8:21 PM | Comments (0) | TrackBack

Sarah Palin: Whipping Girl of Left AND Right

Health Insurance Insurrections , Media Madness
Hatched by Dafydd

Proving yet again that literacy may be overrated, now it's the Washington Times -- not the Post, the Times! -- which absurdly misinterprets what Sarah Palin said about ObamaCare "death Panels"... even after she explained, very clearly, exactly what she meant (incidentally vindicating the last two posts in this series by Big Lizards):

Like Mr. Dick's obsession with "poor king Charles' head" in Dickens' David Copperfield, the Times cannot break free from the patently erroneous conclusion that Palin could only have been talking about the "end of life care" counseling... as if that were the only possible way that health-care rationing could enter the equation.

Worse, the writer, Jon Ward, uses deliberately misleading rhetoric to falsely imply that Palin accused Dr. Ezekiel Emanuel (Rahm's older brother) of espousing literal "euthanasia" -- a charge so easily dismissed that its only function is to discredit the target... like accusing Palin of believing there's a Boogieman under her bed:

Mrs. Palin has been widely panned by independent fact-checking groups for her talk of "death panels." Her attacks on Dr. Emanuel have led to charges that he is advocating euthanasia.

Claiming that Palin said the House ObamaCare bill includes provisions for "euthanasia" is more or less like claiming -- well, like claiming she said that she can see Russia from her house: It's not a serious charge; it too is just a punchline.

Note the sly phrasing -- Palin's attacks "led to charges;" charges by whom? I've seen nobody accuse Emanuel of euthanasia; I have only seen people accuse Palin of accusing Emanuel of euthanasia. And now TWT joins that disreputable, accusatory brigade.

Mrs. Palin derives the idea of "death panels" from a provision in a bill under consideration in the House that would give doctors financial incentives to give counseling sessions on end-of-life care to older patients. Mrs. Palin's charge is that while the sessions are technically voluntary, physicians can and will initiate the conversation and senior citizens will be pressured to accept "minimal end-of-life care" because the sessions are "part of a bill whose stated purpose is 'to reduce the growth in health care spending.' "

Oh, the damage caused by that dolt, Sen. Johnny Isakson (R-GA, 76%), who listened to his inner "anonymous phone caller," rather than simply reading what Palin actually wrote.

That said, Ward's error is partially mitigated by bringing a new admission from Emanuel to the story: Ezekiel Emanuel now admits that he did indeed advocate a deliberate policy of rationing in the past, though he says he no longer believes that today:

Dr. Ezekiel J. Emanuel, the White House official targeted by Sarah Palin and other conservatives as an advocate for health care rationing and "death panels," said Thursday his "thinking has evolved" on the need to decide who gets treated and who does not.

"When I began working in the health policy area about 20 years ago ... I thought we would definitely have to ration care, that there was a need to make a decision and deny people care," said Dr. Emanuel, a health care adviser to President Obama in the Office of Management and Budget, during a phone interview.

"I think that over the last five to seven years ... I've come to the conclusion that in our system we are spending way more money than we need to, a lot of it on unnecessary care," he said. "If we got rid of that care we would have absolutely no reason to even consider rationing except in a few cases."

This is important to highlight, as is the fact that Newt Gingrich -- and even more important and thoughtful philosophers, such as Big Lizards -- agrees with Palin that the House bill inevitably leads to health-care rationing. But let's return to those thrilling days of yesteryear (rather, yester-day) and see what, exactly, Mrs. Palin really said...

In her first Facebook posting, she made it quite clear what she was actually saying -- Sen. Isakson notwithstanding:

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

One might argue that by personalizing the "death panel" claim to include the phrase "stand in front of Obama's 'death panel'," Palin contributed to the misunderstanding; obviously, Medicare patients do not literally stand in front of a MedPAC (Medicare Payment Advisory Commission) panel today, nor would ObamaCare patients literally stand in front of an "ObamaPAC" panel. This might have been a (feeble) excuse before yesterday; but after Palin's widely reported and circulated (and heavily footnoted!) second Facebook post explaining her earlier post, there is no excuse for misunderstanding. Its substance begins and ends thus:

Yesterday President Obama responded to my statement that Democratic health care proposals would lead to rationed care; that the sick, the elderly, and the disabled would suffer the most under such rationing; and that under such a system these “unproductive” members of society could face the prospect of government bureaucrats determining whether they deserve health care....

Of course, it’s not just this one provision that presents a problem. My original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama and the brother of the President’s chief of staff. Dr. Emanuel has written that some medical services should not be guaranteed to those “who are irreversibly prevented from being or becoming participating citizens....An obvious example is not guaranteeing health services to patients with dementia.” Dr. Emanuel has also advocated basing medical decisions on a system which “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.”

In addition to making sure folks understood her original point -- that ObamaCare leads inexorably to medical rationing (triage!) -- she also responded to President Barack H. Obama's dismissal of the "end-of-life" counseling provisions of the House bill. She had to... because in the process of misunderstanding her original point (intentionally or un-), Obama also told some whoppers about the very provision that he falsely connected to Palin's point.

This part of Palin's argument occupies the middle section of her second Facebook post; I excerpt a bit here:

The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation.” With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.

Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often “if there is a significant change in the health condition of the individual ... or upon admission to a skilled nursing facility, a long-term care facility... or a hospice program." During those consultations, practitioners must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services.

Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care? As Charles Lane notes in the Washington Post, Section 1233 “addresses compassionate goals in disconcerting proximity to fiscal ones.... If it’s all about obviating suffering, emotional or physical, what’s it doing in a measure to “bend the curve” on health-care costs?”

These are all excellent points, and almost unanswerable; but they are ancillary to her original post, and Palin makes that very clear in her follow-up post. Clear, that is, to everybody except those who insist upon opining about posts they have never even read -- Isakson -- and those who give undue deference to subliterate slanders slung by Palin critics who never met an accusation they didn't repeat... even when its provenance is some unnamed telephone caller at some undisclosed venue.

Even when the original is still there, on Palin's Facebook page, where anyone who is willing can read it.

Hatched by Dafydd on this day, August 14, 2009, at the time of 6:54 PM | Comments (3) | 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 12, 2009

Attn: Johnny Isakson... Please Call Your President!

Health Insurance Insurrections , Obama Nation
Hatched by Dafydd

Yesterday, we wrote about Sen. Johnny Isakson's (R-GA, 76%) lunkheaded misunderstanding of Sarah Palin's "death panel" remark: In his anti-Palin hysteria, he imagined she was talking about "living wills" and the "end of life directive." Isakson thought that Palin was saying those amounted to euthanasia -- when in fact, she was talking about the health-care rationing that inevitably results from a single-payer, government-run system... which itself is the inevitable and intentional end result of the putative government "option."

It was an incredibly humiliating mistake for Isakson, exacerbated by its provenance: Isakson never even troubled to read what Palin herself actually wrote on her Facebook page, relying instead on the caricature by an anonymous telephone caller. (Perhaps Isakson should be made to sit in a corner of the Rotunda with a conical dunce-cap on his head, and write a hundred times on the chalkboard, "I will not rely upon unknown third parties when a primary source is available.")

I read a fantabulous Power Line post yesterday that accurately explained what Palin was talking about; alas, I cannot give credit either to John Hinderaker, my favorite blogger on my favorite blog, because the best part of the post was written by an unnamed "knowledgeable reader" corresponding with Hinderaker:

[S]o the only choice is limiting choice and quality....and that in turn requires a de facto single payer accomplished through the subterfuge of dictating the terms of "private" insurance, turning them into all but public utilities, engineering the transfer to the "public option" over a relatively short period of time, and then dictating payment terms to providers through rate setting, service bundling and, most important in this context, the MedPAC council which will determine "quality-adjusted effective" treatment protocols. The net effect is that an elderly person won't get a hip replacement or a coronary bypass....and will have nowhere --- in the US --- to turn.

The disingenuousness of the left on this point is breathtaking. Perhaps some are just too stupid to get the point....but the issue is NOT euthanasia, living wills etc....that's a pure straw man however insidious the proposal is and however dishonest they have been in covering it up or describing it. The real issue is the MedPAC council....there won't be any actual "death panel" adjudicating case-by-case....there won't need to be!....the MedPac council will set up criteria and rules, more or less in secrecy....rules determined by "experts" and by design removed from Congress to prevent pressure to approve expensive protocols at the end of life....or for "life unworthy of life"....a faceless bureaucracy with a maze of rules will simply be built into the system....diffused responsibility, nobody accountable, just the way it will be, no one can do anything about it.

Well, yeah. What Mr. Anonymous said.

MedPAC -- the Medicare Payment Advisory Commission -- already exists; it was created in 1997 by the Balanced Budget Act of that same year. Its purpose, in its own words, is "to advise the U.S. Congress on issues affecting the Medicare program."

The Commission's statutory mandate is quite broad: In addition to advising the Congress on payments to private health plans participating in Medicare and providers in Medicare's traditional fee-for-service program, MedPAC is also tasked with analyzing access to care, quality of care, and other issues affecting Medicare.

MedPAC sets a government-enforced price-control system for doctors and hospitals. It's important to understand that medical providers lose money on Medicare reimbursements, which they're forced by law to accept; they make it up by jacking up charges to all other patients. If they didn't have the lifesaver of non-Medicare, non-Medicaid patients on private insurance plans, many doctors, medical groups, and even hospitals would have to shut down, because they simply couldn't afford to practice medicine: We would have fewer health-care providers.

Under the House bill, patients shunted into the "goverment option" will be treated the same as current patients in Medicare; this requires exactly the same sort of price-control commission -- whether called MedPAC or by any other name, say ObamaPAC -- to make the same sort of decisions:

To decide payments to private health plans participating in ObamaCare and providers in ObamaCare's traditional fee-for-service program; and to analyze access to care, quality of care, and other issues affecting ObamaCare.

Get it? When ObamaCare engorges itself, like the Blob, to engulf and devour all health care, then the new ObamamPAC will make all decisions on what treatments will be covered. An unelected handful of wise men will pick and choose what medical treatment and procedures you and I and everyone else is allowed to receive.

(Everyone but presidents, senators, and congressmen, of course; they will always have their own system -- with unlimited treatment, no premiums, and no deductable -- at least, none paid by top federal officials; it will be our generous, if involuntary gift to the One and his minions.)

As demand for medical care skyrockets ("it's freeeee!"), and as the number of doctors and hospitals plummet, we will no longer have enough doctors to provide all that demand. Since prices will be controlled by ObamaPAC, the only remaining solution will be rationing, literal rationing. As in, no hip replacements for Granny, no expensive long-term care for Down Syndrome babies, and suchlike.

When Sarah Palin warned of "death panels," she was talking about the miserly ObamaPAC commission, staring at a staggering mismatch between demand and supply, deciding what care will be allowed to which class of patient -- not that stupid end-of-life counseling directive.

Well, today we have two followups: First, another charter member of the Duncecap Delegation, Ricardo Alonso-Zaldivar of the Associated Press; and second, a perfect illustration of exactly what Sarah Palin meant -- and why she was right all along.

In AP's inaptly labeled "FACT CHECK," Alonso-Zaldivar smirks that there is no "death panel" in the House ObamaCare bill -- as if he expected to find a title or section with the name DEATH PANEL, and that its absence is ipso facto proof that Palin is an idiot. But he ruins his own flame by making (you guessed it) the exact, same mistake that Isakson made:

Former Republican vice presidential candidate Sarah Palin says the health care overhaul bill would set up a "death panel." Federal bureaucrats would play God, ruling on whether ailing seniors are worth enough to society to deserve life-sustaining medical care. Palin and other critics are wrong.

Nothing in the legislation would carry out such a bleak vision. The provision that has caused the uproar would instead authorize Medicare to pay doctors for counseling patients about end-of-life care, if the patient wishes. Here are some questions and answers on the controversy:

Q: Does the health care legislation bill promote "mercy killing," or euthanasia?

A: No.

Q: Then what's all the fuss about?

A: A provision in the House bill written by Rep. Earl Blumenauer, D-Ore., would allow Medicare to pay doctors for voluntary counseling sessions that address end-of-life issues. The conversations between doctor and patient would include living wills, making a close relative or a trusted friend your health care proxy, learning about hospice as an option for the terminally ill, and information about pain medications for people suffering chronic discomfort.

The Q&A drones on and one, smugly lecturing the (presumably moronic) Sarah Palin -- and everyone else worried about ObamaCare -- that there is absolutely no cannibalism in the British Royal Navy (kudos and a self-administered backpat to anyone who gets the reference).

I hate to tell Mr. Alonso-Zaldivar... oh, who am I kidding? I love telling him! I rejoice in giddy glee to inform Mr. Alonso-Zaldivar that it is he, not Sarah Palin, who is the dumbass here... because she was not talking about euthanasia, the end-of-life counseling directive, or living wills. She probably has a living will. She was talking about -- exactly this, from Bloomberg:

President Barack Obama said his grandmother’s hip-replacement surgery during the final weeks of her life made him wonder whether expensive procedures for the terminally ill reflect a “sustainable model” for health care.

The president’s grandmother, Madelyn Dunham, had a hip replaced after she was diagnosed with cancer, Obama said in an interview with the New York Times magazine that was published today. Dunham, who lived in Honolulu, died at the age of 86 on Nov. 2, 2008, two days before her grandson’s election victory....

Obama said “you just get into some very difficult moral issues” when considering whether “to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill.

“That’s where I think you just get into some very difficult moral issues,” he said in the April 14 interview. “The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health-care bill out here.”

Speaking later in the same interview about a different subject, banking regulations, Obama said the following:

Obama also said his economic advisers aren’t constrained by ideology or connections to former Treasury Secretary Robert Rubin. “What I’ve been constantly searching for is a ruthless pragmatism when it comes to economic policy,” he said in the interview.

That is precisely what Americans of all ages, political persuasions, and economic conditions are frightened of, what drives the anger and anguish at town-hall meetings, and what has ground polling support for ObamaCare into the dirt: We fear that when health-care policy becomes "economic policy," due to vastly increased government meddling, leading at last to a complete federal takeover of health care, "ruthless pragmatism" will push ObamaPAC to deny Granny her hip replacement, because she's going to die soon anyway.

It may start by throwing only the terminally ill under the bus (as if that itself were morally acceptable); but when ObamaPAC is mugged by economic reality, it will end by throwing us all under those same wheels... just as similar councils have done in every other country that implemented government-run, government-controlled health care, from Great Britain, to Canada, to Japan, to most of Europe, to Cuba, to China, to the old USSR -- and the "new" Russia.

Is this starting to sink into the brains of U.S. Sen. Johnny Isakson and Ricardo Alonso-Zaldivar of the Associated Press? It's certainly already percolating through the brains of most Americans (excuse me, mobs of fascist thugs toting Nazi paraphernalia and intimidating the poor victims in the Service Employees International Union)... which is why they're showing up in droves to town-hall meetings, demanding that their representatives listen to them and not vote on either the House or Senate bill... that Congress tear it up and start over. (And I have a suggestion of how, exactly, to "start over.")

Sadly, our congressional "leaders" are neither leading nor even following their constituents; the Democrats who control Congress and la Casa Blanca have chosen instead to get in the way of real health-care reform.

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

Hatched by Dafydd on this day, August 12, 2009, at the time of 6:07 PM | Comments (1) | TrackBack

August 11, 2009

Isakson Aims at Palin, Hits Own Foot

Health Insurance Insurrections , Pompous Pedantry
Hatched by Dafydd

Recently, Sen. Johnny Isakson (R-GA, 76%) offered a succinct "debunking" of a recent Facebook comment by Sarah Palin anent ObamaCare: He said Palin's take was "nuts."

This was immediately picked up by numerous lefty sites, including ThinkProgress and the Hufflepuffington Post, of course; but recently, even some very anti-liberal friends of mine (who already dislike Palin) have quoted Isakson's brilliant counterargument as if it were definitive... and that this proves Palin really is nuts.

But has any of them personally looked into her claims, compared them to Isakson's counterargument, and decided which is correct? I doubt it; because if anyone had, he would never bring up the humiliating, self-immolating Isakson attack again, and might think a second time before ever using Isakson as an authority on anything.

Not everybody has seen Palin's actual words; you can read the cause of all this hysteria on her Facebook page. The specific paragraph Isakson, et al, refers to is this:

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

Palin only notes what has happened in every other country on Earth that has implemented a single-payer system -- which Barack H. Obama repeatedly stated in the past was his ultimate goal, and which many of his most prominent supporters on ObamaCare say is the inevitable end result of a "government option," as George Will noted last June. Government control never leads to cost savings; Palin quotes Thomas Sowell on this point. Thus, when government finds it cannot pay for what it has promised, it is inevitably driven to health-care rationing.

This has already happened in Great Britain, in Canada, in Japan, and in every other country with socialized medicine: Sooner or later, a government panel must decide who receives health care, and who is told, "sorry, none for you."

  • An 87 year old woman falls and breaks her hip. She needs a hip replacement. The panel decides that it's a waste of scarce resources, because she isn't going to live long anyway.
  • The government-run health-care plan cannot afford to give every baby that needs it expensive incubator medical treatment; so the panel decides that a severely handicapped baby, one not expected to live to see age eight anyway, should not get that treatment, because it's a waste of resources.

This is not speculative; this is what already happens in countries such as Canada, our closest neighbor (not just geographically but culturally). Hence the "joke" (uncomfortable fact put into a humorous context to avoid despair) that the health-care plan of many Canadians is "head south."

So joking aside, what is Sen. Isakson's actual counterargument to Palin's point? This is it, from the ThinkProgress piece linked up top:

[Washington Post’s Ezra] KLEIN: How did this become a question of euthanasia?

ISAKSON: I have no idea. I understand -- and you have to check this out -- I just had a phone call where someone said Sarah Palin’s web site had talked about the House bill having death panels on it where people would be euthanized. How someone could take an end of life directive or a living will as that is nuts. You’re putting the authority in the individual rather than the government. I don’t know how that got so mixed up. [...]

It empowers you to be able to make decisions at a difficult time rather than having the government making them for you.

In the first place, only two people here are "so mixed up," Ezra Klein and Johnny Isakson. Sarah Palin never said "euthanized," and she was not referring to a "living will" or an "end of life directive;" she was referring to health-care rationing, and to the government panel that must eventually decide who receives scarce health-care resources, and who does not.

Why does Isakson so completely misunderstand a very clear and understandable point? The major clue is in his first statement: He gets his entire take on what Palin is saying from "a phone call where someone said..."

He hasn't even read her Facebook post! He's calling Palin "nuts," and accusing her of getting things "so mixed up," and he hasn't even read the Facebook entry he's criticizing.

Is this the authority anyone really wants to rely upon -- a senator who calls the former governor of Alaska insane... based upon what "somebody" told him in a telephone call? Isakson is not really arguing against Palin's position; he is arguing against a caricature of her position that "someone" passed along to him over the phone -- he doesn't even appear to know who.

But what possible counterargument could anyone make to the Palin point... that the "government option" won't eventually push everyone in to government health care? That we, uniquely -- unlike every other country with government health care -- won't end up with government rationing? That rationing won't fall disproportionately on the elderly and the disabled? Who then would be at the short end of the stick -- the hale and hearty young?

Or is Isakson just saying that, while Palin may be perfectly correct, it's unseemly of her to bring up such inconvenient truths? After all, he does support a government option in health-care reform; and there aren't too many logical arguments in favor of that position beyond, "'Shut up,' he explained."

In this case, Palin is simply right, and Isakson is simply wrong; but more than wrong, he is humiliating himself by attacking her sanity and her comprehension -- based upon a ludicrous "mixup" caused by Isakson relying upon a hearsay caricature by "someone" who is obviously hostile to Sarah Palin.

We already know that Democrats have no sense of shame, but does Republican Sen. Johnny Isakson?

Hatched by Dafydd on this day, August 11, 2009, at the time of 3:05 PM | Comments (1) | TrackBack

August 10, 2009

A Commonsense Health Reform Plan

Health Insurance Insurrections
Hatched by Dafydd

First, let's simply list what we need; then we can propose the smallest possible reform that delivers those needs. As a general rule, we should always try the easy, inexpensive, less intrusive reforms before trying any authoritarian, patronizing, socialistic, and irreversible scheme. (Would that the Democrats in Congress believed this... or even the Republicans!)

There are about 46 million uninsured at any one moment; but only 20 million are chronically uninsured because they cannot afford insurance (the "deserving poor," perhaps). The rest are well-to-do people who simply don't buy insurance (often young adults who think they're invulnerable), illegals, people who already qualify for medical assistance but don't bother signing up -- and a huge chunk of people who are simply transiting from one job to another, and will only be uninsured for a couple of months.

The only two problems that attract most people to health-care reform are insuring the chronically uninsured and lowering cost. Fix those, and everybody will be satisfied... except for irredeemable and unrepentant lefties who want equality above all -- even if that means making everybody equally sick and equally miserable.

Ultimate goals

What should a really good health-insurance reform include? At the highest level, it must lower costs -- not just shuffle around who pays for those costs; it must increase choice for the patient and doctor; and it must allow enough capital to flow in order to pay for quality health care (to avoid rationing, either public or private).

More specific goals

We can further break this down into a few points that we know work to promote all three goals:

Portability: You should not forfeit your plan if you switch jobs, or if you switch from being employed by a boss to working for yourself. Employer-based insurance forces many people to stay in jobs they hate, as Charles Krauthammer noted, just to keep their health insurance.

Competition: We already know the only force that can hold costs down to a reasonable level in any endeavor... competition. It's the basis of Capitalism; it defines the market. We must increase, not decrease, the competition between different health-insurance plans.

Individual responsibility: Patients and doctors should decide treatment, not insurance companies, and especially not the government. Similarly, patients must ultimately be responsible for their own health-care decisions -- which includes paying more for better care.

Universal access: (Note -- not the same as "universal coverage.") Nobody should ever be told, "Sorry, your pre-existing conditions prevent you from qualifying for any health insurance from anybody." Insurance must be available for those willing to pay for it. Those who cannot afford it should receive aid -- again, we cannot have people priced out of insurance, because that leads to using emergency and trauma-care centers as doctor's offices.

Fix Medicare and Medicaid: Medical care for seniors and the disabled (Medicare) and for the destitute (Medicaid) should get out of the business of being monopoly health-care providers; they're really bad at it.

No externalities: Health care should not be affected by external considerations unrelated to health care or health insurance.

Now, let's get even more specific, and I think we'll actually have a positive plan, not just anti-ObamaCare talking points.

Action items to achieve specific goals

The first point to understand is this: Nobody has a "right" to health care, just as nobody has a "right" to food or shelter. There is nothing in the Constitution protecting or creating such a right. If you have the right to health care, then you can compel someone else to provide it for you; but we already have a term for the idea that you have the right to force someone else to labor for your benefit: socialism.

We also already know that socialism does not work in the real world... so please divorce the false idea from your mind that health care is a right.

Various government entities have enacted legislation creating such a "right;" but that's a different use of the word. A better way to look at such legislation is that governments conclude that it's very bad public policy -- political suicide, in fact -- to allow people to die of easily treatable injuries, illnesses, and conditions; but it sounds cooler to enact a "right" than just policy... so they improperly use that word.

(I'm sure lawyers would argue that it's just a different use of that word; but it amounts to the same thing.)

Let's call this the First Rule of Health-Policy Political Reality: If voters have to step over dead bodies to get to the polling place, it affects their vote.

Thus the overriding concern in any health-care reform should be that we "do no harm;" that is, let's not make things worse: Let's not end up with more people dying in the streets or more people going bankrupt just because they get sick.

So let's get to the main points...


Portability means just that: The abililty to carry your insurance with you wherever you go. This divorces insurance from the employer and attaches it to the individual... meaning you don't have to worry about getting new insurance if you change jobs, become unemployed, or become self-employed. (Which we should encourage as many people to do as can swing it; that's the future of the wealth creation in civilized countries... more market Capitalism, less corporate feudalism!)

But how do we do this? The easiest way I can think of is to use tax incentives to prod employers to offer defined-contribution (DC) health-insurance plans; that's where, in addition to offering ordinary group insurance, they also offer a plan where they subsidize your private insurance payments up to a defined amount, or a percent of your salary -- paid directly to you.

That insurance would be your personal insurance; if we also make it easier for companies to create group plans that are not bound to employment (see "Competition" below), the DC plans can be group plans as well. And of course, since it's your decision, you can pick anything from a gold-plated plan that covers everything (abortion, sex-mutilation surgery, psychiatric care, weight loss, massages) to a minimalist health-savings account (HSA) plus catastrophic care -- or anything in between. Or you can choose to have no insurance at all, if you post a big enough HSA-style bond to satisfy the minimal requirements of the First Rule.

The benefit to you is that, since you own the insurance, if you move from one job to another, that company will also likely have a DC option -- so you can keep the same policy if you like it. Then it's simply a matter of money: The new job will pay more or less, counting both salary and the specific health-insurance contribution; but that makes it easy to compare one job offer to another.

If you become self-employed, you pick up the premiums yourself, if you want to keep the plan; you don't have to go insurance-shopping unless you want to. And if you become unemployed, but you have savings, you can pay the premium yourself until you get a new job -- which gives you a good incentive to get off your keyster and pound the bricks. (If you're destitute, there will be local, state, and federal assistance programs -- First Rule, and all that.)

A defined-contribution (DC) option is also cheaper for the company, since they no longer must pay to administer the plan for that employee... a staggeringly huge savings. This frees up more capital for the company to offer higher defined contributions in order to lure better employees. Some companies might offer nothing but DC plans.

(Note: employers would have fewer employees in their traditional plans, since some would be in the DC plan; this might increase the rates for those plans. But the relaxed group rules would allow employers to join with other employers to still get good group rates for their traditional plans.)


In theory, the rule of competition should be this: Aside from force or fraud, any insurance company can offer anyone any plan it wants. The First Rule of Health-Policy Political Reality requires us to add one more "aside" -- no Mike Tyson plans that look pretty but fold at the first punch. In political language, that means three requirements:

  1. No insurance company should be able to force people onto its plan, including by "slamming" -- switching people without their knowledge, as long-distance phone companies used to do;
  2. No insurance company shall be allowed to use fradulent inducement to trick people onto its plan, and all insurance-company promises shall be enforceable in a court of law -- with damages if they fail to live up to them;
  3. Nobody shall be "blacklisted" (banned from the insurance pool because of pre-existing medical conditions) or "redlisted" (offered a plan at so exhorbitant a rate that it's de facto blacklisting). Everyone must have access to at least some reasonably affordable medical insurance plan.

Note that you cannot satisfy requirement 3 merely with a "government option," because that violates the basic law of competition: The existence of choice.

In practical terms, that means:

  • Lift the ban on interstate sale of insurance policies. Let anyone buy insurance from anywhere in the United States... or perhaps in the world, provided the company meets the national requirements for solvency and honesty. (The feds should maintain a database of companies that are acceptable options.)
  • Do everything possible to encourage insurers to allow easy creation of group plans along lines other than employees of the same company... say, club membership, trade or technical organization membership, alumni of some university, church-synogogue-mosque membership, subscribers to a magazine or newspaper, and so forth. Any large group should be able to get group rates better than individuals buying insurance entirely on their own.
  • Remove the perverse tax disparity between employer-paid health insurance and self-paid health insurance. Krauthammer suggests taxing employer-paid benefits and rebating that money to the employees for their own insurance; but I dislike getting the government involved. I'd rather just allow every filer to separately deduct the amount he pays for health insurance, even if he doesn't itemize.
  • Guarantee everyone a range of plans from gold-plated to minimalist. This would mostly be covered by lifting the ban on sales; but states might want to ensure that employers offer a DC-option, to ensure that employees aren't locked into a single group plan.
  • Create an "assigned risk" system, similar to automobile insurance, so that every company that offers insurance must accept a certain number of customers who they know in advance are going to cost them money. The insurers will raise their rates accordingly; but competition will keep such raises to a minimum.

The individual-responsibility mandate below will increase demand for insurance, causing upward pressure on rates; but the increased competition causes downward pressure to compensate. There is no way to guess which will "win"... but even if rates go up, it won't be anywhere near the $1.5 trillion to $3 trillion for government-controlled health care.

Individual responsibility

  • Every person legally residing in the country must be able to demonstrate that he or she has the financial resources not to be an undue burden on society.

In practical terms, this means every person must be covered by some sort of plan -- whether it's a typical insurance plan, an MSA plus catastrophic care, or a big, honking MSA of at least as much as a normal plan would pay in a person's lifetime. (Health care for illegal immigrants is a matter for a different post, and would surely have to be part of comprehensive immigration reform.)

Per the Constitution's grant of powers, the mandate should be enforced by the states, who in turn would be goaded by the threat of loss of federal medical revenues -- Medicaid, Medicare, and so forth.

  • Patients, no matter how poor, must bear some portion of the cost for every treatment they get.

This gives every patient a financial incentive to ask, "Is this test or treatment really necessary?" That question will be answered in dialog between the patient and his doctor, with the patient taking into account what his insurance plan covers.

  • Government should neither mandate nor forbid treatment or tests.

If your insurance doesn't pay for it, then it doesn't pay for it. Don't like it? Get a better policy.

  • Doctors should be at risk of losing their licenses to practice medicine if they engage in medical malpractice. But tort reform would prevent minor errors from turning into a Lotto ticket for the patient... or more likely, for his John-Edwards-clone attorney.

This should eliminate "defensive medicine," where doctors order medically unnecessary tests for no purpose other than to stave off a lawsuit if a known and disclosed potential risk causes injury or death. It will also dramatically reduce the cost of medical malpractice insurance, which can cost individual doctors hundreds of thousands of dollars a year, and hospitals and suchlike tens of millions.

Old Doc Krauthammer suggests eliminating medical-malpractice suits altogether, offering instead a pool of money for patients who are injured by faulty medical care, the amount to be decided by a panel of medical experts.

But again, I disagree; I would rather allow such suits, but make the test such that a patient can only recover damages if the doctor used an unapproved treatment without disclosing that fact and the risks inherent in it; or if the doctor delivered substandard care in a treatment, whether approved or not, regardless of any disclosures.

Further, I would ban expert testimony from witnesses hired by either side; the court should hire the expert witnesses from a pool of such, and they should be paid the same no matter which side they end up taking. Maybe give each side a couple of peremptory expert-witness challenges, like they have for jurors, so they don't get stuck with a doctor obviously biased one way or the other.

Universal access

As above, we need an "assigned risk" category for patients with serious pre-existing conditions, similar to what is already done in group plans. In addition, we must maintain some system for helping veterans, the elderly, the disabled, and the destitute obtain insurance, if they cannot afford it.

All of these reforms combined will signficantly reduce the number of deserving poor who are chronically uninsured and underinsured.

Fix Medicare and Medicaid

Those dependent upon state or federal help for medical care should receive the same choice and opportunity as those on any other insurance plan; yet Medicare and Medicaid have proven that federal government is fundamentally incapable of administering an insurance plan. Costs have skyrocketed as treatment nosedives; recipients are treated like dirt and given no options; and care is rationed, either overtly or covertly.

So let's change the whole Medicare model. Instead of thinking of the programs as insurance policies, directly contracting with doctors and hospitals for treatment, let's start thinking of program recipients as if they were in the same insurance-category as federal or state employees. (We include here other government insurance entitlement programs, such as SCHIP.)

That means the programs should function not as insurers, but as employers offering a range of private plans... with one caveat: No federal, state, or local government should be allowed to offer anything other than a defined-contribution (DC) option to Medicare or Medicaid recipients.

Why that constraint? Because if government could pick a private insurer and offer that plan, the opportunities for corruption and mischief would be irresistable. (The VA could continue to offer its own primary care, but long-term care should be put on the same basis as Medicare and Medicaid.)

As George Will wrote back in June -- referring to the "government option" in ObamaCare, but applicable to Medicare and Medicaid today:

Assurances that the government plan would play by the rules that private insurers play by are implausible. Government is incapable of behaving like market-disciplined private insurers. Competition from the public option must be unfair because government does not need to make a profit and has enormous pricing and negotiating powers. Besides, unless the point of a government plan is to be cheaper, it is pointless: If the public option conforms to the imperatives that regulations and competition impose on private insurers, there is no reason for it.

So we do not allow the government to be in the business of directly contracting with care providers. Rather, the plans would pay directly to a private or group insurance plan chosen by the recipient; the amount paid would be calculated to cover most (say 80%) of a typical, low-end insurance policy.

Thus a recipient could simply accept that low-end plan and pay only a very small amount in premiums, plus whatever co-pay is required; or he could pick a more robust plan, pay somewhat more for the premiums, but have better coverage. And in every category of plan, the recipient would have a large number of carriers from which to choose.

This should minimize both corruption and government intrusion and coercion, while capping government spending on several so-called "entitlement" programs -- Medicare, Medicaid, SCHIP, the VA, and so forth. This reform alone would save hundreds of billions of dollars every year.

No externalities

"Externalities" are consequence of economic activities that are experienced by unrelated third parties; but I'm using a slight redefinition of that term: economic activities not directly related to health care that affect its cost. I mean to include such economic activities as filing warrantless lawsuits, the cost of malpractice insurance, politicized government mandates for insurance coverage, bizarre tax disincentives for insurance, and so forth.

As a general rule, such externalities should be removed whenever they are discovered; let the insurance market be affected only by its natural components -- doctors, patients, the amount of coverage sought, medical research and technology, and so forth.

Imagine if people could sue restaurants for selling food that doesn't taste as good as it looks -- and were winning millions. Fantasize that it begins mandating that every restaurant must offer at least twelve vegan dishes on its menu, even if nobody ever ordered them. Suppose that the sales tax rate at restraurants was doubled for parties larger than two people. Do you think that might artificially inflate the cost of eating out and deform the market?

In addition, any reform bill should eschew unrelated amendments -- such as porkbarrel spending (say, money for Lockheed Martin to build 200 more F-35 Lightning IIs), more stimulus funds to ACORN, a vehicle for globaloney nonsense like Cripple and Tax Cap and Trade, banning trans-fats from restaurant menus, and so forth. If these programs are worthy, then put them in their own, separate bills; don't try to piggy-back them onto health-care reform!

And that's it!

I believe these changes would give us tremendous savings; would ensure that everybody, or as near as makes no difference, is insured; and it would do so without squashing the greatest health-care delivery system in the world beneath the invisible foot of the State, without taking choice away from the American people, and without running deficits so big it's almost impossible to visualize them and what they mean. (A $1.8 trillion deficit means that every family of four "involuntarily borrowed" an additional $24,000 this year... but Barack H. Obama spent it all.)

Much of this is in the GOP plan, available -- with a great deal of hair-tearing, tooth pulling, and a lot of time on your hands -- from their website; but it's not as succinct and easily understood as here. (I think it's left over from John S. McCain's presidential run last year.) And I've also added a lot more specifics, such as encouraging "defined contribution" health-insurance plans.

Really, once you break the problem down, it's not that tough to come up with solutions that are both more plausible than ObamaCare and less dangerous. Where are the elected Republicans? Why aren't they out there pushing a unified alternative health-care reform very like this one?

Your guess is probably better, and less charitable, than mine.

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

Hatched by Dafydd on this day, August 10, 2009, at the time of 7:21 PM | Comments (7) | TrackBack

August 6, 2009

Pernicious "Public Option" Polling Peculiarities

Health Insurance Insurrections , Polling Keeps a-Rolling
Hatched by Dafydd

I noted in a post yesterday that in an otherwise coherent poll on ObamaCare, Quinnipiac inexplicably slipped in a Mickey, a bizarrely formulated question on the so-called "public option" or "government option;" as the question was phrased, it strongly implied that the individual insured, not his employer, gets to choose whether to stick with the private insurance his employer currently provides or jump ship for the loving embrace of Uncle Sugar:

23. Do you support or oppose giving people the option of being covered by a government health insurance plan that would compete with private plans?

Support 62%
Oppose 32

Of course, no version of the Democratic health-care plan ever left that choice to the worker; they always put that decision in the hands of the employer -- and then stacked the deck, virtually shoving companies in the direction of government. (Hence the well-founded fear by us gun-totin', swastika-sportin', well-bribed, fishy mobsters, us capitalist-imperialist, running-dog, reactionary disruptors of official government information dispensing at town-hall meetings, that the real goal of ObamaCare is a full, Canadian-style, single-payer health "care" scheme.)

Why stiff the individual in favor of the capo? Because individual choice is messy: People often make "the wrong decision." That's why Democrats have always resisted privatizing Social Security with a ferocitry bordering on hysteria. Paradoxically, it's much easier to push around a company, even a giant corporation, that has so much more to lose by annoying the man in the big chair.

It turns out that Quinnipiac is not alone in the casual creativity with which they describe the government option. Reading through Polling Report's roundup of recent polls on ObamaCare, I came across this question asked by the CBS/New York Times poll of July 24-28, 2009:

Would you favor or oppose the government offering everyone a government-administered health insurance plan -- something like the Medicare coverage that people 65 and older get -- that would compete with private health insurance plans?

Support 66%
Oppose 27

Note the similarity of the responses to both these polling questions, each of which makes it seem as if you, personally, get to decide; could such wording have anything to do with the seemingly overwhelming support for the provision? In yesterday's post, I made the following prediction:

This would be a fairer and more accurate question that I wish they would ask:

Do you support or oppose allowing employers to drop the current private coverage of their employees in favor of a government-run health-care plan?

I suspect the answer to that question, making it clear that the choice belongs to the boss, not the worker-bees, would elicit a very different response from voters.

Polling Report reports many polls (hence the name); some ask a less loaded version of the government-option question than those by Quinnipiac and CBS/NYT. Contrast this question by the NBC News/Wall Street Journal Poll of July 24-27, 2009:

And, thinking about one aspect of the debate on health care legislation: Would you favor or oppose creating a public health care plan administered by the federal government that would compete directly with private health insurance companies?

Support 46%
Oppose 44

That's quite a discrepency -- from 62-32 (30-point gap) and 67-27 (40-point gap) to 46-44 -- a 2-point gap.

And then there is this recent poll by Time Magazine, July 27-28, 2009:

Would you favor or oppose a health care bill that provides for the following?... Creates a government-sponsored public health insurance option to compete with private health insurance plans.

Support 56%
Oppose 36

This shows a wider gap (20 points) than the NBC/WSJ poll; but the Time poll is very skewed to the left on virtually every question; clearly they had a much more liberal respondent pool. (For example, in the Time poll, a plurality of 49% favored "a national single-payer plan similar to Medicare for all, in which the government would provide health care insurance to all Americans" -- !)

But even with such a left-leaning sample, support for this question is significantly lower than support for the similar-but-different question on the Quinnipiac and CBS/NYT polls.

Anecdotally, support for the government "option" has waned in recent months, as more and more American voters understand that it's not a personal option for them but an "option" decided by their employers -- on a playing field that is anything but level. Thus it's hardly surprising that the further back in time we go, the more support we see for this component of ObamaCare. But even back in the Kaiser Family Foundation Kaiser Health Tracking Poll of July 7-14, 2009, in an ambigious wording of the question, we still do not see the high numbers of the two misleadingly worded questions on Quinnipiac and CBS/NYT. Kaiser asks:

Do you favor or oppose this? Creating a government-administered public health insurance option similar to Medicare to compete with private health insurance plans:

July 7-14: Support 59% Oppose 36 (23-point lead)

April 2-8: Support 67% Oppose 29 (38-point lead)

(Note the trendline; in three months, the lead dropped by 40%.)

The punchline is that, as usual, the exact wording of questions often determines the poll result. I am more than ever convinced that with my even more honestly worded version of The Question -- "Do you support or oppose allowing employers to drop the current private coverage of their employees in favor of a government-run health-care plan?" -- opposition would be even stronger, almost certainly a plurality.

Speculation aside, the cold fact is that voters have quite a disparate reaction to the government "option," depending on the wording of the question... that is, depending on how close it is to, or far from, the grotesque reality wending its way through Squeaker Nancy Pelosi's (D-Haight-Ashbury, 100%) House and Majority Leader Harry "Pinky" Reid's (D-Caesar's Palace, 70%) Senate: The more voters know about the actual provision, the more they recoil.

The lesson Republicans should draw from this fact is to keep pounding on this provision until every last voter knows what the liberals are really proposing; don't let Nan and Pinky intimidate us into silence.

And while we're at it, let's shine a light on some of the other widely disliked provisions as well:

  • Taxing the health benefits of working Americans;
  • Taxpayer funding of abortions;
  • Mammoth deficits marching into the future, caused by health-care "reform;"
  • Subsidizing the government plan while hogtying private plans in red tape;
  • And banning all private insurance that is not "qualified" -- where qualified means the plan must duplicate the gold-plated coverage the government will offer (at taxpayer expense)... thus cutting off the ability of the market to compete with the nanny state.

Find out when and where your congressman and your U.S. senators are holding a town-hall meeting; you may have to do a little digging, because after confronting angry voters time and time again, Democrats are probably going to start sending invitations only to registered Democrats (or perhaps only to their own campaign donors). Show up and politely but persistently demand answers to these vital questions.

They're your representatives; you have every right to insist they tell you where they stand... no matter how fishy such unObamic activities may sound to Linda Douglass.

Hatched by Dafydd on this day, August 6, 2009, at the time of 3:50 PM | Comments (2) | TrackBack

August 5, 2009

Light Dawns on Marblehead

Health Insurance Insurrections , Polling Keeps a-Rolling
Hatched by Dafydd

If it seems to you that voters are rudely beginning to awaken to the looming health-care catastrophe that is ObamaCare -- then you're right! At least, so sayeth that well-known bastion of the Vast Right-Wing Conspiracy, Quinnipiac University. (Note to liberals who might read this: That last sentence was a sarcastic jibe, not a fair characterization of that fine institution of higher yearning.)

In a Quinnipiac poll of "2,409 registered voters nationwide," with an MOE of ±2%, here are some of the findings:

  • By 57% to 37%, registered voters say Barack H. Obama should drop health-care reform if it would add significantly to the deficit.
  • By 72% to 21%, voters think the Obamacle is lying to us about the looming deficits caused by ObamaCare.

(Quinnipiac phrases this more politely, of course: "By a 72 - 21 percent margin, voters do not believe that President Barack Obama will keep his promise to overhaul the health care system without adding to the deficit." In other words, he lies in his teeth.)

  • 39% say the plan will "improve the quality of health care in the nation," but 41% say it will hurt the quality.
  • More specifically, only 21% of voters think it will improve the quality of health care they, personally receive, while 36% think it will hurt the quality of care they receive.

Alas, this is yet another instance of the Democrats' best friend... the argument, "It might hurt me personally, but I'm sure it must be helping somebody somewhere!"

I believe this fantasy of an invisible army of losers who must be helped -- even at the expense of the very visible but silent majority of non-losers -- is a direct result of the victim mentality so carefully inculcated into our citizenry from childhood, via relentless propaganda in the public schools. The result is a nation of people who think they, personally, can handle their own affairs better than the government can... but who nevertheless support a government takeover because of all those other people who are helpless.

At least in this case, the nays still outnumber the yeas anent ObamaCare; yet the discrepancy abides.

  • By a 44% to 34% margin, voters think ObamaCare will hurt, rather than help the economy.
  • By 42% plurality to a scant 18%, voters think ObamaCare will make their own, personal health-care more expensive; 33% believe it will make no difference in the cost.
  • Even more astonishing -- voters, by a whopping 66% to 6%, think ObamaCare will increase the taxes they pay. (23% think it won't make a difference.)

The poll contains one ray of sunshine for ultra left-wing Democrats, such as Squeaker of the House Nancy Pelosi (D-Haight-Ashbury, 100%) and Senate Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 70%), and of course the One himself. But even on this question, I believe the favorable response is based upon a fundamental misunderstanding:

23. Do you support or oppose giving people the option of being covered by a government health insurance plan that would compete with private plans?

Support 62%
Oppose 32

Sounds like voters really like that terrible government "option" component... but wait, what exactly did respondents think they were being asked about?

Read the question again: "Do you support or oppose giving people the option...?" I submit the most likely way for respondents to interpret that question is each individual deciding for himself between the government plan or a private plan he has now -- which is not how it will work, of course (as even President Obama has admitted).

Rather, the decision between the current private plan, a new private plan, or the government plan would be made, not by individual employees, but by the boss... and the deck will be stacked in favor of the government plan, giving employers monetary and regulatory incentives to drop their own company's coverage and just pay the feds to do it.

Employees will be forced, willy nilly, to go along with the switch, regardless of their own choices. If a respondent hadn't already heard this, he couldn't possibly figure it out from the Quinnipiac polling question.

This would be a fairer and more accurate question that I wish they would ask:

Do you support or oppose allowing employers to drop the current private coverage of their employees in favor of a government-run health-care plan?

I suspect the answer to that question, making it clear that the choice belongs to the boss, not the worker-bees, would elicit a very different response from voters.

Still and all, excellent polling numbers from Quinnipiac. And more important, the trend is in the right direction; most of these questions were asked on a July 1st poll; and in every case, support for ObamaCare dropped significantly in one month, while opposition skyrocketed.

It appears that the more Democrats and the president explain their "reform" of medical-care coverage, the more they terrify voters. This actually bodes quite well for those of us who believe that in this case, the prescription is more deadly than the disease.

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

Hatched by Dafydd on this day, August 5, 2009, at the time of 7:03 PM | Comments (0) | 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

July 29, 2009

Senate Democrats: Caving - or Bushwhacking?

Confusticated Conservatives , Congressional Calamities , Health Insurance Insurrections
Hatched by Dafydd

AP breathlessly reports that the Democratic leadership has "reached a shaky peace" with the somewhat moderate Blue-Dog Democrats (which AP calls "the party's rebellious rank-and-file conservatives"):

The House changes, which drew immediate opposition from liberals in the chamber, would reduce the federal subsidies designed to help lower-income families afford insurance, exempt additional businesses from a requirement to offer insurance to their workers and change the terms of a government insurance option.

What does "change the terms" mean? A New York Times story clarifies that the shaky peace retains the most odious element of ObamaCare, the government so-called "option" -- which won't be optional at all, if your employer dumps his plan in favor of heavily taxpayer-subsidized government-controlled health care:

While the federal government would still establish and run a new public health insurance program, to compete with insurers, the new entity would not use Medicare rates to pay doctors and hospitals. Instead, the government plan would negotiate rates with health care providers, just as private insurers often do.

On the Senate side of the Capitol rotunda, however, the deal being cut in the Senate Finance Committee omits the government option in favor of "non-profit cooperatives" -- which the shaky House peace also includes... another provision that might undercut private health insurance and employer-offered health insurance, if those co-ops are allowed to operate at a loss, then receive regular bail-outs by the feds (as happens with Amtrack, for example). From AP:

More problematic from the Democrats' point of view is a tentative agreement [in the Senate Finance Committee] to omit a provision in which the government would sell insurance in competition with private industry. In its place, the group is expected to recommend non-profit cooperatives that could operate at the state, regional or even national level.

Let's suppose, for sake of argument, that this is how it's ultimately passed in each chamber and sent to the Joint Committee for reconciliation: The House enacts government-controlled health care plus non-profit co-ops, the Senate only enacts the co-ops. Suppose further, as would almost certainly be the case, that Senate Majority Leader Harry "Pinky" Reid (D-Caesar's Palace, 70%) appoints to the joint committee a strong majority of senators who support the government "option." This would of course result in that provision being reinserted into the joint version of the bill, which is then sent to both chambers of Congress.

Can the resulting bill be filibustered? If not, then of course it will pass; there is no way that Republican senators plus Blue-Dog democrats equals 51 votes against it. But if it can be filibustered, then there is a very good opportunity to kill the bill: If, say, 37 of the 40 Republicans vote against cloture, then it would only take four Blue Dogs to get to 41, which means the best the rest of the Democrats (and the defecting Republicans) can get for cloture is 59 -- which is not enough. I suspect that at least four moderate Democrats in normally Republican states will be afraid to thwart their constituents, so will vote against cloture... knowing that the other Democrats will eventually have to compromise, so there will be a bill -- just not the current bill.

So it's an important question to analyze: Can the bill be filibustered?

Note: We're dealing with the arcana of Senate rules, and I'm out of my depth... as is anybody who hasn't spent his life studying those rules! So I may very well be utterly wrong in my interpretation. Anyone who has actual working knowledge of the Byrd Rule in action, please post in the comments; if necessary, I will change this post -- even if that means the post becomes completely wrong and must be publicly retracted.

In theory, if a bill enacts a provision that was already included in the budget resolution, and if the budget resolution includes "reconciliation instructions" prohibiting amendments and limiting debate, then the bill cannot be filibustered; it only takes a simple majority to enact it. But there is an exception, which I'll get to in a moment.

On April 29th, the Democrats (with no Republican votes) enacted the budget resolution for fiscal year 2010, which begins on October 1st; and they did indeed include health-care reform and "reconciliation instructions":

The budget resolution also includes reconciliation instructions for healthcare and education overhaul proposals, which Republicans lambasted. Under reconciliation, healthcare and education legislation would only need 51 votes, thwarting any Senate filibuster.

At a meeting of conferees Monday, Senate Budget Committee ranking member Judd Gregg, R-N.H., characterized the move as a power grab and likened Democrats to Venezuelan President Hugo Chavez for including reconciliation in the budget resolution. Obama was criticized by some lawmakers recently for shaking Chavez's hand in a visit earlier this month to Latin America.

"I can understand shaking Chavez's hand, but I can't understand accepting his politics, and basically shutting down the minority," Gregg said. "It will harm the final product."

So facially, it would appear the Senate Democrats can "bushwhack" their own Blue Dogs by tricking them into voting for a health-care "reform" bill that does not include government insurance, then sneak it back in during the joint conference and pass it over the objections of Republicans and even the Blue Dogs themselves.

But in that same passage quoted above, Senate Budget Committee Chairman Kent Conrad (D-ND, 95%) opines that he does not believe the nervy tactic will work:

Conrad, who opposed the use of reconciliation to pass major legislation, said he did not believe that healthcare legislation would be written with its use.

"I believe, as people get into it, they will find that it just doesn't work well for that purpose," Conrad said. "I believe health care will be done under the regular order."

What did Sen. Conrad, a Democrat, mean by that? Why wouldn't it work?

There's one potential fly in the Democratic ointment: There is a provision of law called the Byrd Rule which allows, under certain circumstances, any senator to raise a "point of order" and object to any provision of any bill that falls under the reconciliation rule of no filibustering... so long as the Senate parliamentarian determines that the provision violates any one of the six "tests" the Byrd Rule sets up. In such a case, the provision is called "extraneous," and it is stripped from the bill -- unless it's waived by the full Senate. And the Byrd Rule can only be waived by (you guessed it) a cloture-like vote of 60 senators.

In other words, a filibuster is ordinarily not allowed for a bill that is covered by reconciliation; but if a provision of that bill violates the Byrd Rule (any one of the six tests), and if any senator objects to it on those grounds -- and if the parliamentarian agrees that the provision breaks the rules -- then that provision will be stripped from the bill unless 60 senators vote to let it stay.

(The only other person who could stop that process would be the Presiding Officer of the Senate, I believe, who could in theory overrule the Senate Parliamentarian's decision about whether the provision violates one of the Byrd Rule tests.)

The purpose of the Byrd Rule (named after Sen. Robert Byrd, D-WV, 79%) is to prevent the budget resolution being used to shield non-budgetary bills or provisions of bills from filibuster. For example, you couldn't push handgun prohibition or a repeal of the ban on partial-birth abortion through the Senate without being subject to filibuster merely by first including it in the budget resolution, because neither of those has anything to do with the federal budget, except incidentally. (Unless you had a pliant parliamentarian or a tyrannical Presiding Officer of the Senate.)

Here are the six tests:

Byrd rule tests - Section 313(b)(1) of the Congressional Budget Act sets forth six tests for matters to be considered extraneous under the Byrd rule. The criteria apply to provisions that:

  • do not produce a change in outlays or revenues;
  • produce changes in outlays or revenue which are merely incidental to the non-budgetary components of the provision;
  • are outside the jurisdiction of the committee that submitted the title or provision for inclusion in the reconciliation measure;
  • increase outlays or decrease revenue if the provision's title, as a whole, fails to achieve the Senate reporting committee's reconciliation instructions;
  • increase net outlays or decrease revenue during a fiscal year after the years covered by the reconciliation bill unless the provision's title, as a whole, remains budget neutral;
  • contain recommendations regarding the OASDI (social security) trust funds.

In the case of ObamaCare, the two important tests are numbers four and five, highlighted above in blue: If the government-option provision increases spending (which of course it does) and the ObamaCare bill as a whole fails to conform to the instructions in the budget resolution; or if the government-option provision continues to increase spending even after the period covered by the budget resolution (ten years) -- unless the entire ObamaCare bill can be shown to be "budget neutral" -- that is, it doesn't increase the deficit any more than the budget resolution allows it to do.

But here is the problem for Democrats: In order to shoehorn the government takeover of health-care into the budget resolution last April, they had to declare that it would pay for itself... that ObamaCare would be deficit neutral. From the House Committee on the Budget "fact sheet:

Assumes Health Reform Will Be Paid for so that it Does Not Add to the Deficit -- Our budget leaves it to the authorizing committees to determine both the policy and how to pay for health care reform.

So any provision of ObamaCare that spends money is subject to the Byrd Rule, unless (a) the Democrats can get the Congressional Budget Office (CBO) to declare that, contrary to their earlier claim that the bill would add an extra several hundred billion dollars to the deficit, it's really going to add nothing at all to the deficit; and (b) that the provision in question won't cost a dime beyond the year 2020.

Each of these assertions would be risible, of course; the bill grossly expands the deficit, and the provision in question will require spending for as long as it exists. Since the Democrats certainly don't want to enact ObamaCare with a "sunset" clause, so that it automatically ends after ten years, they're going to have to live with the Byrd Rule.

I do not believe that the CBO will go along with either of these preposterous fantasies... in which case, as soon as the bill comes back from the joint committee, and the Democrats try to claim that under reconciliation, it cannot be filibustered, any single Republican -- Minority Leader Mitch McConnell (R-KY, 80%), for example -- can rise to a point of order, object to the goverment "option" and any other odious measure under the Byrd Rule, and force a vote where the Dems need to get 60 votes to prevent those provisions being stripped out.

That is what Michael Barone meant yesterday when he said, on Hugh Hewitt's show, that under the Byrd Rule, Democrats will be unable to prevent filibusters of the health-care reform act. That's what Sen. McConnell meant when he said today on the same show that the bill "would be subject to filibuster."

But wait! What if the Senate Parliamentarian, Alan Frumin, simply ignores reality and declares that the Byrd Rule doesn't apply? Sure, in theory he could do that; and in fact, he has been heavily lobbied by both sides of the aisle since it became clear that the Democrats were going to taint the budget bill with reconciliation instructions for ObamaCare, to try to prevent a GOP filibuster.

But according to the Hill, a Capitol Hill newspaper that is considered quite authoritative, if the Democrats expect the parliamentarian to back their partisan power grab, they picked a horse that is backing up the wrong tree:

“I talk to him regularly. He is not looking forward to this,” [former parliamentarian Robert] Dove told The Hill. “All I can tell you is he’s a very good man. He will call it straight. He will make all kind of enemies....”

Both parties are already lobbying Frumin. Democrats on the Senate Budget Committee and Senate aides from both parties have met with him to discuss the Byrd rule, named after initial sponsor Sen. Robert Byrd (D-W.Va.). Frumin told Senate Budget Committee Chairman Kent Conrad (D-N.D.) a few weeks ago that legislation passed through the reconciliation process may end up looking like “Swiss cheese,” because certain provisions of a bill may survive while others are stricken, Conrad said....

“He’s known for being substantively rigorous and he understands the value of precedent,” said Stan Collender, a partner at Qorvis Communications and a former Democratic budget aide. “He’s not likely to just come up with a ruling that’s completely off the wall. He’s known to do his job really well and tries to call it pretty straight.”

The upshot of bottom line of this analysis is that I do not believe the Democrats will be permitted by the parliamentarian to abuse the reconciliation process to jam ObamaCare through the Senate; nor do I believe the Presiding Officer of the Senate would be so reckless as to overrule the parliamentarian... as that might cause Republican and Blue Dog senators to bring the entire body to a screeching halt, thus imperiling not only certain provisions of ObamaCare, but the entire bill, plus every other element of the radical agenda of President Barack H. Obama.

It would also hand a powerfully effective issue to GOP senatorial challengers next year: "Democrats stifle the Senate's own parliamentarian in order to take away your health insurance!"

One way or another, they are going to have to get 60 senators to agree specifically on the government "option," on taxing your health benefits, on employer mandates, and on every other controversial element of the Obamacle's attempted government hijacking of Americans' health care. Further, I do not believe that those 60 votes currently exist, and support will only weaken as we pass into September and October. So I don't believe the Democrats will be able to pull this off.

Hatched by Dafydd on this day, July 29, 2009, at the time of 9:36 PM | Comments (2) | TrackBack

July 1, 2009

With Fiends Like These...

Globaloney Sandwich , Health Insurance Insurrections , Media Madness , Presidential Peculiarities and Pomposities
Hatched by Dafydd

Is the worm beginning to turn the tide?

AP breathlessly writes about President Barack H. Obama's health-care insurapalooza today in Virginia -- but look what they're saying! The tough-love starts with the headline: "Emotion, few details, in Obama's health care pitch"... and it only goes south from there:

  • "The health care changes that Obama called for Wednesday would reshape the nation's medical landscape. He says he wants to cover nearly 50 million uninsured Americans, to persuade doctors to stress quality over quantity of care, to squeeze billions of dollars from spending.

    "But details on exactly how to do those things were generally lacking in his hour-long town hall forum before a friendly, hand-picked audience in a Washington suburb."

  • "Some of Obama's questioners Wednesday were from friendly sources, including a member of the Service Employees International Union and a member of Health Care for America Now, which organized a Capitol Hill rally last week calling for an overhaul. White House aides selected other questions submitted by people on YouTube, Facebook and Twitter.

    "Republicans said the event was a political sham designed to help Obama, not to inform the public.

    "'Americans are already skeptical about the cost and adverse impact of the president's health care plans,' Republican National Committee spokesman Trevor Francis said. 'Stacking the audience and preselecting questions may make for a good TV, but it's the wrong way to engage in a meaningful discussion about reforming health care.'"

  • "'The biggest thing we can do to hold down costs is to change the incentives of a health care system that automatically equates expensive care with better care,' the president said. He said the formula system drives up costs 'but doesn't make you better.'

    Obama did not make specific recommendations for changing the incentive formulas."

  • "Obama said, however, that he is working with the American Medical Association to explore ways to reduce liability for doctors and hospitals 'when they've done nothing wrong.' He offered no specifics for a problem that has vexed the medical and legal industries for decades."
  • "Obama said a government-run 'single-payer' health care system works well in some countries. But it is not appropriate in the United States, he said, because so many people get insurance through their employers working with private companies.

    Still, he again called for a government-run 'public option' to compete with private insurers, a plan that many Republicans oppose."

Each of these points is factually correct, and one might argue that each is neutral; but they are not presented in a neutral way... and astonishingly enough, the spin is entirely anti-ObamaCare.

Even the last point presents the government option as a refutation of his pledge not to push a "single-payer" system, tacitly accepting the well-founded GOP warning that a subsidized and privileged government option will necessarily drive employers away from private plans for their employees, plans that are overtaxed, heavily regulated, and disfavored in a myriad other ways.

The Washington Post was nearly as bad; please pay close attention to the adjectives used in the opening of their story:

President Obama offered today a wonkish defense of his embattled health care reform effort during an hour-long town hall meeting in Annandale that featured seven questions, including one sent in via Twitter and several from a hand-picked audience of supporters.

As the president's health care bill struggles on Capitol Hill, the administration increasingly is seeking to pressure lawmakers with evidence of the public's desire to get something done as well as proof that the health care industry is a stakeholder in -- not an opponent of -- the effort.

The tone sometimes turns neutral, but never pro-Obama. And I nearly fell out of my chair reading this a few paragraphs later:

In the highly stage-managed event, questions for Obama came from a live audience selected by the White House and the college, and from Internet questions chosen by the administration's own new-media team.

Of the seven questions the president answered, four were selected by his own staff from people who submitted videos on the White House Web site or who responded to a request for "tweets" from the administration.

The president called randomly on three audience members. Each turned out to be members of groups with close ties to his administration: the SEIU union, Health Care for America Now, and Organizing for America, which is a part of the Democratic National Committee. White House officials said that was a coincidence.

Yeah, yeah, a "coincidence" -- that's the ticket!

If the president turns to the New York Times for succor, he will be disappointed. Here is a news commentary story on the global-warming bill just passed in the House; the story is written by John M. Broder, and it's found in the Politics section, not among the Op-Eds:

As the most ambitious energy and climate-change legislation ever introduced in Congress made its way to a floor vote last Friday, it grew fat with compromises, carve-outs, concessions and out-and-out gifts intended to win the votes of wavering lawmakers and the support of powerful industries.

The deal making continued right up until the final minutes, with the bill’s co-author Representative Henry A. Waxman, Democrat of California, doling out billions of dollars in promises on the House floor to secure the final votes needed for passage.

The rest of the piece details some of these payoffs -- including a number that are sure to produce screams of anguish and rage from potential Obama supporters, including:

  • Utilities that operate coal-power plants will receive "tens of billions of dollars worth of free pollution permits," as well as "billions for work on technology to capture carbon-dioxide emissions from coal combustion to help meet future pollution targets." Broder notes that the deal was negotiated by Rep. Rick Boucher (D-VA, 84%), "a conservative Democrat from Virginia’s coal country;" that is the only concession to the Times' traditional animus against "conservatives." (When did someone who votes 84% liberal become a conservative Democrat?)
  • A billion dollars of pork for Rep. Bobby Rush (D-IL, 33%) to distribute around Chicago.
  • "Democrats from Southeastern states" got a special deal: reducing the target for getting energy from renewable resources from 25% to 15%, "with states given the ability to reduce it further if they cannot meet the target."
  • More tens of billions of dollars in government goodies for refineries, rural energy co-ops, and a massive expansion of "carbon offsets" that can be sold by argibusiness -- as well as shifting their regulatory burden from the EPA to the "farmer-friendly Department of Agriculture."

I wonder if this change in the media weather has something to do with the Obamacle's sagging approval ratings? Today, Rasmussem Reports has the president's approval down to 54% positive, 45% negative -- which can hardly be called "sky high" anymore -- and with an approval index (percent strongly approving minus percent strongly disapproving) in negative territory, at —1% -- 32% strongly approve, 33% strongly disapprove.

CNN/Opinion Research notes that, although Obama's approval remains high at 61%...

"Since March, Obama's approval rating has gone down one percentage point each month in CNN polls," notes CNN Polling Director Keating Holland.

If that continues for another year...

In the current ABC/Washington Post poll, Obama's approval advantage has dropped from 43 points in February to 34 points in June -- still high, but still shrinking.

Gallup still maintains the fiction that Obama's approval is 2-1 positive; but even they show his disapproval rating rising 20 points since he was inaugurated.

In any event, no matter what the reason, the antique news media have begun to wake from their Obamic torpor: They are finally starting to question the One about his supposed solutions, though they still give him a pass on his own litany of the problems he "inherited" from "the previous administration." (Watch for them to give Barack Obama the credit for winning the Iraq war, because the final pullout will occur on his watch.)

Huzzah. Now let's see some actual coverage of the many, varied, and far more American Republican alternatives to Obamunism.

Hatched by Dafydd on this day, July 1, 2009, at the time of 4:59 PM | Comments (1) | TrackBack

June 23, 2009

Obama Confuses Corruption with Competition. So What Else Is New?

Democratic Culture of Corruption , Health Insurance Insurrections
Hatched by Dafydd

Another question that answers itself:

President Barack Obama on Tuesday squared off with the insurance lobby over industry charges that a government health plan he backs would dismantle the employer coverage Americans have relied on for a half-century and overtake the system....

"If private insurers say that the marketplace provides the best quality health care ... then why is it that the government, which they say can't run anything, suddenly is going to drive them out of business?" Obama said in response to a question at a White House news conference.

"That's not logical," he scoffed, responding to an industry warning that government competition would destabilize the employer system that now covers more than 160 million people.

Wow, that's a toughie: If the free market provides the best quality health care -- then how can feckless, inefficient, corrupt federal government drive them out of business? Here are a few possible answers:

  • By jacking up taxes, administrative fees, and punishing profit on private insurance -- but not government-run health care.
  • By running the government health care at a loss, forcing taxpayers to pick up the difference.
  • By regulating private insurers out of the market.
  • By adding so much red tape to private insurance plans that medical-care approval takes too long.
  • By extorting employers to dump their private plans in favor of the government plan, upon threat of fines, audits, and denial of necessary licenses.
  • By forcing doctors to charge private insurance a premium, under threat of the feds cutting off or reducing Medicare payments if they don't.
  • By seizing control of companies (surely the federal government would never do that!), dumping the private plan, and signing aboard the government plan.
  • By enacting legislation giving unions veto power to block any private health-care plan.
  • By removing a corporate CEO and installing an Obama crony in his place.

Whew! That exercise took all of two and a half minutes.

Next question?

Hatched by Dafydd on this day, June 23, 2009, at the time of 7:31 PM | Comments (2) | TrackBack

June 14, 2009

Let's Beat Something with Something Better! - UPDATED

Health Insurance Insurrections
Hatched by Dafydd

Even though everybody says it, it's still true: You can't beat something with nothing.

So how do Republicans and moderate Democrats beat back Barack H. Obama's plan for the federal government to seize control of all health care -- essentially extending Medicare to the entire country by force of law? By not simply attacking that Socialist Ponzi scheme, but by also offering something better in its place.

What can we possibly offer to solve the health-insurance "crisis?" There are an estimated 45.7 million uninsured. There's nothing, nothing we can do other than hand it all over to the same people who run the TARP bailout program (and the State Department -- they have such a good record of success).

But wait; let's think a second time about this vital issue.

The only driving force behind President Obama's scheme to "reform" (nationalize) American health insurance -- switching to a government-run system à la Great Britain and Canada -- is the problem of the "uninsured." After all, the vast majority of Americans who do have health insurance are fairly satisfied with it and certainly don't want a revolutionary reboot of the entire system.

But by large margins, Americans believe that we have a "crisis" of uninsured. (I believe it's but a minor problem; but in politics, perception is king.)

So what can we do about that Census Bureau number of 45.7 million uninsured in 2007? First of all, we should realize that number includes a very large number of people whose income is far above the poverty line. Appendix B of the linked Census document (p. 53 of the pdf) defines "poverty" based upon total number in the household and the number of children; for a family of 4 including two kids, the poverty line in 2007 was $21,027 per year; you must be a pretty large family (at least five with no more than two kids) for the poverty line to exceed $25,000.

Yet according to Table 6 (pdf page 30) of the same Census document, of the 45.7 million uninsured in the United States in 2007, only 13.5 million (30% of the total uninsured) had less than $25,000 annual income. Amazingly, 17.6 million had more than $50,000 per year -- 38.6% of the total uninsured. In other words, significantly more uninsured have upper-middle incomes or better than live in poverty.

So why the heck don't they have insurance? The "crisis" of the uninsured is not primarily driven by poverty. In most cases, they can afford to buy insurance; they simply choose not to.

With this in mind, the lizards have a modest proposal; we urge the GOP to offer a bill very like this one in place of ObamaCare, forcing the Democrats to brutally suppress it, in full view of the whole country:

  • First, let's start with an indirect federal mandate that every person have medical insurance of some kind.

UPDATE June 14th: Commenter Snochasr makes the point that there is no enumerated power allowing the feds to directly mandate insurance; therefore, I've changed this point from a direct federal mandate to a federalist version: The federal government should make various health-related revenues to the states contingent upon them enacting some form of insurance mandate that meets certain minumum standards.

In the GOP plan, those standards absolutely should not include a laundry list of coverage... that can sink such a mandate quickly. Rather, the federal standard should be very light, allowing each state to create its own plan. That way, some states will do better than others; and the states with overly determined plans will have to face voters eventually. Conservatives can run against those bad plans by pointing to the much less determined -- and more successful -- plans in neighboring states.

Even for a libertarian, which I still consider myself, this isn't too odious a change; a patient who doesn't have insurance at all forces the State (i.e., some other taxpayer) to pay for his medical care anyway... since we're not the kind of society to let people die in the streets from easily treatable injuries, diseases, or conditions. Forcing me to pay for somebody else's stupidity is patently unfair.

(It's especially unfair when the patient with no insurance is also an illegal alien; but that is a subject for another post. We already pay for the health care of illegals, and in the most expensive possible way -- all medical care delivered through trauma centers. We must stop doing so; but again, the American people will not stand for allowing them to bleed to death or die of the flu. It's a complicated enough issue that it deserves its own series of posts on immigration reform in general.)

  • So the feds will bully the states into requiring every resident to have some form of insurance. But what kind? I think the Republican answer should be -- whatever kind each resident wants, from whatever company he wants, so long as it's a qualified, licensed insurance provider that won't just take the money and run. But at bare minimum, a catastrophic health-care policy coupled with a fully tax deductable medical savings account (MSA).

(Again, the feds should not overly determine these state plans; but by setting a very light federal standard, catastrophic plus an MSA, we encourage the states to do the same.)

Therein lies our plan: catastrophic care plus an MSA. Such plans are very, very cheap; but what about people so impoverished, they cannot afford even that? Here's the only major government expenditure in the lizardian policy proposal:

  • For patients who live in poverty as defined by the Office of Management and Budget’s (OMB) Statistical Policy Directive 14, the government pays a significant part, but not 100%, of health-insurance costs, including premiums and/or keeping MSAs "topped off." The requirement that even the poor pay something gives them a greater stake in society.

Note that the government would not offer insurance itself -- no "public option." It would simply pay welfare to the poor, a defined contribution to mostly (not totally) cover the insurance each individual chooses to buy. I believe this would actually result in reduced spending, since with health insurance, the poor could get less expensive treatment than going to the emergency room for every problem.

So the plan comprises an indirect federal mandate; insuring the impoverished by working through the market, not by trying to dynamite it; and the use of catastrophic care and MSAs to insure the uninsured (and the uninsurable).

And that's it. That is all that the feds pay; the rest is mandated by state law, but up to each individual to pay for himself.

So how much would this run? We assume that about 14 million of the 46 million uninsured live in poverty. It's hard to figure an "average" premium cost for catastrophic care, because quotes depend upon each individual. But I have read that catastrophic care in 2004 averaged around $3,000 per year per household (compared to $9,000 for regular insurance). Assuming this is still the same, then in 2008 dollars, that would be $3392.78, according to the Inflation Calculator. So let's make calculation easier by saying $3,500 per year per household.

If we again pick a four-person household as the average, that works out to approximately $875 per (uninsured, impoverished) person per year.

Thus the total premium value would be $875 times 14 million, or about $12.25 billion per year. That's a hefty chunk of change, but it's less than an eighth of the $1 trillion over ten years ($100 billion per year) that Obama estimates his own government-run health care would cost.

(And about Obama's estimates, well, um, I don't exactly trust them. I strongly suspect, as does everybody else -- including ObamaCare supporters -- that such a program would cost considerably more than $100 billion each year.)

But wait, there's more: Somebody must also fill up those MSAs and keep them topped off. If you want, say, $10,000 per household in them, that would be an additional $35 billion; but that's a one-time cost, and you can amortize that over, say, ten years, for an additional $3.5 billion per year.

Then you must keep the MSAs filled. Assuming a continuing cost of perhaps 20% ($500) per year per uninsured, that would be $7 billion per year. The grand total works out to $12.25 plus $3.5 plus $7, or in round figures, a little less than $25 billion per year.

But wait, there's less! Part of the plan is that the feds only pay "a significant part (but not 100%) of health-insurance costs." Even those with incomes less than $25,000 should expect to pay some of the cost themselves; if it's even 15% average, that would reduce the total annual payout to about $20 billion... a tiny fraction of the cost of ObamaCare, even using Obama's own figures.

And the best part is -- the federales would not have to take over America's health care.

Obviously my figures are just estimates, guesstimates even; but they're not out of line. The Republicans can easily rope in some actual insurance experts to find out what premiums insurance companies would charge for such a massive buy (any government purchase should be distributed evenly among all carriers, like "assigned risk" in auto insurance, to avoid even the appearance of corruption).

Then GOP representatives and senators could craft a plan with a completely realistic and accurate price tag that is certainly dramatically lower than socialized medicine. And when combined with allowing all of the insured, above and below the poverty line, to maintain individual control of their insurance and medical care, the plan would be a huge winner with the American voter.

We could sweeten the pot by adding a number of free-market features designed to appeal to the great majority of us who do have health insurance:

  • Making insurance policies portable when we change jobs or move;
  • Creating incentives for insurance carriers and consumers to switch to low-premium, high-deductable insurance coupled with expanded MSAs for anyone who wants that option. Medical savings accounts lower costs, because patients pay for their own minor medical charges out of their MSA, which they must then replentish: When the patient himself is the primary payer, he tends to be a more careful shopper.
  • Creating a national query-friendly database registry of insurance carriers, coupled with software to allow consumers to quickly and easily find their best insurance deal over the web;
  • Allowing Medicare and Medicaid recipients the same range of plans that ordinary insurance consumers have -- "the GOP is pro-choice on health insurance!"

If we did this, then instead of simply being "the party of NO," we'd be the party of options, choices, freedom, and Capitalism. I believe that nearly every single Republican, from a Jim DeMint (R-SC, 100%) conservative to a Rep. Peter King (R-NY, 50%) moderate, would get behind such a proposal.

In fact, the lizardian proposal is so clean and inexpensive (compared to the Obamic alternative), we would probably pick up a number of blue dogs. Imagine the fun of more than half the Senate lining up behind the GOP bill, forcing the humiliated Democrats to filibuster their own Congress. Oh, the humanity!

In any event, we would no longer be trying to beat something wicked with a fistful of nays. Instead, we could go head to head with the Democrats, substance for substance. It is from exactly such principled but unifying proposals that we can build the nucleus of another Contract with America.

Hatched by Dafydd on this day, June 14, 2009, at the time of 2:38 AM | Comments (17) | TrackBack

© 2005-2013 by Dafydd ab Hugh - All Rights Reserved