Category ►►► Health Insurance Insurrections

November 20, 2009

Maritalphobic Democrats Strike Again!

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 (0) | TrackBack

November 7, 2009

Only One GOPsmacked Fool!

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

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

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!

5. 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

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:

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...

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

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!

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...

 

 

Yawn.

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

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

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?

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?

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.

Backwards.

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

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

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

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:

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?

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.

Epilogue

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!

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

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

WWRD?

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

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.

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"

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

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"

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

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")

© 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

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):

• Isakson Aims at Palin, Hits Own Foot
• Attn: Johnny Isakson... Please Call Your President!

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

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!

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:

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

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

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

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.)

Competition

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

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

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:

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

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?

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?

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...

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?

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

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

© 2005-2009 by Dafydd ab Hugh - All Rights Reserved