Tuesday, September 15, 2009

HEALTHCARE

After reviewing President Obama’s remarks on health care in his address to the joint session of Congress, here are my thoughts.

Obama: "There is “agreement in this chamber on 80% of what needs to be done.”

Eighty percent? There may an 80% agreement that certain things need to be fixed, but I think the agreement on how to fix them is substantially less.
DETAILS

Obama: “Nothing in this plan will require you or your employer to change the coverage or the doctor you have.”

Unless the plan you have disappears, or the doctor leaves. That’s already true under the current system, and there’s nothing in ObamaCare that leads me to believe that it won’t get worse, with the “public option” as the plan of next resort.
Obama: “[It will be against the law for insurance companies to deny you coverage because of a preexisting condition ... or ... drop your coverage when you get sick or water it down when you need it most.”

Obama: “[Insurance companies] will no longer be able to place some arbitrary cap on the amount of coverage you can receive ....”

Obama: “We will place a limit on how much you can be charged for out-of-pocket expenses ....”

And every one of these “against-the-laws” will cost additional money. How can they not increase the basic cost?
Obama: “[Insurance companies] will be required to cover ... routine checkups and preventive care ....”

First, it’s already been shown that preventive care does not save money in either the short or long term.

Second, if it covers routine/preventive care, it’s not insurance; it’s prepaid medical care. I have no problem if some folks want to buy prepaid medical care, but what of those of us who want insurance for catastrophic events (like hospitalization)?

Obama: "We’ll creat[e] a new insurance exchange - a marketplace where individuals and small companies will be able to shop for health insurance at competitive prices.”

This is actually a good idea, and one I could agree with if Obama would limit the government role to writing the law allowing private cooperatives to be formed.

For example, I’m a member of the Northern Virginia Electric Cooperative, which supplies electricity to my house. I own it (well, along with thousands of others) and consequently have immediate motive to ensure that it’s well run.

I’m also a member of a number of professional organizations and credit unions who could serve as the “sponsor” of an insurance exchange. In each case, I have reason, responsibility, and means to ensure it would be run to my satisfaction.
Obama: “[F]or those ... who still can’t afford ... [insurance] ... we’ll provide tax credits ....”

Which will have to be paid for by taxes somewhere else. Who? I'll bet that since I'm the one who can (barely) afford insurance, I'll get the "privilege" of paying more for the same service. Give me a reason why I should.
Obama: "[I]ndividuals will be required to carry basic health insurance.”

The auto insurance analogy Obama used is clever, but wrong. States require auto liability insurance - for damage to others. Personal property, collision, and comprehensive are not required (except by the lienholder).

More importantly, how does the administration propose to verify -and enforce - the requirement that every individual has insurance? Never mind the probable invasion of personal privacy; think about this: How many uninsured vehicles are on the road, despite the fact that all cars must be registered with the state to travel on public highways?
LIES AND MISREPRESENTATIONS

In choosing to discuss the "lies and misrepresentations" promoted about Obamacare, the President asserted that with his health care reform, there will be:

“No death panels.”

Of course not. The “death panel” is a metaphor - vivid, it's true - for the certain knowledge that Obama’s health care reform will be resource limited and inevitably rationed.

Our current system already rations health care - by price. So knowing that rationing already exists, the "death panel" question is simply one of "Who gets rationed?"

And knowing what we already know about the government’s efficiency at delivering services, is there any reason to believe that the rationing won’t get worse?

“No insuring illegal immigrants.”

Technically, the statement is true, I suppose, but without an enforcement mechanism - which isn't in the bill before Congress - it’s meaningless.
“No federal dollars for abortions”

So does that mean that the “public option” will cover less than private plans? I suspect that there's a discrimination question yet to be addressed in the "no federal dollars" assertion.
“No ‘government takeover -’ public plan is an option only for those who don’t have [private] insurance.”

Obama [intentionally?] misses the point. The fear is that the “public option” cost will be low enough to encourage employers to quit offering insurance (and insurance companies to quit offering individual plans) and thereby force Americans into a public option plan backed by the federal government (where the risk is lower).
“No taxpayer subsidy for the ‘public insurance’ option.”

Here’s the question: if there’s no taxpayer subsidy, isn’t it almost by definition just another private insurance option? For the answer, look to Fannie Mae and Freddie Mac. Both are obstensibly private corporations, backed by "full faith and credit" of the federal government. Now ask yourself “What was the proximate cause of the housing bust?” Answer: government meddling.
PAYING FOR OBAMACARE

Obama: “I will not sign [a plan] if it adds one dime to the deficit, now or in the future, period.”

If true, then Obama can’t sign the bill he outlined in his speech, as it’s already been scored as not deficit-neutral by the Congressional Budget Office.
Obama: “[M]ost of this plan can be paid for by finding savings within the existing health care system, a system that is currently full of waste and abuse.”

Unfortunately, we’re all too aware that the federal government is bloated, inefficient, wasteful, and pork-laden; so there’s little doubt that savings are potentially there. How much? And can Obama produce them? Produce the savings first; then fund the reform.
Obama: “[M]uch of the rest would be paid for with revenues from the very same drug and insurance companies that stand to benefit from tens of millions of new customers. And this reform will charge insurance companies a fee for their most expensive policies, which will encourage them to provide greater value for the money .”

Okaaaaay. I see two realistic possibilities. One, prices for the ‘gold-plated’ policies go up, or two, the gold-plating turns bronze. The latter seems more likely (and is probably the administration’s preferred option).
To summarize my thoughts, essentially there was nothing new in President Obama's address. Despite his assertion to the contrary ("My door is always open ..."), there was no hint of bipartisanship in his address. His use of phrases such as “scare tactics,” “score short-term political points”, and “think it is better politics to kill this plan” were aimed directly at Republicans and intended to exclude them.

The President doesn’t, can't, or won’t understand that there can be principled opposition to his plan. John Hinderaker had this to say: “I’m not sure whether Obama and his handlers understand how this sort of talk grates on those of us who are not liberal Democrats (a large majority of the country). Debating public policy issues is not ‘bickering.’ Disagreeing with a proposal to radically change one of the largest sectors of our economy is not a ‘game.’ This kind of gratuitous insult – something we never heard from President Bush, for example – is one of the reasons why many consider Obama to be mean-spirited.”

The President’s “cost analysis” simply doesn’t hold water. The CBO has already scored the health care reform as budget-busting, and no amount of smooth-talking is going to change that. As I noted above, if there is so much waste and inefficiency in Medicare/Medicaid, why not wring it out and only then use the savings to fund reform? Arnold Kling had the same thought but was more sarcastic: “Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan ... And if we don’t pass this plan, does he intend to keep the waste and inefficiency, out of spite?”

The answer is “of course he will” simply because no administration or Congress has ever been able to reduce it.

And that’s why Obama's "payment plan" doesn't hold water.

FOR THEE, BUT NOT FOR ME

"One of the clearest messages from the Town Hall forums during the August congressional recess was that people want Congress to be covered by the same health care reform plan they impose on the rest of us.... [A]n amendment offered by Rep. Dean Heller, R-NV, during a House Ways and Means Committee meeting just before the recess began that would have required Members to be covered by the Public Option plan if they approve it for private citizens. Predictably ... the Heller amendment was defeated, with all 21 committee Democrats voting against it. "

Or, in other words: “'The higher taxes, debt payments and interest rates needed to pay for health reform mean lower living standards.' But lower living standards for you are a small price to pay in exchange for more power for the political class — whose living standards won’t be going down at all . . . . "

CABLE NEWS HEADLINES

Just for curiosity, I decided to check the headlines for two cable news websites, FOX NEWS and CNN, to see how they compared. The lists below were taken from screen captures at 11:15 am this morning, September 15. FOX had 19 “top stories;” CNN, 21.

FOX Headlines
- Mullen: More Troops = Victory
- Senate Cuts ACORN Loose
- Closing In on Ivy League Campus Killer?
* 'Cash for Clunkers' Spawns Retail Sales Hike
- Airline Workers Busted on Drug Smuggling Charges
- Israel, Palestinians Guilty of 'War Crimes'?
- North Korea Unwilling to Give Up Nukes, South Says
- Recount Ordered at 10 Percent of Afghan Polls
* Iraqi Shoe Thrower Freed, Claims He Was Tortured
- H1N1 Spreads Long After Fever
- Obama Renews Push for Wall Street Oversight
* House to Discipline Wilson for 'You Lie!' Outburst
- FBI: Watch Out for Bomb Materials in NYC
- Schools on Pledge: You Have Right to Remain Silent
- Teens Sue Team Over 'God Bless America' Ejection
- Tracking Taxes: Unnecessary Earmark Projects Linger
? Baucus Health Bill May Leave Dems Cold
- Iran Nuclear Talks Likely to Be Held in Turkey
- McCain and Graham Hold Town Hall

CNN Headlines
- Student fatally stabbed at Florida school
- Actor Patrick Swayze dies after cancer fight
- Al Qaeda operative reported dead in U.S. strike
* Clunkers drives up retail sales
- 16 hurt after train hits barricade
- Ted's sons: Father 'very good at overcoming ...'
- Is Obama witch doctor image racist?
* Bush shoe thrower says he was tortured
? Don't cut my (public) health care
* Rep. Wilson faces resolution of disapproval
- Dem's 'urine' comments raise eyebrows
- Insurgents blown up by their own IED
- Girl, 8, hides, calls 911 during robbery
- Kanye tells Leno outburst 'was rude, period'
- Kanye gets called every name in the book
- Whitney Houston spills drug secrets
- Del Potro U.S. Open win is 'dream come true'
- 9 photos hooked on a feeling
- Police dog poisoned with anti-freeze
- Woman, 107, fears hubby No. 22 will leave her
- Senators split on approach to Afghanistan

Of 40 stories, only 4 (!) were common to both, and one (marked with question mark instead of the asterisk) I gave the benefit of doubt, since both the FOX and CNN stories were generally about healthcare.

Do FOX and CNN report on the same America?

HARDENING OF THE ATTITUDES

President Obama’s approval index has improved significantly in the last week, from -13 on September 7 to -4 today. It was at -8 on September 10, the day of his healthcare address to a Joint Session of Congress.

The approval chart (updated today), though, shows a distinct hardening of the attitudes. Strong approvals (green) are clearly leveling, at about 30%. Strong disapprovals (red) are still rising, however, and show little tendency to flatten. The worrisome trend for Obama is that the undecideds (black) are continuing to jump ship and move strongly toward disapproval.


The trend lines are almost unchanged from a post earlier this month.

JACKASS

President Barack Obama, a black man, calls Kayne West, another black man, a jackass. ABC reports: “Now THAT’S presidential.”

Imagine that.

Now imagine “President George W. Bush, a white man, calls Kayne West, a black man, a jackass. ABC reports: ‘Now THAT’S presidential.’ ”

I can’t either.

BEWARE THE LIBERAL ARISTOCRACY

Michael Barone: “The lesson I take ... is to be wary when media, university and corporate elites warn that we must change our ways or face disaster 50 years hence, and when they insist ... that the time for argument is over.”
“In our two-party democracy, it never is. And shouldn't be.”

DID YOU FAIL YOUR COMMON SENSE TEST?

Then you might be eligible to run for public office since it appears that failing is a prerequisite. (Look at the direction arrow in the bottom right of the picture.)

DECONSTRUCTING THE MINISTRY OF TRUTH

Victor Davis Hanson: “Nothing is so fatal to a con as boredom. Tragically, when a Rangel, Paterson, Jones, or Obama—all enjoying privileges and successes that 300 million Americans might only dream of—start in on the now accustomed trope, the public turns the channel and sighs ‘Been there, done that.’ And I think they really mean it this time.”

I don’t think the public is “changing the channel” this time. I think they’ve decided to turn the set off.