Monday, March 29, 2010

ObamaCare Fallout

For a program that won't provide any benefits to speak of for four years, it's going to hit people pretty hard.

4Little-Known Health Care Law Provision Is a Budget Buster
"...could cost some Americans upwards of $2,000 a year."

4AT&T to Book $1 Billion Cost on Health-Care Reform
Let's start reforming health care by making providing it more expensive.

Related: The ObamaCare Writedowns

4Now It Can Be Told: Doctor Shortages Coming
Too few doctors + millions of newly insured = doctor shortages.

4The VAT Cometh
How they're going to pay for it all.

Wednesday, March 24, 2010

What's Next?

So the health care reform battle is over. (yeah, right)

Does that mean we get to rest? I wish. We know this batch of Democrats are an ambitious bunch, and now they've got the clock counting down to November (I'll be utterly and completely shocked if they don't lose the House).

So they've got to scratch a few more items off the wishlist before they lose the chance.

This didn't get much attention, but they've scratched one off already: college loans. The health care reform bill also made the federal government the sole provider of subsidized college loans. Why? They're going borrow money and re-lend it at a higher rate and use the profit to pay for health care.

Next? The spectre of "climate change." And immigration. And "financial reform."

Like I said, ambitious.

Tuesday, March 23, 2010

What's Wrong with Obamacare? redux

This is a brief summary of my opposition to ObamaCare, aimed mostly at visitors but hopefully also helpful to regulars. I have written thousands of words over the last year on this topic; I'm going to link to those and other folks, so if you want more detail or explanation, follow the links.

First and foremost, opposing ObamaCare does not mean I'm happy with the status quo. There are very few who don't want to reform our health care system. But ObamaCare isn't the way to do it. Setting aside the fact that most of it is unconstitutional and rips away many of our freedoms, it simply won't work.

It will not rein in health care costs.
The biggest problem we have is that costs are rising at an incredible rate. The biggest culprit is that health care costs are invisible to the patient. We appear to be spending someone else's money.

It will only improve access to medical care in a few years and then only for a little while.
When the benefits kick in (four years after the taxes start), people who didn't have insurance — or good insurance — will be able to go see a doctor when they want or need to. But there aren't enough doctors. And people tend to over-use "free" services. So it will be hard to get an appointment. Fees will go up (supply and demand). Then the government will step in and limit fees. And, like now with Medicare and Medicaid, providers will stop seeing people on these plans.

We can't afford it.
It's "cost savings" is based on accounting gimmicks. Every government program ends up costing more than promised. In the end, the government will have to increase taxes (which we can't afford), borrow money (which we can't afford), or cut services.

It's designed to lead us to single-payer.
Mr. Obama and just about every other major Democrat has said publicly this is supposed to be a first step toward a single-payer system. They can slowly push the system that direction. But the current bill also seems to be designed to fail in that direction — for instance, when doctor's start rejecting people on these subsidized plans because they don't pay enough, the Dems can call this a flaw in the private insurance market that is best fixed by putting everyone into one system.

Everything proposed has been tried somewhere else and failed.
What has been passed and what will be proposed next, it's all been done — whether in a state or another country. It doesn't work.

The latest on Massachusetts here and here.

What will work?
The only thing left is to reconsider the whole concept of health insurance. Why isn't it more like auto insurance — catastrophic coverage? If we ask health insurance to cover less, premiums go down. That savings can be used to pay cash for health care. Patients will be more aware of costs, and providers will have to keep costs in check. It works in eye care. It will work here. And if we still need to subsidize some people's care, we can, but that's in a system that is pushing health care costs down rather than driving them up.

More: Indiana's experience with HSAs

What's Wrong with ObamaCare?

Monday, March 22, 2010

ObamaCare: The Morning After

Barring some miracle preventing the president's signature, ObamaCare is law. What's left to say?

For Democrats, the ends justify the means. We already knew that, of course, but they sunk to new levels in this. The bribes, lies, and backroom deals were amazing to watch. You know it's bad when we feel it was a victory to get them to actually vote on the bill.

We know the truth about "pro-life" Democrats. They are either two-faced or terribly gullible — believing an executive order will accomplish what they couldn't make law and trusting an executive that has broken every promise he's made. Most of all, no matter how pro-life they claim to be, if they vote for Nancy Pelosi as Speaker, they're supporting the radical left's agenda.

We now know that the Democrats are more committed to their leftist ideology than to their constituents. They didn't care that the people didn't want it. They didn't care that it's failed everywhere it's been tried. Their ideology demanded it, so it happened.

This isn't over. They've promised this is only step one. We know they want to go to a full-fledged single-payer system. In fact, I strongly believe they know this thing they've created will fail. I think it's weaknesses are coordinated to make single-payer look attractive. We have more work to do.

Elections matter. The American people put these guys in power, and this is what we got. Hopefully people will see we cut off our nose to spite our face. Hopefully the November elections will reward the Dems for these shenanigans.

There is hope. Many have argued that this bill, once passed, would be almost impossible to undo. And I certainly think we've got to hurry — the longer it lasts the harder it will be to undo. But given the way it was passed and how much we the people said we didn't want it, we may be able to generate enough political will to remove.

If it lasts long enough to start to damage things, the Dems will call for another leftward lurch, but we can remind the public that they said this wouldn't work from the beginning and they shouldn't trust the Dems to fix it.

There is more hope. Yes, life will be harder — higher taxes, lower employment, waits for doctors and procedures, less R&D into medicines and technology — but suffering is good for the soul. Seriously, though, one thing we must remember is that this world, no matter how bad it gets, isn't all there is. Seventy, eighty years and we're done. A drop in the bucket measured against eternity.

Friday, March 19, 2010

ObamaCare: All the GOP's Fault

While we fight the Democratic nightmare that would be ObamaCare, we shouldn't let the GOP off for their part in this monstrosity. If they had seriously addressed health care reform 10 years ago, we wouldn't be in this mess today.

When the Republicans first retook Congress in the 90's, everyone was sick of health care reform, so it's hard to blame them for letting it sit for a while. But they let it sit for 10 years.

That's when they invented Health Savings Accounts, although their version was poorly-executed and little more than a band-aid on our broken system. It was something, but not enough. They let a lot of time pass with no real attempts at changing the status quo.

President George W. Bush made another attempt at getting Congress to make some basic reforms in 2007, but the Democrats were in control by then and were not going let a Republican get any credit for health care reform.

What happened between 2003 and 2007? I mean besides the GOP spending spree.

In November, the Democrats will almost certainly lose at least one house of Congress for what they've done on this issue. And they deserve it.

I'm just not sure the Republicans deserve to replace them.

Thursday, March 18, 2010

Healthcare Headline Ho-down

It’s About Government, Not Health Care
"the governmentalization of health care is the fastest way to a permanent left-of-center political culture"

He's right:
Pelosi: ObamaCare is the beginning of taking America “in a new direction”

Democrats launch ObamaCare bait-and-switch scam
"It revolves around incessantly mentioning only the least unpopular aspects of the legislation."

Mass treasurer slams ObamaCare
A Dem says the "model" for ObamaCare is failing.

The Failure of RomneyCare
"Fifty-six percent of Massachusetts internal medicine physicians no longer are accepting new patients... [For those] who do get an appointment ... the average waiting time is 44 days... [leading to] an increasing number of patients who rely on emergency rooms for basic medical services."

FACT CHECK: Premiums would rise under Obama plan
... meaning costs will too

Walgreens: no new Medicaid patients
When gov't cuts payments, providers can't afford to provide. Hello waiting lists.

Would the Line-Item Veto Ruling Invalidate the Slaughter Rule?
We can only hope.

Tuesday, March 16, 2010

Do HSAs Hurt the Poor and Sick?

Liberals have finally had to admit that conservatives do more than say "no" to health care reform. There are actual ideas — even bills — on the table. I'm pleased to say some of them are even interacting with those ideas.

Jonathan Chait of The New Republic says, "Democrats propose to shift resources from the rich and the healthy to the poor and the sick. Republicans want to do just the opposite."

One idea he hates is health savings accounts (HSA) which, in his words, "give individuals who buy insurance a tax deduction for money they set aside for a high-deductible plan. Since tax deductions are worth more to people in higher tax brackets, and since high-deductible plans appeal more to those with lower medical expenses, the plans attract the rich and healthy, leaving the poor and sick behind."

Health care costs
He's partly right; in the short-term, going to an HSA-based system would not help the poor or the sick, especially those with chronic illnesses/pre-existing conditions. Could we do something to mitigate that? Of course.

Long-term, though, HSAs — no, let's call it what it is, cash. Long-term, only going to a cash-based system will reduce overall health care costs.

Insurance-based systems of one stripe or another have been tried in every corner of the world, and they have failed to control costs. The simple fact is insurance-based health care makes costs invisible to the user. Make costs visible and felt and patients will force health care costs down — or at the very least to flatten out — quite naturally.

We've seen this in eye care and veterinary medicine. It will work here too.

And reigning in health care costs helps everyone.

How HSAs work
But in his indictment against HSAs, I don't think Chait really understands how they work. First, it's not a "tax deduction" but pre-tax money. A minor difference? Yes and no.

The people he's concerned about largely don't pay income taxes, but this will still increase the amount of money they take in on April 15. And pre-tax money, unlike a deduction, decreases your adjusted gross income no matter what — you can still take the standard deduction and there wouldn't be any cutoffs.

The other key feature of HSAs, at least as envisioned by conservatives, is their permanence. Many people have a "flex" account that has to be used or forfeited every year. Money in an HSA would be yours until you die, and then it is inheritable. So you start saving now for health needs in fifteen years. This gives the young and healthy poor the chance to save up for when they get old and sick.

What about the poor?
I think Chait underestimates how many this can help. Employers who can't afford conventional health insurance could still afford to put a little into your HSA. The same goes for those who don't make enough to buy their own insurance — at least they can put a little in an HSA.

But maybe there would be people who can't put enough back to pay for their medical expenses. Don't we already have a system to deal with that? Most people accept that there is and must be some kind of social safety net. Can we fund HSAs for the poor much like the food stamp debit cards? Could we subsidize care for sudden expenses or chronic diseases?

Of course. That some people might need help under this system doesn't mean it isn't the best option for controlling health care costs long-term.

It is the best option. So far, it's the only option.

If you've got a better idea, we'd love to hear it.

Monday, March 15, 2010

Daylight Saving Time and Gov't Wisdom

Are you suffering a Daylight Saving Time hangover? I am. Twice a year, but especially in the spring, we all complain about having to adjust to the time change.

Who imposed this upon us? Our government. Why? To save energy.

Does it? Probably not. It made sense back when the biggest household energy use was electric lighting. Now that we rev up the air conditioning when we get home, it's probably counter productive.

On top of that, the DST switch has been shown to increase car accidents and heart attacks and to decrease productivity. Even if it actually saved energy, would it be worth this? Probably not.

Will it ever change? Also probably not.

It's very hard to get Congress to admit to its mistakes. Actually, I don't think they've done it since Prohibition was repealed.

What does this have to do with anything (other than whining about the time change)?

Congress plans to make a massive change to our society. The end result will be to fundamentally alter how health care is provided and paid for in our country.

Their plans have never worked in any country where they've been tried.

They are really bad at recognizing their mistakes.

If we let them do this, we're stuck with it.

Respond as you deem appropriate.

Monday Morning Update

Stories you might have missed over the weekend:

Stupak on Dem opposition to his position:
"If you pass the Stupak amendment, more children will be born, and therefore it will cost us millions more."

The Cost-Control Illusion
"ObamaCare's real cost-control plan boils down to this: First subsidize coverage so much that costs explode, raise taxes as much as possible to pay for it, and when that isn't enough hand power to an unelected committee to limit treatment and control prices by government order."

Social Security to start cashing Uncle Sam's IOUs
We're broke, and now the bills are coming due. A great time to add a new entitlement.

A succinct explanation of Slaughter's House Rule

Friday, March 12, 2010

Headlines 3/12/10

House Dems look at 'Slaughter Solution' to pass Obamacare without a vote
They're about to slaughter the Constitution.

U.S. considers some free wireless broadband service
"Free" only for some. Another entitlement.

U.S. Sitting on Mother Lode of Rare Tech-Crucial Minerals
But do we have the will to use them?

An end to fishing?
Fish are, after all, more important than people.

Tuesday, March 9, 2010

Who Cares About Public Opinion?

Polls consistently show the public doesn't like the current health care reform proposals — whether they think they're too conservative, too liberal, or too stupid is beside the point. They don't like them and don't want any of them.

Many are asking: So what?

Should every policy be based on polls? Are we not a republic instead of a democracy? We elect people to govern, and they must govern, right?

Yes and no.

Every issue is not the same, and there are times when leaders must lead. As the columnist for The New Republic pointed out, public opinion was against the Iraq surge, but Bush did it anyway. That was totally appropriate.

National security and foreign policy often require the consideration of classified information. Decisions frequently have to be made quickly. The issues are complex and have repercussions that are difficult to predict; specialists spend their entire lives studying them and give their educated opinions to our leaders. Only our leaders have all the information, and they must act.

Domestic policy is different. It can be complicated but less so than foreign policy. Issues are less likely to involve state secrets and time sensitive decisions.

Most importantly, they directly affect us.

Foreign policy is about what our country does somewhere else. Domestic policy is about what our country does to us. Decisions about health care reform will directly affect all of us for the rest of our lives.

To argue that the government knows best and should do what is best for us is to advocate treating us like children. I make my kids go to bed, eat healthy food, and get their booster shots because it's good for them. But no one makes me do any of those things. I am an adult and have the right and responsibility to make my own decisions which I must then live with.

If Washington decides to treat us like children and force us to do "what's best for us," I think they'll find out who cares about public opinion: the public. People are very upset about how this whole thing appears to be going down, and November is not that far away.

What do you think? Should the government do what's "best" for us? Do we only have a voice on election day, or should our representatives care what we say every day?

Friday, March 5, 2010

Headlines and Links

... and nary a health care reform article in sight.

Tea Party Diversity
It's not just white people.

Authorities bust 3 in infection of 13M computers
Is calling for the death penalty too harsh?

'Archaic' Network Provides Data Behind Global Warming Theory
So the data have to be massaged, leaving ample opportunity to make it say what you want.

To Keep and Bear Arms
An excellent piece on the right and need of self-protection.

Thursday, March 4, 2010

ObamaCare Headlines

Obama Now Selling Judgeships for Health Care Votes?
After the "Louisiana Purchase" and the "Cornhusker Kickback," this really isn't hard to believe.

Why Health Insurers Make Lousy Villains
"...the profit margin for health insurance companies was a modest 3.4 percent over the past year"
Yet Dems can't seem to get upset over attornies' profits.

Health Insurance Profits: Not Worth the Outrage?
You know the Dems have problems when ABC is turning on them.

Does Lack of Health Insurance Kill? (Probably Not)
" significantly elevated risk of death among the uninsured."
So millions aren't dying because they don't have insurance.

Wednesday, March 3, 2010

Liberal Elitism in Obamacare

There are two things about the Democrat's attempts at health care reform that stand out. First, their approach to the problem relies on the federal government doing many things it has not previously done. Second, as the public gets louder in its rejection of their approach, the Democratic party prepares to run roughshod over public opinion and the traditional legislative process.

Both are symptoms of liberalism.

The first presents no surprise; liberalism believes that the solution to most problems and the appropriate holder of power is the centralized government. Conservatives, on the other hand, believe power should be kept as close to the people as possible both because of our federalist constitution and because it's just wise.

The second should be more of a surprise. Liberals bill themselves as the ultimate populists. They believe in the basic goodness of people (e.g., society makes criminals do bad things vs some people being just bad). They believe they give a voice to the little guy.

And they believe they have to protect the little guy. That is where the trouble appears.

Liberals love the little guy, but they don't respect him. They see themselves as smarter or wiser than the general public. If the little guy agrees with them, that's great, but if he doesn't, they're going to do what they have to for the little guy's sake.

In health care reform, that means passing the bill they think is best (centralized control) even though the public hates the idea. The fact that the public hates the idea is proof that they are smarter than the public.

As the ObamaCare struggle goes on, its liberal proponents have tended to one of two responses to public opposition. One group (usually politicians) says, "How can they oppose a bill that doesn't exist?" They imply, of course, that the public is upset over nothing; they're just lemmings following the latest email they got.

The other group (usually liberal pundits) say, "People don't really understand the issues." The less charitable say, "Americans are stupid, and we should push this down their throats for their own good." That really doesn't require interpretation.

So if we had to boil liberalism down to two simple phrases, this is how it would look: "Government is good" and "people are stupid."

This is about to be played out in Washington. The Democrats appear willing even to lose control of Congress to push through a bill the public hates because they know what's best. And they hope maybe, just maybe, after ObamaCare is imposed upon us we'll realize they were right.

If the Dems do go through with this plan, we all need to realize that every yes vote is calling us stupid and respond accordingly.

Monday, March 1, 2010

Headlines 3/1/10

Can you believe it's already March?

The Indiana Healthcare "Reform" Experience
Cold hard cash changes things.

Paring the Deficit, by Selling Part of the Radio Spectrum
An interesting idea: Raising money by ending TV over the airwaves. I said "interesting," not "good."

Health care bill? What health care bill?
"An emerging talking point from Democrats ... despite the fact that the House and Senate have actually passed national health care bills, ... there is not, in fact, a national health care bill."
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