The president has been on the campaign trail for Nancy Pelosi’s health care plan, battling against minority members of Congress who – in electoral theory, at least – lack the votes to sway the debate. It’s a useful strawman to burn now that shelves are empty of Bush kewpie dolls, but his real enemy is the ticking of the congressional holiday clock and so-called “Blue Dog” Democrats; centrists who refuse to be steamrolled into reforming one-sixth of the US economy without having the chance to understand what it is they’re signing up for.
The Blue Dogs come from politically moderate districts, enjoy the privileges of office enough to want to be re-elected in their next at-bat, and refuse to be pulled to Ms. Pelosi’s left:
We’re only in the early stages of the liberal suicide march, but there already have been three phases. First, there was the stimulus package. You would have thought that a stimulus package would be designed to fight unemployment and stimulate the economy during a recession. But Congressional Democrats used it as a pretext to pay for $787 billion worth of pet programs with borrowed money. Only 11 percent of the money will be spent by the end of the fiscal year — a triumph of ideology over pragmatism.
Then there is the budget. Instead of allaying moderate anxieties about the deficits, the budget is expected to increase the government debt by $11 trillion between 2009 and 2019.
Finally, there is health care. Every cliché Ann Coulter throws at the Democrats is gloriously fulfilled by the Democratic health care bills. The bills do almost nothing to control health care inflation. They are modeled on the Massachusetts health reform law that is currently coming apart at the seams precisely because it doesn’t control costs. They do little to reward efficient providers and reform inefficient ones.
The House bill adds $239 billion to the federal deficit during the first 10 years, according to the Congressional Budget Office. It would pummel small businesses with an 8 percent payroll penalty. It would jack America’s top tax rate above those in Italy and France. Top earners in New York and California would be giving more than 55 percent of earnings to one government entity or another.
Nancy Pelosi has lower approval ratings than Dick Cheney and far lower approval ratings than Sarah Palin. And yet Democrats have allowed her policy values to carry the day — this in an era in which independents dominate the electoral landscape.
Louisiana’s Governor Bobby Jindal accurately summarizes the flaws in the Pelosi plan, and offers an exit strategy: Start over, take your time, listen to all voices in the debate.
First, Mr. Obama doggedly promises that if you like your (private) health-care coverage now, you can keep it. That promise is hollow, because the Democrats’ reforms are designed to push an ever-increasing number of Americans into a government-run health-care plan.
If a so-called public option is part of health-care reform, the Lewin Group study estimates over 100 million Americans may leave private plans for government-run health care. Any government plan will benefit from taxpayer subsidies and be able to operate at a financial loss—competing unfairly in the marketplace until private plans are driven out of business. The government plan will become so large that it will set, rather than negotiate, prices. This will inevitably lead to monopoly, with a resulting threat to the quality of our health care.
Second, the Democrats disingenuously argue their reforms will not diminish the quality of our health care even as government involvement in the delivery of that health care increases massively. For all of us who have seen the Federal Emergency Management Agency’s response to hurricanes, this contention is laughable on its face. When government bureaucracies drive the delivery of services—in this case inserting themselves between health-care providers and their patients—quality degradation will surely come. House Democrats seem willing to accept that problem to achieve their philosophical aim—the long-term removal of for-profit entities from the health-care landscape.
Third, Mr. Obama’s rhetoric paints a picture of a massive new benefit that will actually cost average Americans less than what they pay today. The Democrats want middle-class taxpayers to believe they won’t feel the pinch of this initiative, even as their employers are assessed massive new taxes. They might as well try to argue that up is down. The analysis of the Democrats’ proposal by the Congressional Budget Office shows that it will not reduce government spending on health care, and that it will substantially increase the federal deficit—and this despite all the tax increases.
The Economist says that Pelosi’s “soak the rich” strategy has more to do with untouchable shibboleths than class warfare:
By embracing these two taxes, the House rejected the financing method recommended by most economists (and by this newspaper). The tax preference given to health insurance provided by employers (over, say, the coverage bought by the self-employed) is a market distortion that costs the exchequer some $250 billion a year. Abolishing or even merely restricting that policy could pay for much or all of the cost of universal coverage, as well as boosting labour mobility and making the cost of coverage more transparent to consumers. This virtuous policy never had a chance in the House, because union members get some of the best insurance packages.
That’d be a start, but it will not go far enough without tort reform and health care payments based more upon outcomes than activities – doctors pad their margins and reduce their personal risk by performing unnecessary and expensive testing that has little, if any, relationship to the symptoms presented.
It really is time to take a look at reforming the national health care scheme, costs have wildly outpaced inflation for years and medicare is on the verge of imploding. But if we’re going to take a look at doing so, we have to take the time to do it right, transparently and honestly. The Pelosi plan does not do that; it is a pig in a poke.
Start over.
Although I would like to think otherwise, I realize there’s a chance some may doubt the sincerity of this comment. Still, I really do hope the US will be able to get through this process in a way that results in a workable solution. I have no vested interest in any particular outcome (yeah, sure, I will defend my own system like a mother bear when attacked but that doesn’t mean I think our way is necessarily the right way for you) but as I’ve said before, I think you are in a unique position at the moment to create a system (whatever it might be) that can truly work for you. It is always the darkest before the dawn, perhaps?
Michelle – I actually agree with you on this – wicked shocka
. And with Lex – naturally 
. We do need to reform health care in this country but a government-run option that is forced upon everyone isn’t how to get it done. Ramming this piece of crap thru in such a short time without time for anyone to adequately vette the thing – is typical of Obama’s Chicago-style politics and not something that the American public wants. Recent polling shows that 57% no longer support the reforms Obama is pushing and 90% are quite happy with their current health care plan, thankyouverymuch.
Even Obama himself doesn’t know what’s in the plan he wants railroaded thru the process.
More consideration on this massive subject would be great, if someone can get Obama to stop endlessly campaigning and to start actually leading.
If he doesn’t start doing the latter, this will be a huge blow to his presidency since health care is his signature issue. Alienating the moderates within his own party won’t do him any good in 2012.
Which, let’s be honest – I won’t be heartbroken about.
We all tend to overlook two forces involved, and not generally heard from in these debates; the doctors and the pharmaceutical companies. Who is going to spend $500 million to develop the next Lipitor when the guv-mint is going to set drug prices? Who is going to spend 4 years plus 4 years plus 2 years plus 2 years to be a neurosurgeon when they know their income will be capped? And will the government pick up the cost of malpractice insurance? And will they cap malpractice settlements? I’m thinking of the poor airman who went in for gall bladder surgery and came out minus both legs due to a mistake by the surgeon. Oh, can’t sue the government there son since you’re under government healthcare. Will that be the case for all?
Look at the UK. You just DO NOT SEE people flying there for their world-class health-care. You see UK citizens flying to the US, to Spain, and Thailand to have surgical procedures done. Why? Because the UK mandated health care says “not needed/we won’t pay/wait 6 years”. It’s a joke.
Look at any government run housing projects and tell me you want to live there. Look at any government run emergency services and tell me “now there’s a success”.
I’ve got 25 employees. I’ve worked hard to provide them with a good benefits plan. But honestly what incentive do I have under this new program? An 8% added tax? They are all concerned that I will eliminate their benefits before this program goes into effect. I hate to even consider but ….
You have this right. Who is going to put in the time to become a doctor under this plan? Did you know Oral Surgeons require SIXTEEN years of schooling? 4(BS)+4(Med)+4(Dental)+2+2. Who in the heck is going to want to do that under socialize medicine that is proposed? And who is going to do it if they are salary capped AND have to fork out their Malpractice and with no Malpractice caps?
Nobody.
I live in these fields of medicine. I’m telling you now, everyone I know is waiting to see what happens and nobody is looking at a bright future. It’s not going to be just Neurosurgeons we miss… but every single specialty, which is going to lead to those long lines you hear about in those countries that have socialized medicine.
I see Dead People.
Bou, FWIW, I went “John Galt” 4 years ago, and expect other physicians will too. If one counts from 1st grade, I had 27 years of formal education to become a peripheral vascular surgeon, only to see that when I moved from Ohio to Iowa in 1988, Medicare cut my reimbursement for an above-knee amputation from $850 in Ohio to $450 in Iowa the next year. And their “diagnosis-related-payments” didn’t get any better after that. No wonder Obama got booed by the AMA last month in Chicago; he thinks docs can be squeezed even more. Yes they can – to extinction. I have not and will not recommend anyone go into medicine to make a good living in the future – go into engineering instead.
NO! I’m an engineer! I keep telling my boys, stay out of engineering! Meanwhile, my husband keeps telling them to stay out of medicine! The boys are left scratching their heads trying to figure out what profession to choose. I keep telling them to become plumbers. Everyone needs a good plumber. Or learn how to speak Chinese fluently and get an international business degree. The Chinese are going to be running the world in their lifetime…
Bou, Wow! Why the passionate response? What’s going wrong with engineering? (Not that I’m against plumbers.)
Bill K/
Oh, they’ll be LOTS of Docs–ALL at the NIH sucking on the Govt teat as research types with no malpractice premiums to pay and Govt paid Med-school tuition. Every other US specialist will be either off-shore in the Carrib. if east of the Miss R., or just across the Mex border if west of the river. The GP/FP types will all be retired. I want to be the guy with the Flood ins franchise for the Carrib.–as every island is going to sink under the weight of the relocating Docs. That, or get my Mexican RE license with exclusive rights to sell to Physicians relocating within 50 miles of the border Cali-Tex. Oh, the third thing is to own the travel agency with exclusive rights to sell package health flights to the Far East for elective surgery–as if that isn’t a building trickle already and soon to be a flood-tide. Corner THAT market and you’ll be a rich man.
Bill- We get laid off very easily, in particular those in aerospace and automotive. Pretty much, IMHO, engineers are overlooked and kicked around. We were getting laid off before it became the cool thing to do.
Outsourcing is big in my profession. Right now, I subcontract with a Fortune 50 company, Aerospace (take your pick as to which company… knowing I get laid off if the F-22 gets canned), and they have been pushed to outsource to Puerto Rico… cheap engineering labor. Of course, it’s complete crap, most of what’s put out, and has to be repeatedly redone, but it’s exceedingly bothersome this trend that is going on in engineering.
My 2nd son wants to go to Georgia Tech and major in engineering (he’s 12). I am ‘guiding’ him away from certain areas and suggesting he goes in areas that are useful in the environmental arenas… anything water related, chemical, etc. I’m trying to think of areas that won’t get outsourced to India, China or Puerto Rico.
None of us every wish the uncomfortable that happens to us upon our offspring. We always want better for them.
This is NOT about taking care of the poor people who can’t afford health insurance. Don’t delude yourselves into thinking this. Instead, look back at the Democratic Party’s high-handed actions since Lyndon Johnson and the Great Society. What we’re looking at is “bread for the masses” on a titanic scale. This is all about the Democrats making sure that the pee-pul are beholden to them, and making sure that there is a permanent under-class (gotta keep them there, don’t you know, hawk-spit) that are perpetually tied to the Mule party.
It’s enough to make a grown man sick to his stomach.
How about baby steps instead of the proposed fubar “the government is here to help you” solution by BHO & Co.? After all, the Government is doing such a wonderful job with Medicare, Medicaid, Social Security, Public Education, Welfare, Veterans Administration, Illegal Immigration, Border Protection, Fannie Mae, Freddie Mac, DHS, …..
Tort reform, insurance portability and other similar issues should be no-brainers.
Seems like Obama is doing nothing but high pressure sales pitches. First the stimulus plan (Don’t read it, there’s no time!!11!!) and now this (same). It’s like we tried to elect a President, but instead we got a used car salesman.
I’ve been subject to a high pressure sales pitches in the past and it has never once been in my best interest to buy what they’re selling. That by itself would be enough to tell me this plan is a terrible idea, even if I disregarded all the other reasons.
When the Democrats in the House were given the opportunity in committee to vote on an amendment that would have required them abandoning the current cadillac health plan (paid for compliments of the tax-payer) they currently enjoy and join that Nirvana of a “public option” they are so busily designing for the rest of us they overwhelmingly voted it down. “Do as we say–not as we do.” It’s sorta like–no, EXACTLY like–a Chevy salesman extolling the virtues of the Chevrolet automobile to a perspective customer and when asked what kind of car HE drives, replying: “Why, I drive a Ford, of course.” Would you buy a car from that man? Daffy Duck time…”Ha! Ha!, it is to laff!”
“For all of us who have seen the Federal Emergency Management Agency’s response to hurricanes, this contention is laughable ”
Maybe Bush shouldn’t have made a horse show organizer the head of FEMA? Republican incompetence doesn’t mean government doesn’t work. Is the military incompetent?
I’ve worked inside a uniformed service for three decades, and had the opportunity to work alongside government servants during some of that time, and most especially afterward. They are very different cultures.
Alos/
The problem is that most Democrats are career politicians that have never run a business or ever had to meet a payroll in the real world–and thus are oblivious to financial reality. And it’s even worse with their staffers–the one’s who do the actual writing of the bills. One 1982 study of congressional staffers on the tax-writing committees in both Houses revealed the average age to be 26 with 84% of them single. Further, 97% of them joined the committees straight from college with no experience in the real world. Few owned assets of any kind–homes w. mortgages attached, annuities, stocks, bonds, cash value life insurance, etc., beyond their automobiles. Most rented.
What this study revealed is that those who write the laws that control the very lives of all Americans lead lives very different from those self-same Americans. Their ability to psychologically identify with the dreams, experiencies and daily frustrations in the warp and woof of life is minimal at best. Is not one of the reasons that Congress “in it’s wisdom” grants the home mortgage deduction is the belief that home ownership promotes community stability and personal responsibility? Yet those staffers actually writing our laws lead, in the main, lives that are in no way even vaguely congruent with those of the vast majority of Americans who will have to live under the laws they write.
Most of these Congressional staffers are very bright and are graduates of some of this nations supposedly better schools. Yet their experience in the “real world” is almost nil. Having them doing the majority of the detailed drafting of the laws is like having biology professors who have never even taken a ride in a Cessna C-172 or flown as an airline passenger write the flight manuals for the F-22.
Well, our current health care system can be summed up as follows:
The government insures the sickest part of the population, those over 65 and those on disability, while insurance companies make huge profits off the healthy part of the population by pretending to insure them. This is neither desirable nor sustainable.
And worse, we all still pay emergency room’s top dollars for the many uninsured, when far less expensive and preventative treatment should be available.
In 2008, total cost of uncompensated care was about $56B. The CBO says the house plan is upside down to the tune of $1.04T (over ten years). Only in an alternate universe is that less than paying $56B/yr. for ten years — while still leaving 17 million uncovered.
The reason Obama is in such a rush, is that the American people are waking up to the con. Those with health insurance are starting to figure out they will lose some of their coverage under the House plans. As altruistic as Americans are, they aren’t that altruistic.
Page 16 ladies and gents, page 16.
Have you read it?
If ANY CHANGE takes place in your private ins. policy you are kicked out…
You will then be obligated to apply for a gov’t approved “managed care account” or, join the gov’t health plan (if it actually comes to fruition.)
Page 16. Read it.
Yeah, that’s the one no one will talk about. And Obama claims he doesn’t know about. And what about the provision that says every 5 years after you reach a certain age – you will be required to meet with your doctor to “discuss your situation”…gee, I wonder what that means.
Funny, but the year before, in 2004, for the only time in recorded history, four named storms hit Florida — three of them over 115 knots. The same “horse show organizer” led FEMA then, and the Federal response seemed more than adequate. The only difference in 2005 was the complete ineptitude of the two morons in charge (under federal law), the Mayor of NO and the Governor of LA — both democrats (since you seem so intent on linking “incompetence” to a party).
I guess the people closest to the problem don’t seem to share your disgust with “Republican incompetence” — by 37 points they picked one for their next Governor.
Echoing SCOTT, as someone who experienced Katrina first hand, the “expertise” of “School-busRay”, “Chocolate-City” Nagin and our school-marm Governor–Democrats all–is something I personally lived and suffered, and thus I can fully attest that whatever incompetence FEMA demonstrated–of which there was plenty–it paled in comparison to the performance of local political leadership–of which I was all too privy to “up close and personal,” as it were.
While it may be enjoyable to pin blame on the NO Mayor and LA Governor – primarily because they are Democrats, I suppose – it skews and confidently misses the larger issues.
First, while Florida was hit by four Hurricanes in 2004, nothing there compared to the massive flooding, destruction, human suffering and loss of life in New Orleans.
Second, FEMA also made many incompetent blunders in Florida, too. An inspector general found that FEMA inappropriately declared Miami-Dade count a disaster area and awarded millions, without ever verifying any need of assistance. (they didn’t need it) Although there were no deaths (unlike Katrina) from Frances, FEMA mistakenly paid funeral expenses for 203 Floridians. The list goes on but didn’t make much news.
Third, while former FEMA head Michael Brown has been vilified for the Katrina response, in a way the prescient Brown forecasted the fiasco. He warned repeatedly that FEMA’s absorption into the Department of Homeland Security would “sever FEMA from its core functions, shatter agency morale, and break long standing 1st responder relationships.” As a part of Homeland Security he [correctly] warned FEMA would have “an ineffective and uncoordinated response, to a natural disaster.
And that is exactly what happened.
More about FEMA’s discredited Michael Brown Here.
While it may be enjoyable to pin blame on the NO Mayor and LA Governor – primarily because they are Democrats, I suppose – it skews and confidently misses the larger issues.
No, I’ll pin the blame on them because they are primarily responsible for the cluster fornication in New Orleans. Responsibility for disaster planing, preparations prior to an event and first response in a specific area belongs solely to the local authorities….municipal and county/parish governments. Responsibility then falls to the state. Lastly comes the Feds, who only respond if requested. Nagin is an incompetent twit who didn’t follow his own disaster response plan, Kathleen Blanco is equally unqualified and didn’t lead when she should have. It wasn’t Bush or FEMA that was responsible for that mess.
In Mississippi, where I was sent after Katrina, the locals and the state had their acts together and the response and recovery went smoothly. That includes FEMA’s response. I’m also a veteran of Charley, Francis, Jean, Ivan, Dennis and Wilma and was directly affected by Charley and Wilma. We had issues after those storms as well, but nothing on the level of incompetence displayed in Louisiana after Katrina. Is FEMA flawless? No way, it’s a government bureaucracy. But the New Orleans disaster doesn’t belong in their lap.
Nagin and Blanco were the larger issues.
Ditto to Virgil and SoberSub: In the hurricanes that we have had in NC over the 25 years that I have lived here, we’ve been hurt rather badly by a few. But, WE took responsibility for recovery and did not blame the Feds for not fixing us up, nor did we expect them to.
I agree whole heartedly. I went through Frances, Jeanne, Wilma. My folks through Ivan and Dennis. Our State had their act together. Were there issues? Of course. But, we never had the attitude of ‘it won’t happen to us’. Our attitude is ‘when it happens to us’ which means we are prepared. What happened with Katrina was disgusting on many levels, from the people who lived there, to their local government and state government. FEMA’s issues were just icing on the cake, but only that. The substance of the issues were local and state.
Nice spin, Flit — I have some extensive dealings with FEMA through the Military Support to Civil Authorities effort. FEMA doesn’t really own much — if you will look at the EO that governs what they do, they are there to coordinate the efforts of all of the federal agencies (and listen hard to this part) IN RESPONSE TO THE REQUESTS OF LOCAL AUTHORITIES. Local politicians fought hard to keep the feds out of their knickers, and demanded that all federal actions only come after they asked for them. I understand that left wing folklore wants to absolve Blanco and Naigin, because that just enables more scorn of Bush. But under the EO, there was little FEMA could do until local authorities asked for it. “Pinning” the blame on local authorities has nothing to do with their party affiliation and everything to do with their proven incompetency in responding to a disaster that had been forecast for years. Everyone in the MSCA community knew that a CAT 5 strike on NOLA was the doomsday scenario — it had been gamed for years. And still Naigin and Blanco dithered, and under federal law, FEMA couldn’t do anything until they asked for help.
The “errors” in South Florida (all in aid administration, not in disaster response) you want to point to will happen in any FEMA response — happened in a larger scale in Katrina — for two reasons. First is greed and a willingness to abuse the generosity of the American people on the part of a few. What enables it, is a desire to ease human suffering now, and worry about 100% accountability later, that is part of the FEMA culture. Frankly, while I hope every fraud is punished, I don’t really think I want it any other way.
Scott, thanks for that cogent reply! That parallels what I read at the time of Katrina from John Donovan, who seems to also have a fair amount of experience along your lines.
To be honest, I don’t think FEMA did that poorly, overall. (I can see fliterman rolling his eyes from here, heh) I also agree that the Louisiana leaders screwed the puppy the most. Since I’m a localist (related to Federalist {g}) it should be no surprise that I hold the the idea that operations like this should flow from the bottom up: city, county, state, then federal. I also also agree with Jerry Pournelle, who has repeatedly said that we all spanked the puppy when we disbanded Civil Defense in favor of Yet Another Federal Agency: FEMA.
As for private companies “pretending” to cover healthy clients, well… If they’re healthy, they don’t need much health care, no? That’s one of the dirty little secrets here. For all the drama about “affordable health insurance,” that’s the last thing the Dems want.
Case in point. An 18-year-old boy wants car insurance. He passed the local driver’s ed course with an A, graduated a B average from high school, etc. On the other hand, an 18-year old girl in the same town, from the same high school and graduating class, also a B student, also passed the driver’s ed course with an A wants car insurance. The problem is that actuarially speaking the boy is far more likely to have an accident than the girl. Thus the boy will pay far more than the girl. Is this “fair?” Not within the context of some ideologies, and that’s exactly the problem we would run into if we treated health insurance as actual insurance.
But don’t mind me, ‘cuz I think we should disband the Department of Education and the Department of Energy, for a start. Not to mention eliminate all agricultural subsidies. Especially not to mention repealing the 17th Amendment.
Might I toss some “matter” into the punch bowl?
What strikes me are a few important points I don’t see mentioned, or not at the top of the heap.
First up: Obama told the press and the people what they wanted to hear to be elected, and has spent 6 months reversing himself in deed, and words, on about ever significant “promise” he made. Even his strident supporters are beginning to see this. So, that being said: He stands before us, and contradicts the very language of the bill in the House. See where I’m going with this? Yep. He lies, bold faced and straight faced to get what he wants, then thumbs his nose at the people when “his” desire is in hand.
Next: For years, the Pew Research Center has consistently documented that Congress, of all notable American Institutions, has garnered the lowest confidence of the American People (as in “We The”). Now, Congress tells us they will take care of us, and they’ll make it all better. The first part of this: We don’t trust them, but we are trusting them, despite saying we don’t trust them. Cognitive dissonance, eh? Side note: The US Military has consistently placed at the top of all American Institutions for the confidence of the people, even above the Presidents, yet….those in uniform ad looked down upon by those who have the big microphones. Cognitive dissonance, eh? My suggestion: Transfer the “excess” military in the downsizing straight into running the plan. I bet it would get done, and done well, and effectively.
Third: JUST WHAT FREAKIN’ MAJOR GOVERNMENT PROGRAM HASN’T COST US AT LEAST 10X AS MUCH AS “THEY” TOLD US????? Cost overruns, the fingerprints of the congressmen who took our money and then took more, and more, and more are all over this, too.
But…as usual, I digress…
Obama is proving to be a much more adept campaigner than leader. Last night was a real deer in the headlights moment.
Until he got to one subject near the end. Finally showed some steel in his spine. Took on a tough target.
Someone needs to tell him, punching down isn’t presidential.
Someone needs to tell him, punching down isn’t presidential.
Scott,
Thanks for the free quote for the next time Palin makes the news.
I do have to admit-I don’t know why he took that bait either. It really was not smart of him to do.
So, are you looking for Palin to be “presidential” anytime soon?
I think you can get a house next door to any number of people.
Actually I’m moving overseas anyway-regardless of who is in the White House. Thailand is offering a special on retirement visas next year.