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Ruth Bader Ginsburg: The Supreme Court’s Drama Queen

July 02, 2014 By: Scott Spiegel Category: Health Care

???????????????If Justice Clarence Thomas is the Supreme Court’s intellectual leader, surely Justice Ruth Bader Ginsburg is its resident drama queen.

On Monday the Supreme Court decided 5-4 in favor of craft supply store Hobby Lobby and cabinet maker Conestoga Wood Specialties, which filed suits against the federal government in 2012 opposing Obamacare’s mandate that they offer 20 birth control methods to employees or pay fines of up to $1.3 million daily.

The Court ruled that these “closely held” family-owned businesses aren’t obligated to offer 4 out of 20 birth control options they object to, at least one of which is considered an abortifacent or “morning-after pill.” Such a requirement, the Court ruled, violates the 1993 Religious Freedom Restoration Act.

Mitigating the left’s inevitable claim that the ruling constitutes another salvo in the war on women, here are all the things female Hobby Lobby and Conestoga employees can do if they don’t like the decision:

  • Use one of the other 16 methods of birth control Hobby Lobby and Conestoga offer;
  • Pay out-of-pocket for one of the 4 methods not offered;
  • Apply for government-funded coverage directly from insurers, just as employees of non-profits who object to paying for birth control can do, to obtain one of these 4 methods;
  • If it’s that big a deal to them to work for an employer that makes Sandra Fluke happy, choose one of the 8 million other companies in the country who offer all 20 methods.

Instead, the White House is jabbering about setting up a federal fund to pay for birth control, and Senate Democrats are chewing over legislation to ensure that every woman in America has free morning-after pills perpetually at her fingertips.

Meanwhile, back on the bench, three of the four liberal Justices had the sense to cast their votes and then keep their contorted reasoning to themselves.

But leave it to the histrionic Ginsburg, who gets inspiration for deciding Supreme Court cases from the opera, to hyperventilate for 35 pages about the disastrous consequences of the majority decision in a separate dissent.

Here are a few nuggets from Ginsburg’s jeremiad:

Ginsburg claims that the decision will wreak “havoc” on society. She argues that birth control facilitated women’s entry into the labor force, and that not requiring every employer to give out free morning after pills will drive women back to a barefoot and pregnant state of existence.

Ginsburg warns that the decision will require “the government, i.e., the general public, [to] pick up the tab” for birth control pills if employers don’t cover them. But only in the fevered imagination of a liberal does a commercial transaction require the federal government to either (1) force some private party to pay for it or (2) force taxpayers to subsidize it. How about individuals who want it buy it themselves?

In the most sweeping section of her dissent, Ginsburg slams the Citizens United (2010) decision and analogizes the two cases, claiming there is “no support for the notion that free exercise rights pertain to for-profit corporations. Until this [Hobby Lobby] litigation, no decision of this Court recognized a for-profit corporation’s qualification for a religious exemption from a generally applicable law.”

She adds, “The absence of such precedent is just what one would expect, for the exercise of religion is characteristic of natural persons, not artificial legal entities.” To which I would respond: Tell that to Marriott Hotel, which phased out pay-per-view adult TV and stocks its rooms with The Book of Mormon; In-N-Out Burger and Forever 21, which print Bible verses on their packaging; Whole Foods, whose CEO incorporates Buddhist philosophy into his management practices; and dozens of other corporations whose religions motivate their values.

Justices Stephen Breyer and Elena Kagan, who agreed with Ginsburg’s ruling, politely distanced themselves from large chunks of her nutty rantings, averring, “We need not and do not decide whether either for-profit corporations or their owners may bring claims under the Religious Freedom Restoration Act of 1993.”

Is it any wonder that a justice who thinks government has the right to trample on people’s checkbooks when they refuse to buy a product on the private market also thinks it’s OK to force citizens to follow a law even if it tramples on their religious freedom?

Ginsburg gives the game away when she writes, “The state may justify an inroad on religious liberty by showing that it is the least restrictive means of achieving some compelling state interest.”

So Ginsburg thinks it’s peachy to crush religious liberties if that’s the least painful way to ensure some crucial government goal—in this case, the left’s century-long dream of socialized medicine.

Come to think of it, if I were a liberal who had been drooling over the fantasy of national health care for 81 years and faced the prospect of having it snatched away, I might react dramatically, too.

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What You Don’t Know Will Make You Vote Democratic

April 23, 2014 By: Scott Spiegel Category: Health Care

originalLately the media have been trotting out their timeworn strategy of lecturing the public that the only reason Democrats face imminent electoral trouble is that people are too stupid to know any better.

The New York Times recently published a front-page story warning that those who benefit most from Obamacare are the ones who are least likely to vote in this fall’s midterm elections.  (Would that Democrats were lucky enough for that trend to continue, given the miserable experience signups have had finding affordable plans, competent doctors, and timely appointments.)

The problem, according to the Times, isn’t that Obamacare stinks—it’s that those for whom it was designed can’t comprehend the immeasurable largesse Democrats have generously bestowed upon them.

For example, young people who investigate what’s available to them and decide that their money could better be spent on things like paying back student loans for the college tuition Democrats artificially drove up, are shortsighted and don’t realize that they could at any moment fall out of a tree or acquire Zucotti Lung.  Millennials couldn’t possibly be smart enough to have researched the healthcare exchanges’ premiums, deductibles, and copays and made a rational choice about where their limited funds should go.  No—they’re too focused on booze and birth control.

Meanwhile, Republicans are allegedly busy spinning fantasies about the law and using ignorance and fear to drum up opposition to the bill. Representative David E. Price (D-NC) says of the health care debate and rollout, “There was an ability to exploit the unknown, to exploit the fear of people losing something that they have.”  An ability to exploit the fear of people losing something that they have?  Does Price think that that might have anything to do with the fact that people lost something that they had?  Is it “exploiting the fear” of losing your baby if I point out that a kidnapper is about to run off with your stroller?

Jonathan Martin, author of the Times piece, reiterates Obama supporters’ point that because Obamacare wasn’t designed to be a universal, single-payer system like Social Security or Medicare, that made it easier for Republicans to dupe voters into seeing it as a wealth transfer from rich to poor.  So a less universal transfer scheme involves greater redistribution than a more universal transfer scheme?  Who does Martin think was going to pay for that universal, single-payer program—the mountain folk of Appalachia?

The media treat voters who are eligible to receive coverage, yet leery about accepting it, as either morons for not accepting free goodies from the government or monsters who want their communities to suffer.  (Isn’t it liberals who are always accusing conservatives of being selfish and caring only about themselves?)

In an unguarded—and ill-advised—departure from script at the end of his press conference last Thursday, President Obama let loose the following tirade: “You have 5 million people who could be having health insurance right now at no cost to these states, zero cost to these states, other than ideological reasons, [Republican governors] have chosen not to provide health insurance for their citizens.”

Zero cost to these states—other than high startup costs at a time when most states are groping their way through budget crises, and the dollars they must shell out after three years once the free money from the federal government stops rolling in.  Given his track record with blanket promises and black-and-white declarations on the glories of Obamacare, the President might want to modulate his healthcare assurances in the future.

The left refuses to acknowledge the existence of principled, thoughtful opposition to Obamacare.

But it’s liberals’ stupidity that got us into our current mess.

Skilled doctors are the centerpiece of our world-renowned healthcare system, and training new doctors is an expensive, labor-intensive process that takes more than a decade.  Yet liberals touted Obamacare as a humane, utopian scheme that would somehow manage to cover millions more people and save billions of dollars—all without adding any new doctors to the rolls.

Suppose we grant liberals’ declaration that they’re wiser than conservatives.  What good is a high IQ if it leads you to believe crap like that?

Liberals always accuse conservatives of being anti-intellectual, but there’s something to be said for common-sense insight.  And it’s sad when some of the supposedly most intelligent minds in our society produce a destructive policy like Obamacare—then sneer at young, low-income, and minority voters for being too dumb to recognize the brilliance of their benevolent overlords.

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Obamacare Enrollment Counted Using Common Core Math Standards

March 26, 2014 By: Scott Spiegel Category: Health Care

ABC-Diane-Sawyer-Obamacare-numbers-release-11-13-2013-620x427Last year the Congressional Budget Office estimated that Obamacare would enroll 7 million customers by March 31, 2014, a number the administration subsequently adopted as its goal.  As it became clear that that target would remain elusive, the administration proceeded to move goalposts and extend deadlines so that they would be able to claim, at the end of the open enrollment period, that they had succeeded.

Despite all their cheating and number-fudging, they still can’t make that claim.

On October 23, 2013, after three weeks of dismal performance, President Obama extended the deadline for complying with the individual mandate from February 15 to March 31, 2014.

On November 22, he extended the deadline for those who wished to receive coverage starting January 1 from December 15 to December 23.

On December 12, he strong-armed insurance companies into letting consumers make their first payments by January 10 rather than January 1.

On December 23, he extended the December 23 deadline for January coverage to December 24.

On December 24, he announced that those signing up at the last minute who were having trouble with could have their enrollment deadlines extended if they could prove they had tried but failed to enroll in a plan.

In February 2014, when time was running out, the administration quietly revised its enrollment target from 7 million down to 6 million.  This would allow them to later falsely claim that their goal was never 7 million, and that they needed only 6 million enrollees for Obamacare to be sustainable.  (Note: The administration’s original projection in 2010 was 13.9 million, which means that the 7 million target was already a 50% reduction from their original expectation.)

Yet all of these tricks haven’t been enough to carry Obamacare over the finish line.  Perhaps because of the politically motivated one-year delays in the large and medium employer mandates, and the three-year delayed individual mandate for those with health plans that don’t comply with Obamacare, total enrollment isn’t predicted to hit even 6 million by March 31.

The Obama administration reported 5 million enrollees as of March 17, 2014.  Democratic activist Charles Gaba, who styles himself as a Nate Silver of Obamacare enrollment prediction, correctly foresaw the date the government would hit the 5 million mark.  He projects 5.4 million enrollees by March 31.

But Gaba admits that his estimate doesn’t factor in whether these enrollees end up paying their first monthly premiums.  Insurance companies have estimated that about 20% of so-called enrollees never make their first payment.  So even by the modified estimate of a pro-Obamacare statistician, total paid-for enrollments by the repeatedly extended deadline would be a paltry 4.3 million, or 62% of the administration’s goal.

As embarrassing as are that number and the administration’s attempts to spin it as a huge success, the crucial recruitment test is whether they get the right mix of enrollees.

Obamacare needs enrollees in the following categories, in descending order of importance: healthy young people, healthy old people, sick young people, and sick old people.  Tracking healthy and sick participants is difficult, but so far the administration has enrolled a smaller-than-desired percentage of young people.  The administration needs the enrollee base to consist of at least 40% young people, but they’ve hit only 25%.

So recruitment is well below the needed enrollment target, and well below the target percentage of young enrollees.  In addition, there’s an elephant in the room that upends all of these calculations.

Namely, it’s still the case that more people have been kicked off their plans than have enrolled and paid for plans on the federal exchange.

Even if every single exchange enrollee had been previously uninsured, the net difference between new enrollees and those who lost their plans would be negative.  But many consumers who signed up for the exchanges did so only because they were kicked off their old plans.  A recent McKinsey survey revealed that only 14% of exchange enrollees had previously been uninsured, and that most who had been insured were finding replacement coverage.

Everyone knows that it’s difficult to precisely track participation in large, unwieldy programs like Obamacare.  It’s understandable if groups for and against the legislation derive slightly higher or lower counts.  But when Democrats cut themselves break after break in interpreting the numbers, ignore qualifiers that greatly alter, mitigate, or render their counts useless, and redefine the meaning of the word “enrollment,” we’re not talking about harmless rounding error.  We’re talking about brazen mendacity.

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Deconstructing Harry Reid

March 05, 2014 By: Scott Spiegel Category: Health Care

HarryReidThis could be a hunch, but I suspect vulnerable Congressional Democrats are going to regret Senate Majority Leader Harry Reid having kicked off the 2014 midterm season by declaring his party’s campaign slogan to be “All Obamacare Victims Are Liars.”

Last week, after regaling his colleagues with the glories of Obamacare, Reid warned, “Despite all that good news, there’s plenty of horror stories being told.  All of them are untrue, but they’re being told all over America.  Those tales turned out to be just that—tales, stories made up from whole cloth.”

Reid is far from the only liberal claiming Obamacare victims are an urban myth.  Pulitzer Prize-winning Los Angeles Times reporter Michael Hiltzik mused, “Maybe there are no genuine Obamacare horror stories.”  Mother Jones’ Kevin Drum demanded, “Has anyone in America actually been harmed by Obamacare?”  The ever-certifiable Paul Krugman decried “Health Care Horror Hooey.”

Yet according to a recent Rasmussen survey, one third of Americans report that they personally have been hurt by Obamacare.  Projecting to the entire U.S. population, that’s an awful lot of liars.

Can we reflect for a moment on the insanity of Reid’s claim?  Supporting Obamacare because you believe it will help the needy, even if the middle class and well-off will suffer, is one thing.  And downplaying the cost of redistributing wealth through government subsidies is Democratic boilerplate.  But claiming that there is literally no downside to a law this big and complicated, that not one single person will be adversely affected by it, is borderline demented.

Consider the circles of hell Obamacare victims have wandered through in the past six months:

  • Millions have lost their health care plans
  • Many haven’t been able to find equivalent coverage due to higher premiums or deductibles
  • Some with life-threatening illnesses have lost their doctors or hospitals and watched their conditions worsen due to discontinuity of care
  • Millions have had to waste hours, days, or weeks scouring poky online exchanges to replace something they already had
  • Many are being forced to buy coverage for things they don’t need
  • Many who didn’t lose coverage are watching their premiums increase
  • Employees are having their hours cut or losing their jobs
  • The eventual enforcement of the delayed employer mandate will yield millions more policy cancellations

Yet liberals’ argument against these complaints is: “No one has been hurt by Obamacare, or if they have, it was completely unnecessary.  If only they’d spent hours researching dozens of plans and generating spreadsheets comparing premiums, coinsurance, and deductibles, they’d find a plan we think is better for them.  And if their costs are going up, it’s because greedy insurance companies raised their rates—which totally coincidentally happened right as Obamacare began.”

The left is ecstatic that they’ve been able to poke holes in the stories of a few cancer victims whose coverage was dropped and supposedly could have gotten comparable Obamacare plans.  Liberals believe that, because trained investigative reporters who consult insurance executives and interview Consumer Reports writers are able to sleuth around for hours comparing the costs of various bronze, silver, gold, and platinum plans, little old ladies who are scared of computers should be ashamed at themselves for not doing the same.

So what if a few of the horror stories aren’t as egregious as their confused victims believe?  The fact that these victims are confused by what Obamacare is doing to them while they’re trying to fight life-threatening diseases should be horrifying enough to anyone with a conscience.

Even Hiltzik admits that there are “numerous cases of individuals or families who are paying more for coverage this year than last, and possibly for less coverage than they had before.”  He concedes that provider networks are smaller than those subscribers previously had, and acknowledges that many major insurance carriers did a poor job explaining options to customers after dropping coverage.

But in Hiltzik’s mind, stories of frustration and hardship don’t rise to the level of “horror” unless patients’ Obamacare doctors are sporting hockey masks and chainsaws.

There are numerous other reliable stories out there—see the cases of Stephen Blackwood, Jeff and Victoria Haidet, Linda Deright, Tom Gialanella, and Julie Stovall—that the left hasn’t been able to deconstruct.  But liberals aren’t interested in learning whether there are any genuine Obamacare horror stories; they’re interested in snookering the public into accepting their sneers about how all such stories are false.

If Democrats don’t start acknowledging the people hurt by the fatally flawed Affordable Care Act and supporting its delay or repeal, they may be the ones with Obamacare horror stories come November.

Previously published in modified form at Red Alert Politics

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Who Should Decide Whether Multivitamins Are Useless?

December 18, 2013 By: Scott Spiegel Category: Health Care

748269-4b723010-6779-11e3-879d-630c394bcc3dSeveral Johns Hopkins medical doctors recently published an eye-opening editorial in the Annals of Internal Medicine arguing that multivitamins and nutritional supplements are a complete waste of money.  (We’ve known that for a long time about, say, Head Start and a thousand other useless government programs.  Will we be defunding them anytime soon?)

The authors discuss research that they and their colleagues conducted for the U.S. Preventive Services Task Force, in which they found that Vitamin B, folic acid, numerous antioxidants, and virtually all daily multivitamins have no effect in preventing heart disease or prolonging longevity.  Multivitamins may have a minor impact—much less so than eating healthy and exercising—on preventing cancer, but only in older men.

Other research found that Vitamin D was ineffective in strengthening bones; fish oil was useless for treating atrial fibrillation; and nutritional supplements had no effect on preventing dementia.  (Watching MSNBC, on the other hand, accelerated dementia onset.)  In addition, Vitamin A, Vitamin E, and beta carotene had no detectable prophylactic effects, and might even be harmful to people at risk for lung cancer.

As compelling as the Annals findings are, there are dissenters, and these don’t just include CEOs of vitamin manufacturers.  Critics note that the researchers’ conclusions apply only to people with no nutritional deficiencies—which may not describe a very large set of Americans—and that pregnant women and those with nutrient absorption problems may benefit from some multivitamins.  Methodological flaws—noncompliance in the heart health study, the fact that participants in the dementia study were all male doctors over 50—make firm conclusions difficult.

And isn’t it suspicious when researchers in some poorly understood field declare their conclusions with utter certainty, as the doctors in the Annals do?  “We believe that the case is closed—supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful…  Enough is enough.”  And this: “The probability of a meaningful effect is so small that it’s not worth doing study after study and spending research dollars on these questions.”  Resistance is futile—the science is settled.  Sounds eerily familiar to the tone global warming advocates use to bully skeptics into silence.

Yet there may be something to the researchers’ findings, and I give them credit for daring to oppose the multibillion-dollar vitamin industry.  People are slow to change and sometimes need a kick in the pants to get them to stop engaging in pointless or unhealthy habits.  Remember how long it took for the USDA’s ridiculous food pyramid—with its hysterical warnings against eating too many servings of food groups that include things like fish, olive oil, and nuts, and its reckless injunction to eat up to 11 servings of starch, pasta, and bread a day—to be discredited?

In the end, decisions about multivitamins and other health issues should be made on an individual basis, by those who would take or eschew them, based on individual risk tolerance and health.

Preventive Services Task Force member Wanda Nicholson states it perfectly: “In the absence of clear evidence about the impact of most vitamins and multivitamins on cardiovascular disease and cancer, health care professionals should counsel their patients to eat a healthy, well-balanced diet that is rich in nutrients.  They should also continue to consider the latest scientific research, their own experiences, and their patient’s health history and preferences when having conversations about nutritional supplements.”

As an example of such considerations, I was fascinated to discover that the Japanese have similar smoking rates as Americans, but lower lung cancer rates, presumably because they drink an average of five cups of antioxidant-rich green tea a day.  Informed and engaged people should be allowed to consider such tradeoffs.

And that, to bring the political angle into all this, is exactly the sort of behavior that Obamacare is designed to halt, with its one-size-fits-all regulations that trample on individual choice, blanket mandates that deny controversial treatment options, and end result forcing everyone to lobby the government for special treatment.  Everyday citizens who read headlines declaring multivitamins useless no doubt feel some cognitive dissonance over having engaged in behaviors that may be useless over the past several decades.  That discomfort is a good thing.  The research on vitamins isn’t even close to settled, and controversial findings should prompt people to seek additional information and demand further study.

But people like quick, easy answers, and government agencies are often too quick to supply them.  Some portion of the population appears to conclude with regularity, “If the government says so, doesn’t that mean it’s true?”

If we don’t rid ourselves of the pestilence known as Obamacare, then ten years down the road the decision to take multivitamins—and other, far more substantial health decisions—may be one people don’t even think of making themselves, but passively follow whatever their government-controlled doctors direct them to do.

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All Obamacare Plans Are Aluminum

December 04, 2013 By: Scott Spiegel Category: Health Care

RustyCarLiberals pretend that, for people who lost their health care plans because of Obamacare, the Affordable Care Act will lower monthly premiums while offering the same or better coverage—and other people won’t even be affected!  They promise a veritable gold standard for 21st-century health care delivery.

Their claim is all flash and no substance.

First, health care premiums are not lower across the board, as Obama promised they would be once his act was passed.  They are lower only for certain subgroups, such as people who qualify for federal subsidies; people who live in states like New York or California that have already jacked up premiums exorbitantly; and people with preexisting conditions who justifiably get charged more for the cost risk they pose.

For just about everyone else who lost his plan, premiums are heading north.  In 2014 this will affect those on the individual market and those who work for small businesses.  In 2015, when the employer mandate kicks in, it will affect many if not most who receive insurance through large employers.

Second, even for the minority of plan-losers who enjoy lower premiums next year, the government is offsetting this cost through huge annual deductibles, coinsurance, and copays.  Many low-income people who can afford only the cheapest “Bronze” Obamacare plans can’t budget the outrageous annual deductibles they must pay before they see a penny of reimbursement.  Many middle-income people who fall just below the threshold for subsidies face a lose-lose tradeoff: buy a Bronze plan with monthly premiums similar to what they paid before but a huge deductible, or minimize their deductible by paying higher monthly premiums.

Lots of middle-income people who do meet the subsidy threshold will nonetheless find themselves paying more.  Why?  Because federal and state exchanges cover a narrower range of hospitals and doctors than many plans do now, and consumers who want to stick with their current arrangement will shell out more for out-of-network services that were previously considered in-network.

To sum up, low-income people won’t have it nearly as easy under Obamacare as promised, and many with high deductibles will pay the full cost of expensive medical bills in addition to monthly premiums they didn’t pay before.  Many middle-income people will pay higher premiums, deductibles, or both for the same coverage.

Third, even if Obamacare manages to cover a few people at near-zero premiums and drastically reduced deductibles, it will either help only a tiny sliver of the population, many fewer people than promised; or generate enormous costs to taxpayers who will have to pick up the tab if the program expands to generously cover more people.  As Huffington Post writer Nathan Newman admits, “As conservative critics snipe at Obamacare for out-of-pocket expenses being too high for families making more and not qualifying for these subsidies, we should be pointing to these formulas [for poor people] and agreeing that we need amendments to extend cost sharing subsidies to more families” [emphasis added].  In liberals’ dream world, everyone but wealthy Obama donors will be saddled with Bronze plans.

So a few poor, older people in New York and California may end up better under Obamacare.  But liberals are pushing for generous health care entitlements to spread to an ever-growing swath of society, an arrangement that will eventually squeeze the middle class out of the health care market.  And a nation without a stable middle class can’t fund a massive new entitlement for a swelling portion of society, which means even the poor won’t get much help for much longer.

Finally, Obamacare is funded through openly larcenous schemes such as swiping billions of dollars in tax credits from people who used to be allowed to deduct most medical expenses from their incomes for tax purposes.  This is yet another way in which Obamacare hurts the people it is supposed to be helping.

So Obamacare doesn’t help people who can barely scrounge up enough to pay for a Bronze plan, and it doesn’t help people who have to upgrade to Silver for the same coverage.

It doesn’t help individual market subscribers or those who work for small businesses, and soon it won’t help those with large employers.

It doesn’t help frugal red states, and soon it won’t help prodigal blue states.

It doesn’t help young people, and soon it won’t help old people.

It doesn’t help the middle class, and soon it won’t help the poor.

In the long run, Obamacare’s cheap, flashy, structurally hollow aluminum plans help no one.

Previously published in modified form at Red Alert Politics

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Note to Dems: Disapprobation Does Not Equal Sabotage

November 06, 2013 By: Scott Spiegel Category: Health Care

438px-VillaincLiberal journalists prostituting their reputations by defending the disastrous Obamacare rollout have been wailing that the real reason for’s failure is GOP sabotage.  But there’s a huge difference between the tactic Republicans have been using—withdrawal of support—and the active interference of which Democrats accuse them.

Confusing inaction with action, Politico’s Todd Purdhum labeled the GOP’s restrained disapprobation “calculated sabotage.”  He wrote that Republicans “kept up their crusade past the president’s reelection, in a pattern of ‘massive resistance’ not seen since the Southern states’ defiance of the Supreme Court’s Brown v. Board of Education decision in 1954.”  (Someone needs to remind Purdhum that it was his party leading the segregationist charge.)

Purdhum complained, “Party leaders enforced discipline, withholding any support for the new law—which passed with only Democratic votes, thus undermining its acceptance”—as though voting against the opposition’s legislation represents some kind of heinous, borderline felonious tactic outside the bounds of legitimate governance.  He decried Republican governors’ refusal to implement Obamacare exchanges, whining that the federal government was forced “to take at least partial responsibility for creating marketplaces serving 36 states—far more than ever intended.”  Boo-hoo.  Be glad all 57 states didn’t reject Obama.

Steve Benen approvingly cited an administration official saying, “You’re basically trying to build a complicated building in a war zone, because the Republicans are lobbing bombs at us.”  Lobbing bombs?  More like failing to provide gold-plated reinforcements rushed in by barefoot runners.

Washington Post reporters Amy Goldstein and Juliet Eilperin sympathetically repeated the White House’s sobbing claim that it couldn’t bless states with its own calligraphic diagrams showing how to run a perfect state exchange, because big bad Republicans would “brandish” their charts to the media as the bureaucratic Rube Goldberg schemes they are.

Goldstein and Eilperin also reported that the White House suppressed the number of states refusing to set up their own exchanges and relying on the federal exchange, claiming that Republicans would use this revelation to their political advantage.  (Apparently history repeats itself: Now the administration can’t, just can’t release Obamacare enrollment numbers to a public that’s paying for the program because… Republicans will use the revelation to their political advantage!)

Kevin Drum at Mother Jones argued that most of the administration’s missteps in its Obamacare implementation resulted, not from managerial incompetence or political calculation, but from resistance to Sun Tzu-derived stratagems like “Sabotage Works.”

To be fair, Dick Morris did nastily urge his supporters to visit repeatedly and try to push its capabilities to the limit, overload it, and break it.

Wait—Morris didn’t do any of that; he urged his supporters to “sign petitions asking their states to refuse to establish exchanges.”  Armed insurrection!

In fact, Republicans and Tea Partiers have been practically Gandhi-like in the non-aggressiveness of their measures to overturn the law.

Here are the actual tactics Republicans have used: not voting for Obamacare, not allocating money for the development of the federal exchange, refusing to confirm radical recess appointments to oversee Medicare, refusing to gloss over the macro- and long-term implications of the program, rejecting the administration’s appeals to young people to buy a product not in their economic interest to purchase, declining Medicaid funds that would require their states to kick in taxpayer funds once the money runs out, declining to spend billions in taxpayer money to set up 51 state health exchanges, not approving more money to fix the broken website, not sympathizing with beleaguered Health and Human Services officials in the hot seat, refusing to waste time personally navigating individual voters around, not explaining away the website’s glitches, refusing to preach to Americans the wonders of Obamacare, and refusing to accept Obamacare as “settled law.”

That’s a lot of focused, frenzied activity, but notice what it all has in common: not doing things.

Here are some actions that would constitute genuine sabotage if Republicans actually carried them out: enacting provisions that would hobble the law and make it harder to implement; encouraging constituents to flood the site and put strain on its servers; and lying about premium increases, to name three off the top of my head.  (It’s hard for me to generate more, because I’m not a Democrat and I don’t think that way.)

In the same way that conservatives generally support the “negative liberties” actually protected by the Constitution—the right not to be physically attacked or slandered, not to have your property or firearms confiscated, not to have your income stolen and redistributed—they have similarly pursued “negative tactics” in opposing Obamacare: namely, refusing to condone, fund, or support it.

In other words, Republicans’ means match their goals.

Meanwhile, Democrats who favor imaginary “positive rights” involving redistribution of wealth, judicial activism, and government promotion of social justice naturally confuse Republican failure to help implement Obamacare with active efforts to hamstring it.  Democrats have spent so long pursuing an interventionist government that they can’t distinguish legitimate political dissent from ornery sabotage.  In their view, “all-out war” is equivalent to “not lavishing trillions of dollars on something your constituents despise but the opposition party adores.”

Ironically, the party regularly smeared as “war-mongerers” is engaging in the most passive, serene opposition campaign to Obamacare possible: embodying the mantra, “This too shall pass.”

Previously published in modified form at Red Alert Politics

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October 30, 2013 By: Scott Spiegel Category: Health Care

Health and Human Services Secretary Kathleen Sebelius testifies on Capitol Hill in Washington, Wednesday, Oct. 21, 2009, before the Senate Homeland Security and Governmental Affairs Committee hearing on the swine flu. (AP Photo/Susan Walsh)The most remarkable exchange during Health and Human Services Secretary Kathleen Sebelius’s testimony to the House Energy and Commerce Committee on Wednesday came when Democratic Michigan Representative John Dingell tried to get her to agree that millions of Americans losing their private health insurance plans due to Obamacare will subsequently enjoy greater choice and liberation from being forced into plans they don’t want.

Talk about irony.

Dingell began, “Does the ACA require insurance companies to discontinue the plans that people had when the law was passed?”  This was a reference to an earlier line of inquiry on whether people were being kicked off their plans because of Obamacare regulations.  The law allows people to stay on their plans only if they already had them in March 2010, and only if their plans didn’t change after that.

After Sebelius agreed, Dingell continued: “So if an insurance company is no longer offering a certain plan, that’s because that insurance company made a decision to change their policies, and that caused them to take away the grandfather status from their insurance purchasers?”  When Sebelius conceded it was, Dingell added, “Now, Madam Secretary, I want you to submit for the record a statement of what it is we can do about insurance companies that run around canceling the policies of their people…  I want to get a very clear statement from you as to what you can do so we can take some skin off some folks that have it coming.”

Dingell was half-joking, but his statement inadvertently reveals boatloads about liberals’ view of the morality of those involved in large-scale private commercial exchanges.  In Dingell’s view, insurance companies that change their plans do so willy-nilly, out of carelessness or a desire to squeeze a few more pennies out of their customers.  Insurance executives don’t review their policy options and determine how best to meet the needs of an ever-shifting consumer base in a constantly-evolving market.  No, they’re callous power brokers who make capricious decisions about coverage to maximize personal gain, knowing that customers are stuck in their plans and that they are shielded from ever going out of business.

Wait—doesn’t that describe the role of government under Obamacare?

It’s Obamacare that’s forcing individuals to obtain coverage that meets strict protections consumers may not wish to pay for, given their youth, health, and risk tolerance.  HHS claims to increase competition and offer more choices, but this contradicts all evidence we’ve seen of insurance companies declining participation in state and federal exchanges—thus limiting consumers’ options—and dropping people from their rolls.

And as we’ve seen in the past few weeks, it’s the federal government and its regulatory agencies that are shielded from ever “going out of business.”  If a private company oversaw the disastrous website rollout HHS inflicted on the nation during October, they’d be shuttered by Halloween.  What happened to HHS?  It got an infusion of millions more dollars to implement a “tech surge” in order to do something it should have done months ago.

What happens if the federal exchange website isn’t working by the newly promised deadline of November 30?  Surely Obamacare will be scrapped and HHS will lose its funding?  Surely not—HHS will likely get another blast of cash and another extension to attempt to demonstrate a modicum of competence.

Regarding Americans being dropped by their insurance companies, Dingell asked, “Now, in the cancellation letters… some insurance companies are suggesting an alternative plan at a higher price.  Do they have the right to do that?…  [T]hey have no right… to enforce that demand…?”  When Sebelius declared that they do not, Dingell sneered, “Looks to me like the insurance companies are trying to inflict on their customers the view that this is… the only option available to them, is that correct?”  After Sebelius hedged, Dingell asked again, “But the insurance companies have no right to enforce that view on the customer…  And you don’t… [have to comply] when they come forward and tell you that you’ve got to buy a particular policy, is that right?”

This is a mind-boggling line of questioning, and it’s not surprising that someone as shrewd as Sebelius—much as she’d like to villainize insurers—avoided getting caught up in Dingell’s feverish fantasy of private companies roping in customers and forcing them to switch to more expensive plans.  Again, isn’t that exactly what Obamacare does?

Note that the above discussion doesn’t even touch on the main reason insurance companies are changing their plans—namely, they don’t meet the Obamacare minimum coverage requirements.  It would take a galling lack of integrity and a presumption of damning stupidity on the part of the American people for an administration official to tell them that insurance companies, not Obamacare regulations, are responsible for cancelling their policies.

Oh, wait—an Obama shill has already tried that.

New Jersey Democratic Representative Frank Pallone, Jr. echoed Dingell’s point later in the hearing in this jaw-dropping soliloquy: “You know, what I think my colleagues on the other side forget is that this is not socialized medicine.  This is in fact private insurance in a competitive market.  And if I’m an insurance company and all of a sudden everyone else is selling a better policy with better benefits at a lower price, I can’t continue to sell a lousy skeletal policy that doesn’t provide benefits and cost more because I’ll be out of the market…  Insurance companies are canceling lousy policies with high prices because they can’t compete.  And that’s what’s gonna happen when you have a private insurance market, which is what we have here.  We don’t have a government-controlled system.  We have private markets.”

Got that?  In a private, free-market system, insurance companies have the capacity to hold enrollees hostage and require them to stay in bad plans with high premiums.  But when government steps in and interferes with the insurance company-consumer relationship by forcing them to agree to terms both sides wouldn’t otherwise have chosen, that’s a free system.

Could Democrats’ conception of private markets and government-run systems be any more backwards?

Previously published in modified form at Red Alert Politics

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Liberals’ Top Ten Excuses for Failed Obamacare Rollout

October 23, 2013 By: Scott Spiegel Category: Health Care

iU_wkFDcnf3EThree weeks later, the left is still blaming the disastrous launch of and the state health exchange websites on anything and everything but the incompetence and shortsightedness of the current Democratic administration and the contractors it hired.

Here are the top ten excuses liberals have offered for the failed Obamacare rollout, in approximate order from most delusional to least insane:

1. Problems?  What Problems?

The stories about difficulties enrolling in Obamacare are exaggerated.  Most people who made a genuine effort to enroll were able.  The media are pointing out minor flaws so they can have something to talk about.

Except that the administration refuses to tell us how many people have enrolled, or even how many have applied, and the scant details trickling in from insurance companies suggest that the number of enrollees is… a trickle.

2. This Is a Republican Distraction

Republicans are claiming the Obamacare rollout was a failure to distract attention from the government shutdown, the debt ceiling, and their general unpopularity.  They’re also harping on Obamacare’s technical problems to conceal the fact that the rate increases they predicted aren’t materializing.

Except that Republicans have been vociferously criticizing Obamacare for four-and-a-half years, long before any of the Democrat-induced government funding and debt ceiling crises; and rates for young people are projected to go up in 45 states.  Democrats are the ones who are secretly grateful for the shutdown distraction.

3. Republicans Are Racist

Conservatives are pointing out problems with Obamacare because they hate the fact that we have a black President.  They’re willing to let the poor suffer and go without health care just to make Obama look bad.

It’s true—racist Republicans like Allen West, Tim Scott, and Herman Cain just can’t stand the fact that Obamacare was authored by such African-American legislators as Nancy Pelosi, Harry Reid, and Max Baucus.  You caught us, libs!

4. Republicans Are Naysayers

Republicans are being their typical pessimistic selves about government ever being able to successfully help people. They’re nitpicking instead of finding solutions.  They expected Obamacare to fail, so they’re biased about its rollout.

Except that nonpartisan IT professionals who know how a site like should have been implemented are making ominous predictions about how the site will take months, and possibly years, to fix.

5. Republicans Are Afraid Americans Will Love Obamacare Once It Starts

If Republicans think the Obamacare rollout is a harbinger for failure, they should let the program collapse on its own.  However, they know that once Americans see it in practice, they’ll be glad they have it.

Except that families and young people in nearly every state are suffering sticker shock over the premiums they’re being quoted, which are much higher than those they were paying before and those they were promised.

6. The Rocky Rollout Shows How Much Americans Love Obamacare

The Obamacare rollout was troubled, because the administration didn’t foresee how wildly popular it would be.  The groundswell of visitors to overburdened the site’s servers.  The fact that so many people are visiting and signing up, cancelling, signing up again, etc. is OK, because it shows people are carefully shopping for the best options.

According to backwards liberal logic, is a massive failure; ergo, tons of people tried to sign up for it.  But IT specialists who have studied the site’s poor configuration suggest that the problem wasn’t too many people getting on the site—that even a few people trying to get on would have experienced the same problems.

7. It’s Republicans’ Fault and the state exchange websites haven’t worked because of Republican obstructionism.  There weren’t enough people around to work out the glitches due to the Republican shutdown.

Except that the government didn’t shut down until the day Obamacare launched.  Employees tasked with implementing the health exchanges weren’t furloughed.  And state governments responsible for implementing the failed state exchanges weren’t affected by the shutdown.

8. Even Apple Fails

Many commercial websites and large tech companies’ products flounder for a few weeks or months after they launch.  The problems with the Obamacare rollout offer a chance to learn about the infrastructure required for such a massive undertaking and ensure smoother implementation of future government projects.

Except that no one is forced to buy an iPhone or shop at under threat of being fined if they don’t, and such companies—unlike the government—go out of business if they underperform.  When government underperforms, the only ones who suffer are the public.

9. Be Patient

We just need to wait for the glitches to be sorted out.  There’s still over two months for people to enroll and get coverage by January 1, 2014.  The Republican-predicted ‘death spiral’ resulting from young people giving up, but old people persisting, won’t occur, because Americans have until February 15, 2014 to enroll before being penalized.

Except that IT experts are pessimistic about’s problems being solved by the end of the year, or even by February, and there won’t be enough of a window for the seven million people needed to sign up.

10. But—Healthcare! may have glitches, but that doesn’t mean Obamacare will fail.  Technical problems with the Obamacare rollout pale in comparison to the benefits the program will provide people.  The fact that the launch has been troubled proves that it’s a difficult, worthwhile endeavor.

Except that if Obamacare architects can’t manage the launch of a simple website, there’s no reason to trust that anything else they’ve planned will go according to intentions or within budget, especially given that we’re talking about the federal government.

By the time December 31 rolls around, and the administration is either delaying the individual mandate for a year or suffering enormous public disapproval over its refusal to do so, Republicans’ government shutdown strategy may look positively prescient.  And Democrats won’t be able to blame anyone but themselves.

Previously published in modified form at Red Alert Politics

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Democrats Blame Disastrous Obamacare Rollout on a YouTube Video

October 16, 2013 By: Scott Spiegel Category: Health Care

Obamacare-crashLiberals have been claiming that if Obamacare doesn’t roll out as smooth as butter, it will be solely because of Republican obstructionism.  But implementation architects have managed to screw up quite nicely on their own.

After the first day of national enrollment, California gleefully boasted that it had welcomed 5 million visitors to its state health exchange website—a wildly inflated figure it later revised downward by 87 percent.  State officials reported receiving 70,000 applications, though only a quarter of those have actually been completed with household eligibility determined.  How many applicants have enrolled?  That’s highly classified information, but reports suggest that as of October 3 the number was between zero and ten.

Colorado, Oregon, and Hawaii, which also set up their own exchanges, have each received zero completed applications and zero enrollees.  I don’t mean that these states can’t confirm whether they’ve enrolled anyone—I mean they’ve announced point blank that they haven’t enrolled anybody due to glitches in their systems.  Hawaii’s rollout was so disastrous it had to relaunch its state website two weeks after the first launch.

An important determinant of the economic feasibility of Obamacare will be the percentage of younger, healthier enrollees vs. older, sicker enrollees.  Thus, Washington Post reporter and obvious Obamacare supporter Sarah Kliff boasted that one third of applicants to Connecticut’s program were under 35.  However, Kliff never bothered to tell us how many of those applicants were part of the 1,846 who actually enrolled.

Similarly Maryland, which poured millions into insuring a successful, high-profile rollout, has enrolled a total of… 1,121 applicants.  Maryland Health Connection eagerly reported that 36 percent of those who created accounts are under 35, but again refused to tell us what percentage actually enrolled once they got over the sticker shock.

Kentucky and Washington seem to be the only states with their own exchanges that have captured even a fraction of their projected enrollees, with each state signing up about 9,500 participants.  (Even a broken program is right twice a country.)  Rhode Island snagged 1,698 enrollees; Vermont got 115.  The other states with their own exchanges—New York, Massachusetts, Minnesota, Nevada, and D.C.—aren’t talking.

In case you haven’t been doing the math, that’s fewer than 25,000 enrollees across 15 states.

And remember: these are the 15 states that are the most gung-ho for Obamacare and have been doing the most to prepare for it!  The other 36 states, which are relying on the federal exchange, have been having considerably less luck.

The administration claims its site got 14.6 million “unique visits” in its first 10 days (note to HHS: there’s no such thing as “unique visits”; the relevant metric is “visits” or “unique visitors”).  However, one insurance industry executive who spoke to the Washington Post anonymously estimated that enrollment in the federal exchange as of October 3 was in “single digits.”

Maybe potential enrollees should be more persistent and try logging in during non-peak hours, say 3 in the morning, and giving it a couple of weeks and hundreds of tries before they give up.  Oh, wait—they already have!

Consumers have been having so much trouble with the federal website that private insurance agencies have been directing interested parties to sign up using their company websites, promising that the process will be quicker and more reliable than  However, individuals who apply directly through insurance websites won’t be able to take advantage of the subsidies and tax breaks offered by the government—the big selling point that was supposed to make the plan affordable for many people.

Evidence of the number of enrollees via insurance company websites is scant, but CoOportunity Health reported enrolling a whopping five people in Iowa and nine in Nebraska.  Vantage Health Plan reported enrolling twelve in Louisiana.

(Say, what’s going on in Texas, Florida, and the 31 other states using the federal exchange?  Why, you’ll just have to wait until the middle of November, which is when the Obama administration has announced it will deign to give us an update.)

In a desperate attempt to get around the glitches encountered online, many states have been resorting to paper applications.  However, according to health care “navigators” hired to help people make their way through the system, these applications have to be entered by hand, then fed into the malfunctioning online system.  Thus, if the online system isn’t working, then paper applications enter the system no sooner than, and in many cases later than, the ones entered directly online, all while creating more work and yielding more error.

Yet administration shills insist that these rapidly multiplying glitches are no big deal.

Losing Max Baucus is one thing, but when you’ve got Wolf Blitzer, Robert Gibbs, and Ezra Klein jumping ship, you know you’re in trouble.

Promoters of wildly popular YouTube videos that eat up lots of server bandwidth had better watch their backs.

Previously published in modified form at Red Alert Politics

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