Scott Spiegel

The Democrats’ health care legislation, as is or in very similar form, cannot be passed.  Every choice point they encounter from this stage on leads to an internal contradiction or a dead end.  To use a mathematical metaphor, their situation is overdetermined: there are too many conflicting restrictions; there is no solution to their dilemma.  (To use a liberal metaphor: It’s a slam dunk!)

Democratic proponents of health care reform have the following major goals:

(1)    Create a federal public health insurance option to “compete with” private insurers, or

(2)    Set up state cooperatives to “compete with” private insurers on a state-by-state basis;

(3)    Prevent discrimination by insurance companies based on preexisting condition—i.e., forbid insurance companies from “providing insurance”;

(4)    Limit the ratio of high-to-low insurance premiums by age group.

Whether pursuing any of these goals is the government’s business—and it isn’t—Democrats need to enact some combination of these proposals in order to fulfill their aim of turning us into Canada; the Congressional Budget Office estimates that this will cost about $1 trillion.

Democrats have proposed numerous bad ideas for paying for their legislation, all of which lead to intractable circumstances that they cannot tolerate politically with the general electorate, even if they were able to figure out a way to cobble together, rush through, or force the votes in Congress to pass them.  These funding ideas include:

(1)    Increase the deficit: This would violate Obama’s promise that health care reform will be “dime”-neutral.

(2)    Make taxpayers subsidize the public option: This would keep the government plan from having to cut costs or be efficient to attract and retain customers, as any private insurance company must.  It would therefore eventually force those who are satisfied with their current plans to pay higher premiums or get less for their money.

(3)    Cut $500 billion in Medicare: This would upset seniors, and anyone who plans to be a senior at some point in his life, who fear rationing of care.

(4)    Tax high-cost plans at a 40% rate: This would anger emergency workers and union members, and huge numbers of people who will hit the non-insurance-adjusted premium threshold for this level of taxation in the next 10 years.

(5)    Impose fees on insurance and pharmaceutical companies: These costs would simply be passed on to doctors, who would in turn dump them on to patients.

(6)    Cap deductions for health savings accounts: This would increase out-of-pocket medical expenses.

(7)    Force everyone to buy government-approved health insurance by charging a penalty for not having coverage: If the penalty were low, in order to avoid making it burdensome, then people would wait to get coverage until they became sick, then drop coverage after they recovered, which means the penalty would be useless.  If the penalty were high, in order to make it effective, then the public would be infuriated over the imposition of a costly penalty for not buying something that should be optional.

(8)    Cover fewer uninsured people: This would involve turning the nation’s health care system upside down while failing to fulfill the basic aim of the plan.

In case Democrats are interested, there are provisions to which they could agree, all previously proposed in legislation by House Republicans, which would actually pay for the proposed plan.  These steps should be taken anyway, and should be pursued instead of the Democrats’ aims, but just for the record, they include:

(1)    Medical liability tort reform: This would reduce settlement amounts and lower doctors’ malpractice insurance premiums.

(2)    Tax deductions for health insurance premiums, medical expenses, and prescriptions: This would allow people to decide how to allocate their earnings toward medical expenses, which they can do more efficiently than Kathleen “Jolly Roger” Sebelius.

(3)    Vouchers for opting out of Medicare: This would allow people to decide how to spend their money on medical care in old age.

(4)    Interstate provision of private insurance: This would allow for greater competition and cost-cutting.

Despite conservatives’ nail-biting uncertainty over their ability to defeat HR 3200, they have one advantage: the truth.  All the arguments conservatives have advanced against liberals’ bad ideas are informed by it, whereas liberals must disguise it, distort it, downplay it, or lie about it to persuade anyone that their impossible legislative feat and fevered social engineering fantasy can be achieved.  There are plenty of voters and legislators who are content to ignore the truth and stumble down dead ends, but enough may turn out to be smart and honest enough to see through these efforts and find their way out of the labyrinth.

The eagle-eyed sleuths at Investor’s Business Daily recently dug up a nefarious provision in the House’s 1,018-page health care bill that prohibits you from keeping your current private insurance if any changes are made to it.

On p. 16.

This, in a bill whose table of contents and “general definitions” run to p. 14.  So the House has written a bill whose key, most egregious proviso is hidden so poorly that the authors apparently assumed the public couldn’t be bothered to click two pages to get to it.

Evidently this was too much work for President Obama, whose response during a news conference on Monday at Children’s Hospital to a concerned caller from Maine asking if he was interpreting the stipulation correctly was, “You know, I have to say that I am not familiar with the provision you are talking about.”  What part of the bill is Obama familiar with—the cover?

But don’t worry—Obama says, “If you like your health plan, you can keep it.”  He sure doesn’t know any differently!

In Section 102—that is, the second part of the first section, two pages into the bill—ironically titled, “Protecting the Choice to Keep Current Coverage,” the bill puts the following limitation on those who wish to eschew government-approved options and keep their own coverage: “[T]he individual health insurance issuer offering such coverage [must] not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.”

So it turns out that if you like your health plan, you can keep it—as long as you don’t start liking your health plan on or after the first day of Y1!

The subsequent clause, which discusses dependents, helpfully notes that if you’re sick of your current individual plan and want to switch to a different plan, you still can’t—but the government will be nice enough to let you enroll new dependents under that plan you hate!

Following this is a clause that graciously requires that after five years, “an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan.”

So we’ve unearthed yet another loophole in the first 1% of the bill: if you like the health plan you have, and you happen to get it from your employer, which includes 62% of the population under 65, you can keep it—except that after five years, you can’t!

But don’t expect Obama to be familiar with that provision, either—after all, it’s buried deep into the third page of text in the bill.

After you burrow your way through the labyrinthine textual warrens of pages 17-19, you’ll learn that “qualified” plans may not exclude anyone on the basis of preexisting condition.  On p. 21, the bill mandates that premiums may not vary at all, except by age, state, and family size; and that the highest-to-lowest premium ratio by age group may not be more than 2-to-1.

According to these conditions, a 40-year-old who has chosen to smoke two packs of cigarettes a day his whole life and has contracted lung cancer could end up being charged as little as half the rate of a perfectly healthy non-smoking 60-year-old, just because the 60-year-old is older and has chosen not to smoke.  “Health Choices Act” indeed!

Several years ago, when it was revealed that audience members in Oprah Winfrey’s infamous Great Car Giveaway would have to fork over $7,000 each in taxes, the winners at least had the option to sell the car to pay the taxes and keep the difference—or forfeit the car altogether.

H.R. 3200 isn’t so generous—according to the bill, those who are not in a health plan the government finds acceptable will be fined the full cost of the average plan for their family size.  In other words, you can’t refuse to pay for government-approved health insurance for you and your family, whether you even want or receive it or not.

Rasmussen recently reported that Democrats’ perceived trust advantage over Republicans in the area of health care plummeted from 18 percentage points in May to 4 points in June.  No wonder Obama is racing to get this legislation through Congress before they go to August recess: at the current rate, Republicans will be leading on health care by 38 points come September.

In his speech at Children’s Hospital, Obama intoned, “There are some in this town who are content to perpetuate the status quo, are in fact fighting reform on behalf of powerful special interests.”

There are some around this country who are fighting “reform” on behalf of liberty.