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Who’s More Unhinged: Obamacare Opponents or Obamacare Supporters?

August 14, 2013 By: Scott Spiegel Category: Health Care

imagesAccording to liberals, conservatives’ desire to repeal Obamacare constitutes, not a legitimate, principled policy disagreement, but a mental disorder.

The Washington Post’s Greg Sargent claims that Congressional Republicans’ threat to oppose a continuing budget resolution that includes Obamacare funding is “driven by pathological anti-Obamacare animus.”

Ezra Klein argues that Republicans are on a “kamikaze” mission and “have taken themselves hostage.  They’re threatening to hurt themselves and their states and their voters and their most committed activists if Democrats don’t give them their way on Obamacare.”

The Atlantic’s Garance Franke-Ruta takes President Obama’s phrase “ideological fixation” from his news conference last Friday and runs with it.   Wrestling the GOP onto her psychoanalyst’s couch, she writes, “In 19th-century psychology, the idée fixe was understood as a close relative of monomania and obsessive-compulsion, often accompanied by symptoms of hysteria such as amnesia or anesthesia, the inability to feel.  Idées fixes developed secondary to some sort of trauma or dislocation…  The idée fixe, as such, was a neurotic symptom.”

If opposition to Obamacare is an actual mental disorder, does that mean Obamacare will pay to treat it?

Other left-leaning commentators have argued that Republicans’ opposition to Obamacare is literally insane:

  • Washington Post reporters David Fahrenthold and Ed O’Keefe stated, of Congressional Republicans’ efforts to repeal or defund aspects of Obamacare, “Doing the same thing over and over again — and expecting a different result — is supposed to be the definition of insanity.”
  • Forward Progressives huffed, “Insanity is doing the same thing over and over again and expecting different results.  That about sums up House Republicans.”
  • In his piece “Why Trying to Defund Obamacare Is the Definition of Insanity,” Rick Moran labeled the pro-defunding crowd “nutty” and “crazy” and their quest to repeal Obamacare “madness” and “throw[ing] sanity to the winds”
  • Pollways’ Amy Fried called legislators who oppose Obamacare “the paranoid caucus” and said their supporters are filled with “paranoid fears”
  • Senator Sheldon Whitehouse labeled Obamacare opponents “paranoid,” before comparing them to sadist French revolutionaries laughing before executing their victims
  • Gerald Seib claimed that those who oppose Obamacare betray their “schizophrenia”

At least liberals have moved on from claiming Obamacare opposition is driven by racism!  That constitutes some sort of psychological progress, I guess.

Since we’re playing armchair psychiatrist, how about diagnosing left-wingers who offered notable commentary on Obamacare?

  • Compulsive lyingBarack Obama: “If you like your doctor, you will be able to keep your doctor.  Period.  If you like your health care plan, you will be able to keep your health care plan.  Period.  No one will take it away.  No matter what.”
  • Avoidant personality disorder – Former Speaker Nancy Pelosi, when asked where the Constitution authorizes Obamacare’s individual mandate: “Are you serious?  Are you serious?”
  • Delusional jealousy – Senator Max Baucus: “[T]he wealthy are getting way, way too wealthy, and the middle income class is left behind…  This legislation will have the effect of addressing that mal-distribution of income in America.”
  • Paranoid personality disorderBarack Obama: “There is a lot of disinformation about health insurance reform out there…  These rumors often travel just below the surface via chain emails or through casual conversation…  If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov.”
  • Borderline personality disorder – Former Medicare and Medicaid Administrator Donald Berwick on Great Britain’s National Health Service: “I am romantic about the NHS; I love it.  All I need to do to rediscover the romance is to look at health care in my own country…  Those are my observations from far away – from an American fan, distant and starry-eyed.”
  • Narcissistic personality disorderHarry Reid: “Now that the legislation passed, it is amazing how much different people[’s] attitude is.  I mean, traveling on an airplane people are so nice to me…  We have people coming, sending me notes in church.  ‘I have a disabled daughter.  Thank you very much for taking care of her.’”
  • Passive-aggressive personality disorderBarack Obama: “Ultimately, I’m confident that the Supreme Court will not take what would be an unprecedented, extraordinary step of overturning a law that was passed by a strong majority of a democratically elected Congress.”
  • ADHD; brief reactive psychosis; learning disability – Representative Sheila Jackson Lee on the evils of repealing Obamacare: “Can you tell me what’s more unconstitutional than taking away from the people of America their Fifth Amendment rights, their Fourteenth Amendment rights, and the right to equal protection under the law?”

Behold the party of Occupy Wall Street drum circles, the Weather Underground, Obama cell phone lady, Anthony Weiner, and the above assortment of loony birds lecturing us on which party suffers from greater mental unbalance.  Is that really a direction liberals want the national conversation to go in?

Previously published in modified form at Red Alert Politics

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For Obamacare to Work, We Must Ignore What Insurance Is

August 07, 2013 By: Scott Spiegel Category: Health Care

3193124-man-closing-his-eyes-while-covering-his-earsLiberals are just now grasping the economic case against Obamacare that Tea Party protestors and townhall attendees have been making for four years—and they’re still getting it wrong.

Witness economics professor Robert H. Frank’s Sunday column in The New York Times called “For Obamacare to Work, Everyone Must Be In.”  In it Frank notes that there are two incompatible propositions framing the Obamacare debate: that people shouldn’t be denied coverage based on preexisting medical conditions, and that government shouldn’t force individuals to buy health insurance.  Both conditions, Frank writes, cannot be adhered to simultaneously.  (Guess which one he thinks we should drop?)

Frank describes how banning denial of coverage due to preexisting conditions without instituting an individual mandate leads to an “adverse-selection problem,” whereby people with expensive illnesses are willing to pay the universally-priced premiums, but healthy people drop out of the market, thus driving up the price of insurance.  This process continues, with relatively healthy people leaving the market as premiums steadily increase, until insurance becomes exorbitantly expensive.  (For evidence of this phenomenon, see California, Washington, New York, or New Jersey.)

This problem with government-regulated markets is also known as the insurance “death spiral” (not to be confused with “death panels,” another correctly-anticipated Obamacare consequence.)

Frank argues that the only way around the adverse-selection problem is to force everyone to buy health insurance: “The adverse-selection problem explains why almost no countries leave health care provision to unregulated private insurance markets.”  He labels the problem “a profound source of market failure that renders unregulated insurance markets a catastrophically ineffective way of providing access to health care.”  He challenges, “We must ask those who would repeal Obamacare how they propose to solve the adverse-selection problem.”

Leaving aside the suggestion that we should take what socialist and authoritarian states around the world do as a model for our behavior, there is in fact a way around this dilemma, and it doesn’t involve forcing anyone to do anything.  It also demonstrates, not the failure of the market, but its genius.

The solution is to treat health insurance as—surprise!—insurance; that is, to treat it as a voluntary plan that you can invest in if you want, or take your chances and decline to purchase if you’re young, healthy, non-risk-averse, and believe you can do better things with your money.

The catch is that whatever you decide, you have to live with.  If you decline to buy health insurance and get sick, you could be in trouble, and may have to rely on savings or loved ones or loans or charity to pay for the care you need.

In this system, there are lots of people forking over thousands of dollars a year to insurance companies and getting nothing in return, because they are “unlucky” enough to remain healthy.  But this is how insurance companies stay in business: in order to be able to pay a “jackpot” to the few people who develop expensive illnesses, their reserves have to be funded by thousands of other people who don’t get sick.

The insurance market is inherently risky and uncertain; as with casino gambling, the house wins in the long run.  Buying insurance usually doesn’t get you anything tangible—it buys you peace of mind.

Naturally, in a free market, premiums go up the older you get and the more illnesses you acquire.  This is insurance companies’ only method of being able to provide insurance to most people without their business model collapsing.

As for people with preexisting conditions, the reason it’s so hard for them to get coverage is that their likelihood of acquiring the illness they wish to hedge against approaches 100%.  Walking into an insurance company and demanding that they pay for your existing or soon-to-develop illness isn’t insurance, it’s welfare.

Switching metaphors, what kind of casino lets you decide whether to bet on the blackjack table only after you’ve seen all your cards?

Insurance with high deductibles is still generally available for people with preexisting conditions for some serious illnesses.  People who have trouble finding any insurance can often join voluntary high-risk pools set up in their states.  But sick people can’t claim that getting their treatment paid for when they already know they’re going to get sick is insurance.

(By the way, note the irony of a writer in The Times scolding us that “Everyone must be in,” when “Everyone” apparently excludes thousands of unions and businesses who have received Obamacare waivers, employers who complained that they couldn’t follow the law in time for its rollout, and legislators and thousands of their aides.  Apparently Obamacare will work just fine without their forced participation.)

The flaw in Frank’s case is his presumption that insurance for preexisting conditions is a reasonable provision and should be offered at all.  It shouldn’t, or at least it shouldn’t be called insurance.

Frank’s argument is a barely more sophisticated version of former White House health advisor Ezekiel Emanuel’s embarrassing plea to young people several months ago to buy health insurance in order to show their support for Obama.  But neither Frank nor any other economist is ever going to come up with a satisfactory resolution to the adverse-selection problem if they refuse to grasp the fundamental concept of insurance.

Previously published in modified form at Red Alert Politics

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Obamacare Conundrums

July 10, 2013 By: Scott Spiegel Category: Health Care

imagesOver the Fourth of July weekend, millions of everyday citizens gathered in streets and public squares to protest the tyrannical leader they had put into power less than a year ago.  Though he had been democratically elected and represented many citizens’ hopes for a new order, he had surprised them by quashing personal freedoms, empowering hard-line ideologues, and ruling in a dictatorial manner.

Ah, I remember those anti-Obamacare Tea Party rallies only four years ago!

Just before the holiday weekend, President Obama dropped the bomb on us that the penalty on businesses with 50 or more employees that don’t give their workers health insurance would be delayed for a full year, conveniently until just after the 2014 midterm elections.  His executive action suggests a Zen-like riddle: Does the arbitrary lifting of a regulation affecting tens of thousands of businesses and dozens of states, three months before it’s set to take effect, represent an encroachment on our liberty or a relief from federal intervention?

What is the sound of one pin falling?

For employers such as fast-food chain Fatburger, which had already begun planning for FY14, it was certainly a burden.  CEO Andy Wiederhorn remarked, “All it’s doing is causing confusion, anxiety and the workers are paying the price.  Now, the mandate’s a moving target…  We feel like we have whiplash here.”  I could be wrong, but I believe Confusion, Anxiety, and Whiplash are three of Peter Drucker’s key management principles.

You may recall Obama’s Department of Health and Human Services announcing out of the blue in April that its small business insurance exchange program would also be delayed by a year, thus forcing employees to use the sole insurance plan offered and denying them any choice among plans—the whole point of the program.

Similarly, Obama unexpectedly cancelled the early retirement benefits portion of Obamacare three years before it was supposed to end, because the bill’s authors had failed to budget enough for the program.

Now the administration is considering eliminating Obamacare’s tobacco-use penalties, which would have boosted premiums for smokers, due to a computer glitch.

This sudden, head-spinning series of announcements got me thinking: If Obama can repeatedly issue executive orders delaying or curtailing key components of Obamacare, without obtaining Congressional authorization, can the next Republican President issue an executive order delaying all of Obamacare forever?

If the House votes to repeal Obamacare 37 times, does it make a sound?

Obamacare implementation is appearing more and more surreal lately, and I think I have an explanation.  Nothing about implementation is going as planned, because the administration never had any intention of doing what it said it was going to do or following executive precedent in implementing the law.  How else to explain the following absurd implementation spectacles?

  • The panicked administration is overhauling the team charged with rolling out Obamacare less than 100 days before the whole thing starts; yet Obama’s shortsighted lackeys are taunting, “Republicans and healthcare naysayers have as much credibility as the Psychic Friends Network”
  • HHS will be using the honor system by taking millions of Americans’ word that they qualify for the government’s subsidized health insurance exchanges, rather than verifying their eligibility
  • Healthy unemployed young people are being asked to fork over ridiculously high premiums to subsidize health insurance for older people with salaries, pensions, and Social Security benefits
  • Congressional Democrats could end up supporting a Republican-proposed delay in the individual mandate until 2015, given that it is the least popular aspect of Obamacare and many less unpopular parts of Obamacare have already been delayed or eliminated
  • Obama informed the populace that he postponed the employer mandate because business owners were complaining about the regulations; yet the populace has been complaining about the individual mandate’s regulations for four years with no relief
  • Supporters, authors, and implementers of the law have been quoted saying that the law is “a huge train wreck,” will spike health insurance rates by “double digits,” gives them “reason to be very concerned about what’s going to happen,” could end up being “a third-world experience,” generates “real issues,” makes them “pretty nervous,” and reveals the administration to be in “triage mode

Expect more Obamacare conundrums to unfold as big-government utopians unwittingly demonstrate the impossibility of carrying out that which cannot be implemented.

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Health Care Rationing: A Love Story

July 13, 2010 By: Scott Spiegel Category: Health Care

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Image by Scott Spiegel via Flickr

What kind of benevolent dictator would declare his love for Britain’s stingy, depressing, complicated, cold and arbitrary National Health Service by describing it as “generous, hopeful, confident, joyous and just”?

That would be Harvard-based pediatrician Donald Berwick, who recently received a recess appointment as Administrator of the Centers for Medicare and Medicaid Services by the benevolent dictator who describes his pessimistic and stale vision for America as “hope and change.”

Recess appointments are an executive procedure used, for better or for worse, when the Senate gives a presidential appointee a difficult time during confirmation hearings—for example, when they filibuster a nominee.  Obama’s appointment of Berwick bears the distinction of having been given without a confirmation hearing having even been scheduled.

It’s as though Obama decided that the very requirement that his nominee appear before a Democratic-controlled Senate constituted an unreasonably difficult hurdle.  This isn’t a recess appointment—it’s a vacation to Bermuda appointment.

As the Wall Street Journal noted, “Circumventing Senate confirmation to appoint the new Medicare chief is part of the same political willfulness that inflicted ObamaCare on the country despite the objections of most voters.”  CBS News observed, “The debate over Berwick’s recess appointment makes clear what the White House knew all too well—Berwick may not have survived the Senate confirmation process, which would have turned into a proxy debate over health care reform.”

Berwick, who will be put in charge of the health care of 100 million Americans without so much as a public query about his plans in office, has been quoted saying, “I am romantic about the N.H.S.; I love it.”  He has called himself “an American fan” of the system, “distant and starry-eyed.”

In his London speech commemorating the N.H.S.’s 60th birthday, Berwick delivered such pro-American pronouncements to his audience as “Do not trust market forces to give you the system you need…  I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care.  That is for leaders to do.”

When it comes to Berwick’s affection for health care systems centered around use of death panels, apparently absence makes the heart grow fonder.  After returning home and mooning over the UK’s National Institute for Health and Clinical Excellence, the operational arm of the N.H.S., Berwick realized that “All I need to do to rediscover the romance is to look at health care in my own country.”

That country would be the United States, which has the greatest health care system in the world, and would be a profound source of inspiration for anyone who truly loved medicine.  Berwick’s own place of employment is Harvard Medical School, where you would think there would have been a few medical advances in recent years to set his heart aflutter.

But no—Berwick’s passion is for euthanasia counseling and quality-adjusted life years.

Berwick of course has never had to live under the jurisdiction of the N.H.S.  You might call his affair with the British health care system a long-distance relationship.

Describing the supposed British backlash against American conservatives’ depiction of the N.H.S. during the health care reform debate last summer, the New York Times gushed, “A Twitter campaign, We Love The N.H.S., is still going strong, with supporters sending messages about their own good experiences.”

In fact, said campaign didn’t even last 30 days from its first Tweet to its last, and has attracted a piddly 520 followers internationally.  This is despite such helpful but unheeded administrative prompts as “What do you love about the nhs?” and “Please Retweet: 10,000 supporters visualised.”

Admittedly, the riotously popular N.H.S. does have a Facebook fan page with 3,500 members.  Then again, an ill-worded N.H.S. sign implying that contraception would be facilitated by anal rather than vaginal intercourse has a Facebook fan page with 124,475 members.  So perhaps fan counts are not such a flattering measure of the N.H.S.’s popularity.

Even the New York Times admitted that Brits “complain endlessly about the National Health Service…  They deplore the system’s waiting lists, its regional disparities in treatment, its infection-breeding hospitals and its top-heavy bureaucracy.”  I guess the grass is greener on the other side of the pond!

If Donald Berwick wants to swoon over endless waiting lists, fatally protracted wait times, diminished access to specialized care, craven efforts to shield patients from learning about or acquiring costly life-saving drugs, dismal heart attack and cancer survival rates, depersonalized patient treatment, and centralized bureaucratic decision-making about individual health care options, that’s his prerogative.  But forgive the rest of the U.S. if we aren’t quite as smitten as he is.

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Gambling on Amnesia

February 24, 2010 By: Scott Spiegel Category: Columns, Health Care

“This president is a real slow learner.” – Oscar Goodman, Mayor of Las Vegas

Speaking of gambling, President Obama has subpoenaed weary Democrats and disgusted Republicans to a Blair House summit tomorrow for a day-long policy-palooza to be broadcast on C-SPAN for Americans who didn’t get enough of the health care reform debate last year.  Obama has decided to wager what little respectability he has left on the hope that the American people will be charmed by his vision of health care reform, will develop amnesia, and will forget everything they hate about the bills passed by Congress last year.

The Associated Press announces that the new proposal released by the President “is important, but not as critical as the political skill Obama can apply to an impasse that seems close to hopeless in a pivotal congressional election year.”

Hmm…  Let’s tally up the campaigns Obama has fought and lost using his “political skill” over the past four months: securing the 2016 Olympics for Chicago, electing Creigh Deeds governor of Virginia, reelecting John Corzine governor of New Jersey, getting UN members to agree to a climate change accord in Copenhagen, and electing Martha Coakley Senator in Massachusetts.  And of course his year-long crusade to sell Congress’s health care plan to the public, which resulted in voters increasing their opposition to the plan in direct proportion to the number of syllables Obama emitted in his attempts to explain it.

Obama views the populace as a huddled mass of slow learners to whom he must explicate Congress’s monstrous health care legislation over and over until it penetrates their thick skulls.

In fact, it is Obama who is the slow learner.  Americans have learned about the bill, debated the bill, and rejected the bill; implicitly and explicitly, at townhall meetings and in polls and at the ballot box; over and over, for a year.

But Obama promises us he has a new proposal that incorporates the best of the House and Senate bills.  The White House posted Obama’s proposal online Monday morning to allow the public to see what bold, fresh ideas the President has to offer.

The verdict: Obama might as well have taken the Senate version of the health care bill and stuck Groucho Marx glasses, nose, and mustache on it.

Obama has been trying to entice Republican lawmakers to attend the summit by boasting that there are “Republican elements” in his proposal—by which he means that there are Democratic elements in it that a few liberal Republicans have been caught on tape saying might be tolerable, if dealt with in isolation, if massively reworked from their present form, and if included only in conjunction with real free-market reforms.

Even AP admits that Obama has nothing new to offer: “Realistically, he’s just hoping to win a big enough slice to silence the talk of a failing presidency.”

Obama’s one significant innovation is increasing the federal government’s power to regulate insurance premiums: “[H]ealth insurers must submit their proposed premium increases to the State authority or Secretary for review…  [I]f a rate increase is unreasonable and unjustified, health insurers must lower premiums, provide rebates, or take other actions to make premiums affordable.  A new Health Insurance Rate Authority will be created to provide needed oversight at the Federal level.”

So Obama proposes to improve on a massive, bloated bill that explodes government intervention in the private sector and is hated for that very reason by… adding more government intervention.  Sounds like a winner!

Even Democrats aren’t on board with the ideas in this proposal, at least to the degree that they were when the House and Senate passed their versions of the legislation last year.  Congressmen up for reelection this fall received the message sent by Virginia, New Jersey, and Massachusetts loud and clear.  The only federal officials who still want to ram this thing through are Obama, Senators not up for reelection, Senators up for reelection who know they’re going to lose, and Representatives from insanely liberal districts that will boot them if they don’t vote for the bill.

And even Democrats don’t really believe anything will come of Thursday’s meeting.  Every time the media asks Democratic Congressional leaders about their goals for the Blair House summit, they respond with the same bromides about how they believe Thursday’s meeting will help “provide affordable, accessible, quality health care to all Americans.”  How, specifically, will it do that?  Specifically?

If anything is to be passed, it will have to be through budget reconciliation—and many commentators say Democrats don’t even have enough votes for that anymore.

The Chicago Tribune recently called the House and Senate legislation “zombie” bills, noting that neither chamber likes the other’s version, the public hates both, and the only reason the bills are still wandering around is that Congressional leaders are hinting that they will try to merge them through reconciliation.  The Tribune condemns reconciliation as “convoluted.  Confusing.  And unnecessary.  The Democrats need to reconcile themselves to what Americans are telling them about these health care bills: They’re too complicated and too expensive.”

Obama isn’t the only slow learner in Washington.

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The Democrats’ Tower of Babel

January 06, 2010 By: Scott Spiegel Category: Health Care

Each of the two ratified versions of the health care bill currently waiting in Congress was barely passed, by virtually the slimmest margin possible, in a hectic last-minute stampede.  Dozens of harsh compromises had to be hammered out to cobble together the fragile framework now standing in each chamber.

The two bills are like delicate Jenga towers, swaying nerve-wrackingly in the breeze, that must now be reassembled by a team of 535 clumsy attention-seekers into a tower twice as tall.  But legislators across the two chambers—and even within them—are not even speaking the same language.

Here are a few of the myriad discrepancies legislators must reconcile to ensure that their monument to Obama’s greatness doesn’t fall:

In the House version of the bill, a government-run insurance exchange is created on a national level and includes a public option.  In the Senate version, exchanges are created on the state level and do not include a public option.  Virtually identical!

The House completely bans the practice 0f charging those with preexisting conditions higher premiums.  The Senate allows insurers to offer unlimited discounts for customers who engage in subjectively defined wellness activities: say, exercising, eating healthy, “not having contracted lung cancer”…

Insurance exchanges are implemented in 2013 in the House bill and 2014 in the Senate bill.

In the House version, employers are forced to provide insurance for their employees and pay a fine if they do not.  In the Senate version, employers are not required to provide insurance, but pay a fine for employees who opt for government-run insurance and receive federal subsidies.  The House has higher penalties than the Senate.

The House version funds the bill by imposing a surtax on families making over $1 million a year.  The Senate version establishes a tax on those with “Cadillac” plans, which includes not only many union members, but millions of families who will unexpectedly find themselves unlucky Cadillac owners over the next 10 years due to the non-inflation-adjusted nature of the provision.

The House version does not tax insurance offered by employers; the Senate version taxes employer insurance above a threshold.

The House version charges older people a maximum of twice the premiums as younger people; the Senate version sets a maximum ratio of three-to-one.  The House offers fewer insurance subsidies for the middle class than does the Senate.  The Senate offers weaker measures to limit out-of-pocket costs than does the House.

The House bill covers 5 million more people than the Senate bill by expanding Medicaid to those earning up to about $2,000 more than in the Senate bill.

The Senate version gives $100 million to Nebraska for indefinite coverage of all new Medicaid enrollees in the state (to buy Ben Nelson’s vote).  The Senate bill gives $300 million to Louisiana for Medicare increases (for Mary Landrieu’s vote); $10 billion to Vermont for new public health centers (for Bernie Sanders’ vote); billions to Nebraska and Michigan to waive nonprofit insurers’ excise taxes (for Ben Nelson and Carl Levin’s votes); millions to Massachusetts and Vermont for Medicaid; and millions to Florida, New York, and Pennsylvania for Medicare Advantage.  None of these provisions is in the House bill.

The Senate version includes, per the insistence of construction unions, an important exception to the employer mandate.  As an article in the New York Times titled “In Health Bill for Everyone, Provisions for a Few” reports, “Under the Senate bill, businesses with fewer than 50 employees would be exempt from the penalties in every industry but construction.”  In the construction industry, the mandate holds for employers with as few as 5 employees.  The House includes no such provision.

Restrictions on abortion funding are tight in the House, with no federal funding allowed; and loose in the Senate, with mere separation of federal and private money, and states allowed to make up whatever rules they want regarding abortion funding.

Coverage for illegal immigrants is not disallowed in the House; it is explicitly banned in the Senate.

It should be sobering for Democrats to realize that if just one Senator or two Representatives decide they can’t tolerate the alternative version of even one of these provisions, that will be enough to topple the whole health care reform edifice.

It’s no wonder, then, that Congressional Democrats now plan to merge the bills behind closed doors, shutting out all Republicans from discussion of the reconciliation process and preventing them from using parliamentary procedures to slow consideration of the bill and allow the public to digest the proposed changes.  Talking Points Memo cites one Democratic House aide who proudly admits, “This process cuts out the Republicans.”  The House will simply take the Senate’s bill, amend it, vote on it, and send it to the Senate; who will then amend the bill, vote on it, and send it to the House; and back and forth until some hideous, lopsided, structurally unsound blueprint garners enough votes in both chambers.

If Democrats had to merge these two bills in a public conference committee—never mind on C-SPAN, as previously promised and recently offered by the network’s CEO—it would take about five minutes for the cacophonous clatter surrounding their health care Tower of Babel to bring it crashing down.

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Top 10 Stories of 2009

December 23, 2009 By: Scott Spiegel Category: Miscellaneous

Warning: Tiger Woods, Michael Jackson, and Balloon Boy are nowhere to be found in this list!

1. Iran Election Upheaval – Brave protestors took to the streets of Tehran and Twittered to the world shocking pictures and videos of civilian beatings and shootings by the Iranian Revolutionary Guard, despite the inability of our Commander-in-Chief to raise an eyebrow over the carnage for a week.  As “President” Ahmadinejad continues to mock the West’s demands that Iran halt its uranium enrichment, the outrage of the emboldened and mobilized protest movement has the potentially farthest-reaching consequences of any event in 2009.

2. Health Care Reform Debate – Simultaneously the most outrageous and boring story of 2009.  On the one hand, we listened all year in disbelief as conservative think tanks unearthed fresh horrors in evolving versions of the bill; on the other hand, we listened to Democrats recite tired lies about “45 million uninsured” and “bending the cost curve” and “Nancy Pelosi approving a surtax on Botox.”  As Obama supporter Camille Paglia admitted, “By a proportion of something like 10-to-1, negative articles by conservatives were vastly more detailed, specific and practical about the proposals than were supportive articles by Democrats, which often made gestures rather than arguments and brimmed with emotion and sneers.”

3. Climategate – In which more pages of e-mails and computer code than in all the healthcare reform bills combined were leaked to the press, revealing climate “scientists” fudging data, threatening to delete data, and doing everything but counting pregnant chads to make the results come out the way they wanted.  Here’s a deal for Michael Mann, author of the discredited “hockey stick” graph of global temperature over the past few millennia: if “trick,” “hide,” and “decline” no longer mean what they once did, then neither do “dire,” “peer-reviewed,” or “consensus.”

4. Afghanistan Surge – General McChrystal begged President Obama in private and in public to give him the troops he needed to implement the counterinsurgency strategy Obama had hired him to carry out back in March.  After four months of dawdling, Obama gave McChrystal 75% of his revised request—which was 50% of his initial request—with no rationale provided for his bargain basement offer.  If this is how Obama treats the “good war,” I’d hate to see what he does to the bad one.

5. Tea Party Movement – Rasmussen released a poll in December showing that in a three-way generic race among Democratic, Republican, and Tea Party candidates, the Tea Party contender would beat the Republican by 5 points.  Despite the left’s ludicrous charges of racism and desperate use of lewd sexual terms never adopted by any Tea Party patriot, the biggest mass uprising against government spending and abuse of power since 1773 grew angrier and more forceful as the year went on, and will only be further inflamed by the Senate’s Christmas Eve passage of the health care spending act.

6. Stimulus Bill Passage – It would give you a concussion if it fell on you, even if dropped by Obama at the nadir of his bow to the King of Saudi Arabia or the Emperor of Japan.  Four months after its urgently required, life-or-death passage, only 5% of stimulus funds had been spent, a detail the administration papered over by simply lying about funded projects.  Naturally, this summer Democrats began clamoring for another stimulus package.

7. Sonia Sotomayor Confirmation – Proof that Democrats were never the party against racism—they were once the party that supported racism, and now they’re the party that supports reverse racism.  If Our Wise Latina’s speeches on biological differences between the races had been half as incendiary, the media would be consoling us that she might have been rejected for the Supreme Court if what she had said had been any worse; yet the fact is, if her words had been twice as offensive, wimpy Republicans in Congress would probably still have voted to confirm her.

8. Ft. Hood Shootings – The first terrorist attack on U.S. soil since 9/11, which was allowed to happen for the same reason as 9/11—the politically correct refusal to identify the danger of Islamism and its adherents’ wish to obliterate us and our allies for promoting freedom.  The most damning detail was Major Nidal Hasan’s PowerPoint presentation to a group of army scientists on the Koran’s injunction to decapitate infidels—to which the army responded by giving Hasan a promotion in Texas to get him out of their hair.

9. Pakistan Helps the U.S. Fight the Taliban – The Pakistan Army finally stepped up to the plate, no thanks to Obama’s dithering over the U.S.’s own commitment in the region.  Pakistan began Operation Path to Deliverance, in which they managed to send the same number of troops Obama finally agreed to as part of General McChrystal’s surge (30,000) to South Waziristan to beat back insurgents.

10. New Jersey/Virginia Gubernatorial Elections – Last year, liberals hooted that Republican primary candidates were avoiding George W. Bush like the plague, but the joke’s on them—their messiah is turning into the kiss of death in just his first year of office.  Obama’s multiple campaign stops for would-be governors Corzine and Deeds did nothing to assist them, and possibly even hindered their candidacies.

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Cheating the Political Death Panel

November 25, 2009 By: Scott Spiegel Category: Health Care

In their quest to pass health care reform legislation, Democrats have been cheating death, robbing Peter to pay Paul, taking candy from babies, lying through their teeth, moving the goalposts, and burning the candle at both ends.  It is all about to catch up with them.

If I were an editorial cartoonist, I’d depict Harry Reid and Nancy Pelosi as Tarzan and Jane, swinging through the forest, dangling a ragtag bundle of Congressional Democrats in a net trap, eking their way from one tree to the next as each vine snaps behind them, nearly sending them to their death in the jaws of lions below.

Here are a few of the nine lives Congressional Democrats have used up in recent months:

(1)    The House version of the health care bill passed in a squeaker of a vote, 220-215, three weeks ago.  Two Democrats voting the other way would have killed the bill (not 3, since Republican Representative Joseph Cao cast his vote for the bill only once he was sure it would pass without him).

(2)    The Senate agreed to begin debate on its version of the bill in another squeaker of a vote this weekend, which was preceded by a $300,000,000 payoff to Senator Landrieu for her state of Louisiana (thanks for the revised figure, Mary!).  As Dana Milbank noted, this sum is 20 times the price of the original Louisiana Purchase, which bought us 14 states.  As The New York Post observed, based on Louisiana Representative William Jefferson’s recent 13-year sentence for accepting a $100,000 bribe, Landrieu should spend the next 39,000 years in jail.

(3)    Pelosi violated her pledge to post the final version of any legislation online for 72 hours.  Instead, she and Reid have been finishing their handiwork on Friday night and ramming through their votes on Saturday night.  Defeating these bills would be hard enough if the public had time to digest them and hold politicians accountable for supporting them, but now congressmen can claim that they were unaware of ornery provisions slipped in at the last minute, because they were unable to speed-read 300 pages of legalese an hour.

(4)    Leaders of both houses have been inserting, modifying, watering down, or removing passages to get approval for the bill or beginning debate, when they know full well that crucial blocs of defectors will never vote for current legislation in the final vote.  These holdouts will demand that all changes be unmade, which will cause even larger chunks of the Democrats’ fragile majorities to drift away.  For example, Pelosi banned federal funding of abortion in the House bill, a restriction that a dozen representatives will never accept in the final bill.  Reid reinserted in the Senate bill a public option, which had been absent from all committee versions, when he knows that every Republican and at least four Democrats would filibuster a vote on such a bill.

(5)    Reid bought holdout votes from centrist Democrats by making minor concessions tailored to their districts’ concerns.  To support the final bill, these and other Democrats are demanding much bigger concessions, which conflict with each other and with demands made by those in the House.  It is not physically possible to satisfy all of these lawmakers’ requirements at once, which is why Reid and Pelosi have barely been able to do it with 12 different versions of the bill over a period of several months.

(6)    Democrats are willing to slash funding for Medicare, which Jay Cost calls “the most significant fiscal policy ‘achievement’ of the Democratic Party in the last seventy years” [scare quotes mine].  Doing so has cost them the support of seniors, who oppose the bill even more comprehensively than the general public.

(7)    Rasmussen reported on Monday that support for the bill has fallen to a new low of 38%.  Some Senators have been jeopardizing their reelection in 2010 by their support for their bill, and at least one—junior Senator Michael Bennet—has been bragging about it.

(8)    Senator Chuck Schumer is now resorting to bald-faced threats, which should go over wonderfully with the public; recently he declared on behalf of all of Congress, “We’re not going to not pass a bill.”

All of this is already starting to take its toll on Democrats: witness the retreat of Republican Senator Olympia Snowe, who voted not to allow debate on Reid’s bill to proceed, when formerly she had been trumpeted as giving the bill a bipartisan veneer by supporting the Senate Finance Committee’s version.  Democrats think they can pass a bill by tossing concessions left and right to keep the ball rolling through each stage, but their momentum is eventually going to grind to a halt.

On a more general note, anyone trying to do something impossible—in this case, have government take over a sixth of the economy and provide better, more widespread care at lower costs than the private sector, with no sacrifices required from anyone—necessarily fights a harder battle than his opponents, because reality is not on his side.  Republicans, as ineffective and mealy-mouthed as some of them have been in making the case against Congress’s bill, possess the inherent advantage of the truth.  The American people and a vigilant alternative media can discover the truth if no one else will.

Congressional Democrats up for reelection next year for one of 535 seats are about to experience a whole new type of rationing.

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ObamaCare Gains Bipartisan Support from Career Gals of Maine Party

October 14, 2009 By: Scott Spiegel Category: Health Care

Thanks to fierce lobbying by Congressional Democrats, the Senate Finance Committee’s version of the health care bill just passed on Tuesday with bipartisan support from (1) liberal senators, represented by Olympia Snowe from Maine, and (2) ultraliberal senators, represented by all 13 Democrats on the committee.

On Wednesday morning, GOP senator and fellow Pine Stater Susan Collins also announced that she was open to health care reform along the lines of the committee’s proposal.

Impressive as this Republican sweep is, you may recall how Obama’s $787 billion stimulus package received even broader bipartisan support last spring, inasmuch as it attracted the votes of no fewer than three Republican senators, including Snowe, Collins, and Arlen Specter, which of course means that the failure of the stimulus bill to do anything it was supposed to lies equally with Democrats and Republicans.  (Of course, Specter became a Democrat five minutes later, but right up until that moment he was planted firmly on the other side of the aisle.)

Snowe, like Collins, Specter, John McCain, and other liberal senators, has a reputation for magnanimously cooperating with the opposition party (the ultraliberals) in passing legislation that might otherwise abridge our liberty.  Legislators such as Snowe (L-ME) serve the valuable function of watering down such legislation to render its impact marginally less onerous on average Americans.

For example, Snowe opposes a “public option” in the health care reform bill—that is, unless private insurance companies don’t live up to arbitrary standards to be issued by the Secretary of Health and Human Services that will ensure such companies don’t get away with swindles like “earning a profit,” at which point the public option will kick in faster than you can say “single payer.”

It’s a shame that no other Republican congressmen will put aside their partisan differences and work with liberal and ultraliberal senators.  (Imagine how Obama would trumpet the expansive consensus of a tripartisan bill!)  As is, even some liberal senators such as Independent Joe Lieberman have expressed resistance to embracing the proposed legislation on the grounds that it will massively increase health insurance premiums for Americans—i.e., that it is self-defeating and crazy.

Some might quibble that the mere addition of one senator to a committee vote does not indicate the establishment of bipartisanship on health care.  Yet Snowe’s vote must signify a major shepherding of Republicans into the fold, in that Finance Committee Chairman Max Baucus has made a host of concessions on her behalf, such as slashing by 50% the penalty for individuals who don’t buy insurance, and increasing subsidies to people whom the bill mandates must purchase insurance (i.e., everyone).  Never mind that the tiny state of Maine receives the same number of votes in the Senate as California—Snowe’s Finance Committee vote is evidently equal to the vote of 13 Democrat Senators!

The mainstream media’s critical, analytical take on this latest development on health care has been: a hearty rah! rah! for health care reformers for clearing such a grueling hurdle in such a graceful fashion.

While we’re talking about hurdles, it’s instructive to peruse an internal memo released by the Finance Committee in early June, which proposed a timetable for moving legislation through Congress.  According to this starry-eyed agenda, the Committee would pass its bill by mid-July, merge it with the Health, Education, Labor, and Pensions Committee’s wildly different bill and send it to the Senate floor for a vote by the end of July, and merge this with the House’s even more wildly different bill and have legislation ready for Obama to sign by October 1.

So the initial round of passing the bill out of committee, the slam-dunk part of the process, was supposed to take a month—and took four.  The next two rounds—merging the Senate bills, then merging the merged Senate bill with the merged House bill—will be far trickier than the initial round.  These tasks are predicted to take two-and-a-half months—by the same people who were confident Obama would have already signed a health care reform bill two weeks ago.  Based on the Committee’s previous underestimates, by my calculation Congress should get around to voting on a final healthcare bill around September 2010—two months before a third of the Senate and all of the House are up for reelection by a public that opposes every plan they’ve seen out of Congress this year.

Now that the Democrats have secured wide-ranging approval among lawmakers for their bill, I recommend that they capitalize on this groundswell of support.  Let’s hope that ultraliberals can leverage the runaway momentum created by bipartisanship from the Snowe Party to ensure swift passage of their bill.

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32 GOP Bills on the Wall

September 23, 2009 By: Scott Spiegel Category: Health Care

In the event that the imminent failure of Democrats’ socialized medicine bill leads them to some soul-searching—perhaps listening to what their constituents have been telling them all summer, or taking GOP advice to start from scratch—it’s worth noting that House Republicans have introduced 32 health care reform bills since the spring, all languishing in the referral stage.

Many of these lonely bills deal with just one or several aspects of health care reform, rather than offering grand, sweeping Ten-Year Plans that will change Health Care As We Know It.  Not all the bills are knockouts; a couple are downright stinkers.  But virtually all contain some good ideas, and some of them contain nothing but good ideas—which means that no Democrat will ever for a moment consider any of them.

For those desiring ammunition to counterattack the liberal slander that conservatives criticize everything on health care they hear from Democrats but have no ideas of their own, here’s a primer on the legislation prepared by our devoted GOP servants in the House:

•    Several bills are flat-out winners, including Clifford Stearns’ Health Care Tax Deduction Act, Michele Bachmann’s Health Care Freedom of Choice Act, and Rodney Alexander’s Sunset of Life Protection Act.  These laws provide for income tax deductions of health insurance premiums and prescription drugs; medical expenses; and long-term care premiums, respectively.  That’s it.  All three bills are so short they could fit on a cocktail napkin together and still have room for a list of Obama’s failed Cabinet nominations.  This is not surprising: bills covering what individuals are allowed to do for themselves require less verbiage than bills mandating what individuals are required to do for their government.

•    Marsha Blackburn’s Health Care Choices for Seniors Act and Louis Gohmert’s Patient-Controlled Healthcare Protection Act allow seniors to opt out of Medicare and receive vouchers for health savings accounts, an arrangement analogous to school vouchers (another excellent idea liberals oppose).  Edward Royce’s Flexible Health Savings Act allows individuals to carry over unused health savings account funds from year to year.

•    John Shadegg’s Health Care Choice Act eliminates restrictions on interstate governing of health insurance, the primary cause of the limited within-state competition among private insurance companies that President Obama keeps bleating about.

•    Two bills—John Gingrey’s HEALTH Act and Michael Burgess’ Medical Justice Act—enact malpractice tort reform by regulating lawsuits for health care injuries or deaths.  William Thornberry’s Medical Liability Procedural Reform Act sets up state “health care tribunals” or medical courts to adjudicate claims.

•    Several unobjectionable but minor bills extend benefits for veterans, reserve members, and their dependents.

•    A few bills would amend the State Children’s Health Insurance Program to supposedly make it more accountable; however, these bills give the costly, bloated SCHIP so much legitimacy that I’m automatically suspicious of their authors’ credibility.

•    Other bills have good intentions but will lead to more bureaucracy and regulation than they aim to prevent; for example, Thornberry’s Health Care Paperwork Reduction and Fraud Prevention Act, which proposes a “Commission on Health Care Billing Codes and Forms Simplification” to standardize billing paperwork.  No doubt the government will first need to establish a separate commission just to simplify the Commission’s name.

•    Thornberry has proposed two more bad bills (why do public officials who want to meddle in our affairs always invent so many devious ways to do it?).  One is the Partnership to Improve Seniors’ Access to Medicare Act, which subsidizes student loan repayment for doctors who accept Medicare patients; not specified in the bill is how much of our bountiful federal surplus we’ll have to dip into to cover this provision.  Another is the Patient Fairness and Indigent Care Promotion Act, which allows doctors to deduct for tax purposes any unrecouped costs from “patient bad debt”—because nothing increases accountability like providing incentives for doctors not to check beforehand whether patients can pay their bills!

Other GOP bills contain additional provisions, and many of the bills are a mixed bag; but the point is that they’re all better than HR 3200, which is putrid right down to its last period.  Considering even a few key GOP bills over the next couple of years would be a sound way to address individual components of health care reform, in a piecemeal fashion, rather than upending our economy right this minute just because Democrats insist on artificial deadlines to maximize their political gain.

In the meantime, the proper response to any liberal who claims conservatives have no ideas of their own on health care reform should be a resounding, “You lie!”

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