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Reelecting Democrats: More Urgent Than Fixing Our Healthcare System

March 12, 2014 By: Scott Spiegel Category: Obama

vulnerable_senate_2014_democrats_ap_328Even though there hasn’t been much Obamacare news this week, more happens with the Affordable Care Act during a slow week these days than occurred during long stretches of time after it was passed in 2010.  Why?

Congressional Obamacare supporters could have spent the months and years between the bill’s signing in 2010 and its rollout in 2013 starting bill implementation, including instituting and enforcing the individual mandate.  Instead, Democrats postponed most of the bill’s provisions until after the 2012 Presidential election, because they knew that the bill was unpopular and that voters wouldn’t reelect President Obama if they suffered its damaging effects right before the election.  It was an artificial, three-and-a-half-year, Democrat-induced calm before the storm that started on October 1, when millions of cancellation notices gusted into subscribers’ mailboxes, federal and state websites crashed against shoppers’ screens, and voters with few affordable options in sight became lost at sea.

Those months and years were squandered; the administration can’t get them back.  But why is Obama continuing to postpone enforcement of the individual and employer mandates, when he claimed back in 2009 that it was so urgent for us to fix our hopelessly broken healthcare system?  It’s as though every single essential component of Obamacare turned out to be not so essential after all.  Someone should ask Obama: Do we all need insurance that covers pediatric dental care and marital counseling right now, or don’t we?  Will we need it over the next three years, or won’t we?  Obama presented his bill as necessary to avert millions of unnecessary illnesses and thousands of avoidable deaths, not to mention millions of dollars squandered on treating conditions that could have been prevented.  So how is putting off the bill’s most important provisions for years at a time helpful for the country’s health?

Does Senate Majority Leader Harry Reid think his claim that all health care horror stories are false is remotely believable, when the administration’s endless delays of Obamacare provisions are clearly designed to prevent more horror stories from circulating?  Does anyone believe that all these postponements aren’t taking place for political reasons—first the ones postponed until after the 2010 midterm elections; then those postponed until after the 2012 Presidential election; and now endless delays past the 2014 midterms, the 2016 Presidential election, and probably beyond?

A great campaign strategy to defeat Hillary Clinton, or whoever ends up being the Democratic nominee in 2016, would be to ask the candidate whether she supports all these Obamacare delays.  If she says no, then she is sharply at odds with Obama, which is politically risky.  But if she says yes, then she must be asked: How can all of these delays be good for the country, if there are tens of millions of people desperately in need of health insurance right now?  And how can a delay strategy be helpful if there are so many people with inferior insurance who are one illness away from going bankrupt?  Does Clinton want her constituents to die or go bankrupt?

Well actually, yes—many Democratic politicians wouldn’t mind, or at least would benefit politically, from more economic hardship among the electorate.  That would enable them to step in as saviors of the ever-growing downtrodden class and snare us into spending even more money on programs to support the general welfare.  Americans going bankrupt from expensive medical care would be all the more justification for Democrats to heavily regulate health insurance companies, doctors, hospitals, and medical device manufacturers.  Democrats are experts at frightening voters with nightmare scenarios about how bad things will get if Republicans deregulate the free market, and health insurance is an especially sensitive area of that market.

Speaking of scare tactics, Salon.com recently published an astonishing essay arguing that the wealthiest 1% of Americans are “sociopathic,” in that they don’t care about other human beings and enjoy attaining positions of power at companies so they can lay off workers.  This is yet another example of the left exaggerating the extent to which Republicans prefer people to fend for themselves: liberals imply that conservatives want everyone to live on an island, carry out every municipal function on his own, and refuse to work together in a community or divvy up responsibilities.  This argument, in addition to being ridiculous, is belied by the fact that conservatives voluntarily give more to charity than liberals.

Which party is really made up of sociopaths?  I say it’s the one that tells us that millions of Americans are going to die over the next few years if they don’t have adequate health insurance—and then promotes that outcome anyway for purely political reasons.

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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 HealthCare.gov’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 HealthCare.gov 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 HealthCare.gov, 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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Democrats Underestimate Potential of Obamacare Repeal Votes

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

diagramSilly Democrats.  House Republicans haven’t been passing bills to repeal or defund Obamacare over and over because they’re crazy or stupid.  They’re doing it to get you all on record supporting every single soon-to-be-detested provision of this ominously unraveling bill.

They’re doing it to get you on the books opposing common-sense fixes like delaying the bill until the administration can figure out how the hell it’s going to implement it.  And the detailed voting records Republicans have been amassing on you will serve as a treasure trove of evidence to clobber you with during the 2014 midterms.  (They’re also doing it to jolt the clueless two-fifths of the population who don’t know whether the bill is still law or not into awareness.)

Other than partisan bluster, why have the Democrats been making such a huge fuss over the GOP’s repeal votes?  When one party passes, along purely partisan lines, using inappropriate legislative techniques, a bill as big, unwieldy, unprecedented, unconstitutional, unpopular, and unworkable as Obamacare, and sets the dates when its major provisions go into effect two Congresses down the road, is it so shocking that opposition party legislators would busy themselves in the interim trying to stop it?

Look how much work it took Democrats to squeak Obamacare through and how many times they came close to losing it.  Can’t Republicans get at least as many chances to take it off the books?

Contrary to popular belief, the GOP has voted only three times to repeal Obamacare in full, one each in the 111th, 112th, and 113th Congresses; all the other votes have been to repeal, delay, or defund specific provisions of the bill.  And far from the GOP having mindlessly, endlessly cast the same vote on Obamacare since January 2011, as the mainstream media have characterized their behavior, many of these votes have been held in response to specific administration scandals or Department of Health and Human Services delays in implementing key provisions.

For example, the revelation in May that the Internal Revenue Service had targeted Tea Party groups for extra scrutiny led Georgia Representative Tim Price to introduce the Keep the IRS Off Your Health Care Act of 2013, which would have blocked the IRS from enforcing or implementing Obamacare (House vote: 232-185, including 4 Democrats who voted ‘Aye’ and 11 who weaseled out of voting).

And Obama’s arbitrary, illegal, one-year postponement of the employer mandate in July, along with the administration’s admission that it couldn’t verify individual eligibility for health care subsidies, resulted in two bills that would delay the employer and the individual mandate for one year and prohibit distribution of Obamacare subsidies until a reliable verification system was in place (House votes included 35 Democrats for the employer mandate and 22 for the individual mandate).

Don’t forget that a number of these GOP votes have been successes for Obamacare opponents.  Repeal votes have gotten seven unpopular provisions struck from the bill, including the onerous tax reporting requirements that were to be imposed on small businesses, extra funding allocated for the IRS to enforce the law, and a program known as the CLASS Act that was supposed to provide long-term care and encompassed 40% of the bill’s supposed deficit reduction but was merely an accounting gimmick.

But the main advantage of these ongoing GOP votes to deconstruct Obamacare may be to cripple the midterm electoral campaigns of Democrats still clinging to the delusion that the bill will work.  With the administration fumbling implementation left and right, even liberal supporters are jumping ship.  In a sense, Republicans haven’t been trying to repeal Obamacare for the past two-and-a-half years; they’ve been daring Democrats to keep supporting it in the face of its impending failure.

(As a fiscally conservative Republican who hates spending taxpayer money even on useful things, I’d normally be loathe to point this out, but those 41 Congressional votes have cost tens of millions of dollars, which means Democratic voters are officially funding the midterm election campaigns of Republican Representatives.  Hey, Dems—that’s for Media Matters and ACORN.)

Remember that, of the 212 House Democrats who voted to pass Obamacare in March 2010, many are no longer in office, a number having been kicked out in the 2010 landslide or retired because they knew their time was up.  The Weekly Standard breaks down the substantial electoral advantage enjoyed by Democrats who voted against vs. for Obamacare in swing districts in the midterms.

And many Democrats in the House today participated in neither the 2010 Obamacare vote nor the Obamacare repeal votes held during the 112th Congress (2011-2013).  They need to be put to the test.

So bring it on, Dems.  Keep sneering that Republicans are out of touch with reality, suffering from a mental disorder, or hiding the fact that they have no ideas of their own.  We’ll see who’s laughing when the airwaves are blanketed with your voting records next November.

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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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Helping Obamacare Succeed Is Not Americans’ Civic Duty

May 22, 2013 By: Scott Spiegel Category: Health Care

Thomas-Train-WreckAccording to liberals, it was “un-American” to protest the adoption of Obamacare.  Now apparently it’s unpatriotic not to go out of one’s way to help make it a roaring success.

The New York Times recently claimed that GOP congressmen and governors are spitefully refusing to fund or participate in Obamacare implementation solely to make the President look bad.  On Monday The Times argued that conservatives are harping on the Internal Revenue Agency scandal just so they can delegitimize the IRS and block its assigned role in determining citizens’ income eligibility for having to buy health insurance.

In the Times’ fantasy world, Republicans are going after former IRS tax-exempt division head Sarah Hall Ingram just so they can stall her installation as head of the IRS’s health care office.  The Times also claims that conservatives are spotlighting Department of Health and Human Services Head Kathleen Sebelius’s improper Obamacare lobbying efforts just so the law will fail.

Meanwhile, The New Republic’s Jonathan Cohn complains that fast food restaurant owners, nursing home operators, and other low-wage employers are trying to “weasel out” of complying with Obamacare—as though it were every businessman’s patriotic duty to mindlessly accept intrusive, expensive regulations, or as though thousands of Democrat-connected organizations hadn’t already been granted waivers to evade the plan’s dictates.

Cohn explains that a loophole in the law may allow companies to offer employees only barebones coverage and pay a smaller fine than if they had offered no coverage.  But even Cohn admits to the role that free market forces properly play under such circumstances: “[T]hese companies would have to consider the competitive effects, which could push in either direction.  Do they provide less insurance, so they keep costs lower?  Or do they provide more, so they can attract better workers?  Different companies will undoubtedly respond in different ways…”  Yes, Jonathan, that’s exactly the way it’s supposed to work in a free market—minus, of course, the government’s forcing employers to provide any coverage in the first place.

Cohn’s tepid nod to capitalism is positively Hayekian compared to the stance of Ezekiel Emanuel, one-time White House health policy advisor and brother of former Obama Chief of Staff Rahm.  Ezekiel admits that Obamacare may be unsustainable, because it forces young, healthy people to pay disproportionately large premiums to subsidize sick, older people—an arrangement that the former won’t stand for and the latter can’t pick up the slack for.

Emanuel’s solution?  A massive public relations blitz that reminds the Millennium Generation just how much they love Obama, and that urges them to buy Obamacare health plans even if it makes no economic sense so that Dear Leader’s presidency won’t fail.

In a hilariously naïve and economically illiterate editorial, Emanuel preaches, “[Y]oung people believe in President Obama.  They overwhelmingly voted for him.  He won by a 23% margin among voters 18-29—just the people who need to enroll.  The president connects with young people, too, so he needs to use that bond and get out there to convince them to sign up for health insurance to help this central part of his legacy.  Every commencement address by an administration official should encourage young graduates to get health insurance.”  Every commencement address by an administration official should also explain to young graduates where exactly they’re going to find jobs in the Obama economy so they can purchase said insurance.

If I understand Emanuel’s appeal correctly, it’s that twentysomethings should subsidize Obama’s legacy, and in return they won’t look like fools for voting for him if his plan somehow miraculously succeeds.

Commenting on Emmanuel’s Don Draper approach to health care reform, Richard Epstein notes, “Emanuel’s expansive view of civic duty plays the game both ways when he accuses individuals who don’t purchase health insurance of ‘freeriding’ on the public.  But their purchase of insurance will allow the [older] preferred plan recipients to free ride on them.”  Emanuel assumes that young people are already in the bag for Democrats, whereas older folks’ votes need to be bought.

Emanuel also assumes that his proposed marketing campaign will cash in on the emotional nature of persuadable young voters.  Good luck with that.  Most young people who voted for Obama and supported Obamacare are nonetheless learning that the penalty for not having health insurance is lower than the actual cost of health insurance, and are acting according to their rational self-interest by declining to purchase it.  Would we expect young adults—who earn the least of all adult age groups—to do any less?

More broadly, would we expect other age groups, or small business owners, or large business owners, or private citizens, or unions, or—yes—Congressmen and their staffers not to try to find a way to get out of a plan they know costs more than it’s worth and unacceptably limits their options?  Are Harry Reid and Nancy Pelosi un-American for not signing up for health care exchanges that the poor schlubs in their districts will be forced to buy?

As Obamacare implementation stumbles on, more and more stakeholders are realizing that, not only is it not their duty to make the plan succeed, it is in their distinct interest to help it fail.

Previously published in modified form at Red Alert Politics

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Congress’s Taxation Power: The New “Interstate Commerce” Clause

July 04, 2012 By: Scott Spiegel Category: Health Care

On Thursday the Supreme Court rejected the Obama administration’s justification for the Affordable Care Act’s individual mandate as being covered by the Interstate Commerce Clause, since the law as written would not regulate commerce but compel it.

The court nonetheless upheld the individual mandate, which requires people to buy health insurance from private companies and health insurance marketplaces.  The administration had characterized the penalty for not buying insurance as such, yet also asked the court to consider it a tax for the purpose of preventing the plaintiffs from suing, since under the Tax Anti-Injunction Act taxes may be challenged in court only after they have been paid.  Roberts and the majority agreed that the penalty could not be considered a tax for the question of whether the plaintiffs could bring suit now.  Yet in their view, it was perfectly acceptable for the penalty to be considered a tax for the purpose of forcing people to buy health insurance.

Roberts admitted, “Congress’s decision to label this exaction a ‘penalty’ rather than a ‘tax’ is significant because the Affordable Care Act describes many other exactions it creates as ‘taxes.’”

Yet in the majority opinion he wrote, “The Federal Government may enact a tax on an activity that it cannot authorize, forbid, or otherwise control.”

And therein lies the rub: Not purchasing health insurance is not an “activity.”  It is a non-activity.  (The hint is the word “not.”)

According to Roberts’ (correct) reasoning, “not buying healthcare” is not commercial activity the government can regulate through the Interstate Commerce Clause.  Yet somehow “not buying healthcare” is commercial activity the government can tax.  How can “not buying health insurance” be non-activity and activity at the same time?

Some conservatives hunting for a silver lining have argued that at least the ruling limited the provenance of the Commerce Clause.  Yet the ruling simultaneously expanded the purview of Congress’s taxing power in such a way as to potentially make up for almost anything the Commerce Clause doesn’t cover.  What have we gained?  What good is restriction of the Commerce Clause if, due to the expansion of other powers, it can’t protect us from abominations like Obamacare?

The ruling expanded Congress’s taxation power in at least three ways.  First, we now know that non-activity can be taxed.  When has the federal government ever taxed non-activity?  Penalized, yes—but taxed our not doing something?

Second, we know that even something that was explicitly disavowed as a tax by its creators and defenders can be considered a tax, if five Supreme Court justices feel like rewriting the law and considering it one.

Third, as spelled out by Roger Pilon, “[T]he power to tax… was designed to enable Congress to obtain the funds needed to carry out its other enumerated powers or ends.  It was not, as Madison made clear in Federalist 41, and often on the floor of Congress, an independent power to tax for any purpose at all.  Search as you will through those 18 enumerated powers and you will find no power to enact ObamaCare or anything like it.”  But thanks to Chief Justice Roberts, we now know that the federal government can levy taxes for any reason it wants, whether it needs the money for any enumerated power or not—and remember that the individual mandate, if it operated properly, would result in $0 revenue.

Also disturbing is the fact that the justices may not have even reaffirmed the limits of the Commerce Clause.  As Mark Levin wrote, “If five justices had intended for their view of the commerce clause (and necessary and proper clause) to be controlling as the majority view, they would have said so by joining or concurring in each others’ [written arguments].  They didn’t.  So, while we can cobble them together, as a formal legal matter, it is a troubling issue.  While the status quo stands re the commerce clause (and necessary and proper clause), there was no formal majority on those issues.”

Of course all this chitchat about RobertsCare will go over the heads of most liberals, for whom I want to ask, not “How is the healthcare law constitutional?” but “Do you even care whether it’s constitutional?”  This is the same group of people, after all, who consistently defended the law, not by talking about its legal soundness, but by claiming that the Heritage Foundation and Mitt Romney had instigated it.  These are the same folks who for two years eschewed discussion of Obamacare’s constitutionality for posting pictures of sad-eyed looking children on Facebook with captions like “Yolanda Rodriguez can finally get treatment for her spina bifida!”

So now we can rest assured that Congress will never mandate that we buy broccoli, drink skim milk, or do calisthenics.  It’s just going to tax us to death if we don’t, and with the imprimatur of a “conservative,” Republican-appointed Supreme Court Chief Justice.

Previously published in modified form at Red Alert Politics

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Obamacare, We Hardly Knew Ye

June 27, 2012 By: Scott Spiegel Category: Health Care

Ahead of the Supreme Court’s likely overrule of Obamacare’s individual mandate, and possibly the entire act, here’s a retrospective of the most hilarious and horrifying quotes from bill supporters over the first three-and-a-half years of Obama’s wasted first term.  Hey libs—Thanks for the memories:

1. “If you like your health care plan, you can keep your health care plan.”  Barack Obama.  Demonstrably false, given that employer-based plans—which over 60% of the population holds—are required to meet Obamacare specifications within five years, so if your current plan doesn’t meet these regulations, your employer will soon have to change it or drop it, if it hasn’t already done so.

2. “Are you serious?  Are you serious?”  Nancy Pelosi, when asked where the Constitution authorized Obamacare’s individual mandate.  Almost as good: “I don’t worry about the Constitution,” uttered by Illinois Representative Phil Hare at a townhall meeting.

3. “These are nothing more than destructive efforts to interrupt a debate…  They are doing this because they don’t have any better ideas.”  Senate Majority Leader Harry Reid on protesters and Congressional opponents trying to “sabotage” the Obamacare debate.  In fact, House Republicans had 32 better ideas than Obamacare in 2009 alone, including malpractice tort reform, Medicare reform, health savings accounts, healthcare tax credits, vouchers for private insurance, pay for performance, private market competition, and efforts to preserve individual autonomy regarding level and type of coverage and risk tolerance.

4. “These disruptions are occurring because opponents are afraid… of differing views…  Drowning out opposing views is simply un-American.”  Pelosi and former House Majority Leader Steny Hoyer trying to delegitimize the concerns of health care townhall protestors.  Compare this claim with liberal commentators’ mentally drowning out the constitutional arguments against Obamacare for two years, and suddenly being shocked that the Supreme Court appears poised to overturn it.

5. “The conjunction of a black President and a female speaker of the House—topped off by a wise Latina on the Supreme Court and a powerful gay congressional committee chairman—would sow fears of disenfranchisement among a dwindling and threatened minority in the country no matter what policies were in play.”  Frank Rich, claiming that Obamacare opponents are simply racists, and maybe sexists and homophobes too.  Yes, it’s true—we just couldn’t stand having African-American lesbian bill architects like Harry Reid, Kent Conrad, and Max Baucus.

6. “If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov.”  The Obama administration e-mailing supporters and asking them to spy on their fellow citizens.

7. “I remember in the last month of her life, she wasn’t thinking about how to get well, she wasn’t thinking about coming to terms with her own mortality, she was thinking about whether or not insurance was going to cover the medical bills and whether our family would be bankrupt as a consequence…  [T]he insurance company said that maybe she had a pre-existing condition and maybe they wouldn’t have to reimburse her for her medical bills.” Obama implying that his mother had had to battle health insurance companies when she was sick with cancer, when it was later revealed that her claims had been paid in full and it was disability compensation he was alluding to.

8. “We have to pass the bill so you can find out what’s in it.”  Nancy Pelosi.  And here most people thought it worked the other way around.

9. “I am romantic about the N.H.S. [the UK’s National Health Service]; I love it…  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.”  Donald Berwick, Obama’s recess appointment for Administrator of the Centers for Medicare and Medicaid Services.  Thankfully the explosively controversial nominee resigned a year later when it became clear Republicans would never vote to continue his appointment.

10. “[W]ell within the traditional bounds of Congress’s Article I power.”  Department of Health and Human Services Secretary Kathleen Sebelius on the federal government’s power to force people to buy health insurance, in a lame attempt to hedge against constitutional challenges to the individual mandate.

11. “They have to understand that the health care bill is not going to be repealed…  [They] should get a new lease on life and talk about something else.”  Reid dismissing Congressional Republicans’ Obamacare repeal efforts.  If the Supreme Court does what everyone expects it to do tomorrow, Reid may just be right.

12. “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.”  President Obama’s ignorant and deceitful comments ahead of Solicitor General Donald Verrilli’s disastrous effort to defend the administration’s position before the court during oral arguments in April.

13. “129 million Americans with a pre-existing condition could be denied coverage without [the] new health reform law.”  The Department of Health and Human Services cautioning against Obamacare repeal, in a claim promptly torn apart by the Cato Institute.  Also: “Thirty million Americans… are going to be able to get healthcare next year because of that law,” Obama recently defending his bill.  Newsflash: Healthcare is not health insurance, and most needy people can get healthcare through Medicaid, parts of Medicare, medical charity groups, or emergency rooms.  Most people without health insurance are temporarily lacking it while in-between jobs or choose not to pay for it.  The Obama administration hyped a nonexistent crisis in order to implement an unnecessary solution.

And the prize for most inane pronouncement in support of Obamacare goes to:

14. “Denying someone their life and liberty without due process…  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?”  Texas Representative Sheila Jackson Lee on the legal implications of Obamacare repeal.  Everything is bigger in Texas, including stupidity.

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The Purpose of the Constitution Isn’t Efficiency, It’s Liberty

June 20, 2012 By: Scott Spiegel Category: Health Care

The Supreme Court’s impending Obamacare overrule seems to have liberal legal types anxious lately.

In their recent lecture-disguised-as-an-op-ed “Health Care Economics 101 And The Supreme Court,” University of Michigan professors Jill Horwitz and Helen Levy argue that by intervening in the health insurance market, government has the power to make healthcare uniquely efficient and affordable.

Assuming that that’s correct—and it’s not—so what?

Horwitz and Levy contest that upholding Obamacare’s individual mandate could lead to forcing people to buy broccoli or cars, as several Supreme Court Justices suggested during oral arguments in April.  They write, “[T]here are significant economic differences between health care and the list of goods the amicus brief and some of the Justices cited…  [T]he market for health care is characterized by multiple and substantial departures from the assumptions of perfect competition…  [A]ppropriately structured government intervention—which in this case means guaranteed issue, community rating, and an individual mandate—can actually promote efficiency, solving the problem of market failure and making the pie bigger for everyone.”

Actually, who cares?  Where in the Constitution can Congress force people to do something they don’t want, just because liberals think it will make life easier?  Actually, where does the Constitution give the federal government the power of central planning for the quixotic purpose of “making the pie bigger for everyone”?

Actually, where in the Constitution may I find the “Correcting Imperfect Markets for Competition via Abridgment of Individual Liberty” clause?

Horwitz and Levy toss out the following unconnected arguments in the hope that one of them will stick: the health insurance market operates poorly on its own; the health insurance market involves many interrelated parts, the failure of any one of which can compound failure in the others; an individual’s need for healthcare is unpredictable; the healthcare industry is high-stakes; the country is experiencing a health insurance crisis.

Not one of these reasons compensates for the egregious constitutional violation of forcing people to purchase a product on the private market against their will.

Obviously the health care market differs from the market for broccoli or cars—no one disagrees with that—though it’s not uniquely different from other markets we don’t allow the federal government to take over.

But all laws vary widely in their outcomes when applied to different referents.  The Fourth Amendment, which prohibits unreasonable search and seizure, could yield different consequences if applied to a pastor’s suburban home vs. a drug-infested housing project.

One could argue that government should be able to randomly invade run-down apartments in gang-infested inner cities, since the likelihood of finding illegal weapons, drug paraphernalia, or evidence of other crimes is much greater there.  You might say that such a law “can actually promote efficiency” in law enforcement.

But does the principle prohibiting government from wantonly entering private homes without a warrant and poking around apply universally, or doesn’t it?  If it applies universally, then it applies whether we’re talking about split-levels or slums.

Similarly, there may be compelling reasons from a pure efficiency standpoint for government to intervene in the healthcare market.  (There aren’t, but bear with me.)  That the government could make healthcare so much more superior doesn’t justify forcing people to buy insurance policies they don’t want, or forcing policies on them that mitigate more risk than they care to pay for.

Perhaps the claim that Obamacare won’t lead to mandating broccoli consumption would be more credible if liberals weren’t regularly trying to ban trans fats, salt, Happy Meals, soda, popcorn, and “milk drinks.”  For a perfect example of the left-wing tactic of abridging liberty while distracting the public with superfluous “good for you” justifications, see Mayor Michael Bloomberg’s 10-year crusade to turn Manhattan into a monastery.

When the Supreme Court overrules the Affordable Care Act’s individual mandate 5-4 next week, liberals are going to gripe about “judicial overreach” for decades, the way they’re still grumbling about Bush v. Gore.  They’ll roll their eyes at anyone who’s happy the Court overturned the law, and try to convince themselves that their legal argument is so much more sophisticated and forward-thinking than ours.

They need to be told why they’re wrong.

Previously published in modified form at Red Alert Politics

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