Tag: Healthcare reform in the United States

What you are not being told about Obamacare (UPDATED)

Lo and behold, we discover that with the 2014 elections coming up, the people that told us they had won the 2008 elections, in a sweep, and would “Fix” things, are now scrambling to hide the cost and effects of the most important piece of social legislation passed in the last 3 decades. From the article:

I don’t know if Members of Congress will be hearing about it in town hall gatherings and other meetings back home over the Fourth of July recess, but the rolling thunder of the approaching ObamaCare train can be heard in the distance. Smart Democrats are beginning to get frantic about the need to suppress the confusion and hide the cost of ObamaCare between now and the 2014 midterm elections. We are just three months away from the October 1st enrollment start date and so far, nothing about the ObamaCare implementation process should be politically encouraging for Democrats. In fact, the more people learn about ObamaCare, the more frightened they become.

So what we will get for the foreseeable future are the usual suspects in the LSM and the donkeys doing their best to obfuscate and hide the facts that the bill they told us had to be passed for us to find out how much good was in it, will hammer Americans on a scale that’s going to be epic. Off the top of my head I can already point out that the ACA has done nothing to control or lower costs. In fact, my costs have gone up by at least 60% in just the last 2 years, and I have been informed that it is going up even more next year. I was also told I could keep my current coverage and doctor. But I already have been notified by my employer that chances are they will be changing providers and plans in the next year or 2,. And my doctor has told me he is seriously considering pulling out of any and all insurance because the regulation will kill his business otherwise. I am going to end up paying a lot more, getting a lot less, having to wait for it even longer, and the quality will suck. That is, unless as we have seen recently has been done, the IRS goes after people like me for our political views. I guarantee you this is going to happen because the IRS will abuse all the new power it gets because of Obamacare. The career workers there are all scumbag libs.

Back to some more good news from the article about secondary “unforeseen” consequences of Obamacare:

Right now, small businesses across America are making the final determinations on how to reduce the working hours of their employees so fewer employees qualify for the mandated, employer-provided health insurance. Employers are also deciding whether it makes more economic sense to pay a fine to the government or pay for healthcare benefits for their employees. What this means is that hundreds of thousands – and perhaps even millions – of Americans will learn that they are being dismissed from their employer’s healthcare coverage.

It’s not only small businesses. Unless you were one of the lucky connected many that bought exclusions from Obamacare from donkey politicians, even big businesses are looking at ways to cut their employees hours so they can avoid having to comply with the stupid business killing ACA. This pattern is repeated across all businesses that could not buy an ACA exclusion.

And the destructive and horrible employment consequences of the AC are not limited to businesses. Even colleges are playing the game and limiting the hours of as many employees as they can to avoid the pain that the ACA will cause their operating costs. Anyone able to understand that the idiotic cost cutting claims by those selling us ACA wasn’t just limited to how much we would pay directly, in taxes, to keep this monster up & running, but the much broader and damaging employment economic impact?

It gets even worse. People aren’t just going to get fewer hours to work, many are going to lose jobs, and worse, not be able to find new employment because of the ACA. From the article yet again;

The healthcare pink slips will start raining down in late summer and early fall. This will push people into the healthcare exchanges, where, in some cases, people will be writing health insurance checks for the first time. And in many cases, people will be facing increased health insurance costs, particularly if they are young and healthy. The negative effects on personal income and the overall economy will be undeniable. Sometime next year, before the elections, the penalties associated with not having or providing health insurance will begin to pour in. Will the fines come in the mail? Will you be able to appeal? What happens if someone doesn’t pay? No one knows. Or, no one who knows is talking. The consequences of ObamaCare are being hidden.

Say it isn’t so! The left is hiding the enormous damage that the ACA will cause? Who would have thunk that would happen, huh?

And that’s unfortunately not the worst of it all. All this damage to our employment market and the economic impact that will ripple from this happening are just are side effects of the real problems to come. The real damage will be to the healthcare system itself. Anyone that still can’t see that the primary purpose of the ACA is to destroy the American healthcare system is in dire need of some psychiatric help.

As I pointed out when we were debating this disaster, the end goal was never to cut any costs. When you add millions of new people to the burden and demand Cadillac plans that pay for everything, there is no way your costs go down. Even if you set this thing up to transfer the cost to others, and making people that would never buy healthcare when they didn’t need it do, just so you could subsidize this cluster fuck might fool some, but that’s their problem, like they have, it isn’t going to be able to cover the increased usage and costs. Even worse is the realization that this behemoth government takeover was definitely not implemented to fix healthcare either, but to do exactly the opposite: kill it.

Americans would never have gone for the single payer system, but once you have destroyed the healthcare system and government controls most of the pieces left over, there is going to be no other option. Of course, our masters will end up with a two tier system like they have in all the collectivist paradises. There will be the system everyone lauds because all us peasants supposedly get free care, whatever that may be, and the one for our masters.

I no longer doubt the people that tell me Obama’s real job as president was to destroy America as we know it. The guy is succeeding in spades (pardon the use of a expression that some might think implies racist beliefs, but it fits so I am using it despite the risk). If I wasn’t going to have to bend over and grab my ankles I would be laughing at the idiots that thought Obamacare was going to be more free shit for them. Get ready to bleed people.

UPDATED: In a move that is certainly caused because the donkeys are freaking out about the beating they will take in 2014, it looks like the WSJ is now reporting that: “White House delays employer mandate requirement until 2015“. Of course, the foreign press again has the scoop too:

A Treasury Department official who declined to be named confirmed to MailOnline on Tuesday that the Obama administration will not begin enforcing employer mandates in the Obamacare law until 2015 – one year later than originally planned – and pinned that change of direction on a combination of politics and economic realities in the marketplace.

Mark Mazur, the Assistant Treasury Secretary for Tax Policy, announced on the agency’s blog that the administration ‘will provide an additional year before the … mandatory employer and insurer reporting requirements begin.’

This thing Obamacare implementation must be an absolute disaster in the make for them to pull this ridiculous stunt this early in the election cycle. These people are despicable. And this shit is unbelievable.

Is Krugman Stupid, A Troll Or A Stupid Troll?

Paul Krugman — fresh off his I’m smarter than you post (I have a few tasty comments in that thread that riled the libs something fierce), says this today in response to the Oregon study:

Fire Insurance Is Worthless!

After all, there’s no evidence that it prevents fires.

But strange to say (as Mark Thoma points out in correspondence), people seem to think it’s a good idea anyway.

I leave the relevance of this thought to the Medicaid discussion as an exercise for readers.

This is the most common defense being dragged out in response to the Oregon study: that maybe health insurance doesn’t actually improve health. But it saves people from being financially ruined by a health crisis! Isn’t that good?

Let’s put aside that the liberals have spent the last four decades insisting that a lack of insurance kills tens of thousands of Americans every year. Let’s put aside that they will drag that bogus stat back out from behind the barn if the next Oregon study shows health gains from Medicaid (and probably even if it doesn’t). No, let’s concentrate on this:

This is what conservatives and libertarians have been saying for a very very long time.

This what is David Goldhill said in his excellent essay four fucking years ago. This is what I have said many many many times. I have specifically asked people to imagine how much car insurance would cost if it paid for every gasup (and how efficient our cars would be). I have specifically pointed out how expensive fire insurance would be if it covered every burnt meal. A number of us have called specifically for catastrophic health insurance that is more modelled after fire insurance than our current “first dollar coverage” model, at least on the government side. For that, we have been mocked as heartless and clueless. We’ve been told that health insurance is fundamentally different from other forms of insurance (which it is, when you consider it a handout).

Now the liberals want to pretend that this is a novel argument? They want to pretend they have discovered that the real benefit of health insurance is risk mitigation, not magical health fairies? Seriously?

I suppose I should be happy. This is progress in liberal thinking, after all. But no, I’m not happy. Because they have turned to this explanation as an excuse for why the Oregon study hasn’t yet shown the huge benefits they thought Medicaid expansion would produce. The minute the wind turns, the minute the next study shows even minimal health gains, they will tack and suddenly start saying that insurance is the only thing that keeps people from dropping dead in the street.

Piling On

Apropos to Alex’s post below, the huge news in the last day is a study from Oregon that looked at the effects of expanding Medicaid. As McCardle points out, the study was done under near ideal circumstances. Oregon could not expand Medicaid to everyone who wanted it, so they created a lottery. Sociologists swooped in and recruited. The result was a study of 6000 people with Medicaid and almost 6000 without. One of the authors was an Obamacare architect. This is the kind of diverse randomly-selected sample that sociologists dream about.

The result is …. not much:

Utilization went up, out-of-pocket expenditure went down, and the freqency of depression diagnoses was lower. But on the three important health measures they checked that we can measure objectively–glycated hemoglobin, a measure of blood sugar levels [and diabetes indicator]; blood pressure; and cholesterol levels–there was no significant improvement.

It’s one of two major RCTs that have ever been done on insurance. And like the first one, it doesn’t show a signficiant effect. That is huge news. Not good news–obviously, it’s much nicer if giving people money to pay for health care makes them obviously much healthier. But big.

And it’s actually bigger, and more important than Obamacare. We should all be revising our priors about how much health insurance–or at least Medicaid–really promotes health. What this really tells us is how little we know about health care, and making people healthy–and how often data can confound even our most powerful intuitions.

In other words, insuring people resulted in more spending by the government, but not necessarily improved health. Gee, I think I’ve heard that before.

As you can imagine, the liberals are spinning as fast as they can. And, to be fair, they have a point. The study covers only of a couple of years and it might take a while for long-term effects to show up. But you know that if the study showed even the slightest improvement in health, they would be shouting it from the rooftops. They have, after all, spent years citing dubious studies that claim that the lack of universal healthcare kills, if I remember the Obamcare rhetoric correctly, at least 17.4 billion Americans every year. And, in fact, when the first Oregon study came out and showed that people weren’t healthier, per se, but felt better, the liberals crowed about it.

The new study is much more difficult to twist abut that’s not stopping their attempts. One thing they have harped on is that the insurance is preventing people from being financially destroyed by a health crisis. But Avik Roy is all over that in a must-read response to liberal excuse making:

Medicaid reduced financial hardship for the poor, by protecting them against catastrophic health risks. Wonderful, but we could have achieved the same outcome for a fraction of the price, by adopting the plan proposed by Florida’s Will Weatherford and Richard Corcoran: Offering low-income Americans a subsidy with which to purchase catastrophic coverage on the open market. That plan was foiled by people—including Republicans—who insisted on expanding Medicaid instead.

Ross Douthat is on the same page:

But what if we lived in a world in which the Republican Party had fully embraced the views of many right-of-center health policy writers (and some G.O.P. politicians, including the John McCain of 2008) and supported an alternative to Medicaid expansion, which would change the tax treatment of health insurance to free up money to create a universal tax credit or voucher designed to spur the purchase of catastrophic health insurance plans? What if the choice, in other words, weren’t between the current health care law and a repeal-plus-nothing G.O.P., but between the current health care law and the best conservative thinking on the issue?

This is, in fact, what most libertarians have advocated for years, including me.

I remind you that this isn’t a trivial question. Obamacare gambles some $750 billion on the idea that Medicaid will improve health outcomes, boost the economy, reunite the surviving Beatles and help us all lose ten pounds with diet and exercise. If the gain from that huge investment is this marginal, it is not worth it. I’m sorry to be cruel, but it not worth $750 billion to save only a few lives.

I do want to repeat my earlier caution that it would be odd to conclude that health insurance has no health benefit. We may not know for a while. But I do think it’s becoming clear that Medicaid expansion is not going to be the miracle breakthrough that so much of the Left has claimed it would be. If lack of insurance really were killing as many people as the Left insists it is, the Oregon data would show it. You might even already see a difference in mortality rates.

I know it surprises some people, but improving our nation’s health is not as simple as simply throwing lots of money around.

UNEXPECTEDLY bad news about Obamacare- Yeah, sure.

It comes as no surpise to me that so many people as this Kaiser poll discovers, don’t even know that Obamacare is the law of the land or that the promises of “free or affordable healthcare” are plain bullshit:

A new poll finds that many Americans are confused about the health care overhaul legislation commonly called “Obamacare.” The Kaiser Family Foundation released results of a non-partisan study today finding more than 40 percent did not even know the law was in place.

“Four in ten Americans (42%) are unaware that the ACA [Affordable Care Act] is still the law of the land,” the report says, “including 12 percent who believe the law has been repealed by Congress, 7 percent who believe it has been overturned by the Supreme Court and 23 percent who say they don’t know enough to say what the status of the law is.”

The survey showed public opinion on Obamacare is at its second-lowest rating in the past two years. Less than half – 40 35 percent – of adults viewed the ACA favorably, whereas 35 40 percent said they viewed it unfavorably. Another 24 percent said they did not know or refused to answer.

I cannot say I am surprised to find out that none of the promises made to sell this giant steaming shit sandwich to the usual morons seems to be panning out. Easier access to better care? Yeah sure, and that’s why the politicians now want to exclude themselves from Obamacare. Cost reductions, or even free healthcare, for all? Want a unicorn burger and a side of mermaid fires with that lie? Remember the CBO projected savings that could only be claimed if this pile of garbage looked at a 10 year window? You know, where taxes were collected for the full 10 years, but coverage didn’t start in earnest until 5 years later. And what about the major accounting schemes and scams, including double counting money that would be directly taken from Medicare or magically appear once government reduced the massive Medicare fraud it had been unable to even tackle, let alone eliminate, for the last 5 decades? What about those exchanges they would force states to voluntarily set up? The list of bullshit is long and distinguished.

The bottom line is that only idiots thought that Obamacare would provide any savings, quality improvements, or expanded access. Reality now clearly shows that the projected $900 billion cost will be at least twice, if not 3 times, as much in the first 10 years. Yeah, that’s the 10 years where the system is rigged to produce more revenue than they projected spending. Of course, after those first 10 years the cost is at least going to double since they no longer have 5 years of taxes without expenditures to offset the real costs. So it is thus no surprise to discover that Reid now wants more money to help the donkeys cover their asses, as this train wreck careens out of control.

Queue the nice cartoon.

Obamacare train wreck

Obamacare train wreck

I guess we had to pass it to allow us to see how it would work out, and right now it is working out just like it would for the little guy forced to live with Bubba the love machine in the small prison cell.

Pelosi Watch: Healthcare Exchanges

So one of the keystones of the Obamacare plan is the health insurance exchanges. These are the inventions, borrowed from Romneycare, that will supposedly heal the diseased health insurance market, right? They are the cure to what ails us, right?

Well guess what? In one of the most predictable developments in history, it looks like they’re not going to be ready in time:

Where was the contingency plan?

That’s what Joe Klein asks upon learning that Obamacare’s health care exchanges, a sort of government-run insurance supermarket, are going to delay implementation of most of functionality that was supposed to be available for small businesses. Instead of a choice of offerings, in many areas, they’ll basically have one. This is worse, not better, than the current markets.

Sure, the administration was surprised when so many states declined to operate their own exchanges, forcing the federal government to step in. But the administration doesn’t seem to have prepared for that possibility, even though it was an obvious threat by last year. Instead, they held open the deadline for states to declare, making themselves even later.

Savor that for a moment. When Obama’s healthcare supermarkets open, many of them will have one product on the shelves. Hugo Chavez’s supermarkets had a greater selection.

In addition to the lack of exchanges and the poor state of the exchanges, the insurance coming out of them is likely to be more expensive than the insurance available right now. I would say that’s another unintended consequence but … it’s kind of an intended consequence. The purpose of the healthcare exchanges is not to bring down the cost of healthcare. It’s to bring it up. Ezra Klein:

When people say that Obamacare will, in certain parts of the country, for certain people, increase premiums, what they mean is that something akin to the switch from Texas Inc. to Vermont LLC. Obamacare will force insurers to upgrade their products to meet a minimum level of comprehensiveness, lay down some rules limiting price discrimination against the sick and the old and the female, and then help people pay for the final product. It’s a lot like what happens if you move to an employer that offers better health insurance and helps you pay for it.

Uh, no, it really isn’t. What your employer does is voluntary. And the money comes from him, not the government.

The intent of Obamacare is to ensure that almost all Americans are covered by high-quality insurance that they can afford. To say that the law will move many Americans onto more costly insurance products is simply to restate part of that premise more negatively, and to leave out the effect of the subsidies, or the change in the underlying insurance product, is to mislead.

What Klein is admitting is that Obamacare is, at its core, a subsidy so that people can get more expensive insurance. This was not how this pile of shit was sold to us. We were told that healthcare costs were spiraling out of control, threatening the very existence of the Republic. It was implied, at least, that this was to make sure that people had a least a minimum of insurance, not a “high quality” plan. Now we’re being told that the purpose is to effectively outlaw cheap insurance. Now we’re being told that this is the equivalent of subsidizing everyone to live in a four-bedroom, two-bath house.

(I shouldn’t give them ideas.)

And then, of course, the liberals will act all shocked and surprised when healthcare utilization and costs spike again. They have never understood that people will use more of something when it is cheaper. If you give people subsidized (or God help us, free) insurance, they will go the doctor for every sniffle.

Oh, and about that “price discrimination” we’re eliminating (or, as it is known in more rational circules: charging people insurance premiums that reflect the costs they will likely incur). Guess what?

On Monday, the D.C. exchange’s executive board voted to prevent insurers from charging higher premiums to smokers than to nonsmokers — meaning nonsmokers are likely to pay modestly higher rates than if smoking surcharges were permitted. The District joins three states — Massachusetts, Rhode Island and Vermont — that have banned tobacco surcharges on their own exchanges.

Mohammad N. Akhter, chair of the D.C. Health Benefit Exchange board and a former city health director, said the authority had no hard data on what cost impact banning tobacco surcharges might have on nonsmoker premiums. But he said the vote furthers the board’s policy of encouraging broad participation in the exchange.

Emphasis mine. They don’t know what this will do to insurance premiums. They don’t give a blue fuck what this will do to insurance premiums. All they care about is getting more people onto subsidized policies.

In a statement, Akhter referred to tobacco use as a “pre-existing medical condition” and added that charging smokers more would be “in direct conflict with our efforts to help people quit smoking.”

I want you to wrap your brain around that statement. They want to get people to quit smoking … by eliminating one of the penalties for smoking! And a “pre-existing condition”? I once smoked. Tobacco is very addictive. But it isn’t leukemia. It is not a pre-existing condition; it is a pre-existing behavior. It is chosen no matter how addictive nicotine may be.

Oh yeah, this experiment in socialism is going to go JUST GREAT!

Sebelius Doesn’t Know What Insurance Is

One of the problems that I encounter in the debate over healthcare reform is that a lot of people simply do not understand what insurance is. Insurance is not a magical money tree that gives you free stuff. It is a way of spreading out risk. It has a secondary function in aggregating purchasing power so that insurance can negotiate prices. But, in the end, insurance will always cost the average person more than paying for things on their own.

The primary purpose of insurance is prevent catastrophe. We buy home insurance hoping that we will lose money on it but knowing it’s there if our house burns down. We buy car insurance hoping we will lose money on it but knowing it’s there if we get in a big accident.

But health insurance, at least by the Left, is seen differently. Rather than being seen as a way to spread out risk or combine our purchasing power, it is seen as a way to get free healthcare. I’ve mentioned this before but it remains a perfect illustration of the problem. When I was in graduate school, the students were pushing for birth control pills to be covered by insurance. And they were shocked and angered to find out that this coverage would increase health insurance rates by … the cost of the pills (actually, very slightly less since the insurance negotiated a slightly lower price). They couldn’t wrap their minds around the idea that insurance is a device to mitigate risk, not a machine for dispensing handouts.

I and many other critics of Obamacare have pointed out that it is actually going to make healthcare utilization higher and costs higher by mandating first dollar coverage. When going to the doctor for every sniffle only costs $10, what do we think is going to happen? When you’re only paying 10% of the cost of an MRI, what is going to happen? Catastrophic plans or plans with high deductibles have been proven to keep healthcare costs down without compromising care. When their own money is at astake, people forgo unnecessary procedures and save up for real health problems. As David Goldhill pointed out, you could get every uninsured person a high-deductible plan, give them a $5000 voucher and you’d still save money over government-issued comprehensive coverage. And not compromise health.

Ladies and gentlemen, our Secretary of Health and Human Services:

But Kathleen Sebelius, the Secretary of HHS, thinks that catastrophic insurance isn’t really insurance at all.

At a White House briefing Tuesday, Health and Human Services Secretary Kathleen Sebelius said some of what passes for health insurance today is so skimpy it can’t be compared to the comprehensive coverage available under the law. “Some of these folks have very high catastrophic plans that don’t pay for anything unless you get hit by a bus,” she said. “They’re really mortgage protection, not health insurance.”

She said this in response to a report from the American Society of Actuaries arguing that premiums are going to rise by 32% when Obamacare kicks in, as coverage gets more generous and more sick people join the insurance market. Sebelius’ response is apparently that catastrophic insurance isn’t really insurance at all–which is exactly backwards. Catastrophic coverage is “true insurance”. Coverage of routine, predictable services is not insurance at all; it’s a spectacularly inefficient prepayment plan.

I want you to sit back and let the roll over you. Our HHS Secretary does not know what insurance is. She really thinks it’s a magical money machine that can give free care to everyone without prices going up. The only reason premiums would go up is because what they had before wasn’t “real insurance.”

Oh, yeah. Obamacare is going to go just fine. It’s totally going to cut healthcare costs when it’s run by people who have no understanding of insurance, medicine, economics or markets. Nothing to see here!

Hindsight is 20-20, and progressive stupid is forever

And I have no doubt that Barney’s claim that he told Obama to not push for the government takeover of healthcare seems a lot like this tool is again trying to dazzle people with his bullshit. Monday morning quarterbacking, and a piss poor attempt at it at best:

Rep. Barney Frank, D-Mass., said he advised President Obama against taking up health care reform following a special election in 2010 that changed Democrats’ fortunes in the Senate, saying that he should have instead turned his focus to financial reform.

Frank referenced former President Bill Clinton and his failed health care plan from the 1990s. “Obama made the same mistake Clinton made,” Frank said in a wide-ranging interview with New York magazine. “When you try to extend health care to people who don’t have it, people who have it and are on the whole satisfied with it get nervous.”

The outgoing representative from Massachusetts added that after Republican Scott Brown won former Sen. Edward M. Kennedy’s seat, breaking Democrats’ filibuster-proof majority, Obama should have backed down: “I think we paid a terrible price for health care. I would not have pushed it as hard. As a matter of fact, after Scott Brown won, I suggested going back. I would have started with financial reform but certainly not health care,” Frank said.

Ya think? What a crock of shit. The problem wasn’t just with how democrats went about screwing all Americans by passing & straddling us this monstrosity. The LSM and the left have done a good job at covering up all the nasty and dirty bits. How often do we hear about all the bribes and back room deals, again at the tax payer’s expense, that where needed to buy off enough democrats to go along with this horrible piece of legislation? And don’t you dare remember how we were told we had to pass it to see what was in it too! Or about the fact that a bunch of leftist twits convinced themselves that it was constitutional for the government to force Americans to buy something they wanted and are now acting like a spoiled child that was told no dessert before they eat their broccoli.

Then there is the massive list of special interest with exclusions. No, I am not talking about either our political class or their union friends that automatically got exemptions so they could keep their plush coverage. I am talking about the people that had to bribe or pay off democrat politicians, I mean make their case for the exclusion, right, in order to avoid the consequences of this disastrous policy, which not only will damage quality and access to healthcare for most Americans, but is constructed in such a manner that it not only is dependant on unconstitutional mandates to force citizens to pay for it, but is assured to fail. And I think that failure isn’t seen as a bad thing by the left, but a feature – a way for them to guarantee that they get the single payer system they would otherwise never get people to go along with in this country. More too big too fail in action.

Now you have tools like Frank complaining about how the left should have focused on the economy. Finally an admission that from the top down this was never, ever a priority with these assholes, despite their claims to the contrary. The proof is in the legislation they passed. Things like Obamacare and the stimulus

That’s why we have a lost economic decade - if we are so lucky I should add, because if we do not end the crap that these leftists are doing it will be even longer - where most Americans that produce wealth, lost out, as massive quantities of wealth was simply destroyed. Yeah, blame Bush. But the fact is that it was neither our leaders during the Bush era acting like liberals when spending, nor the wars we were forced to fight, and certainly not the bullshit about how tax cuts deprived poor government of it’s money as the insane and stupid envy mongers push, but the culmination of insane leftists social engineering policies finally coming up on reality and crashing & burning, that started the economic problems. What followed, the insane government spending and the growth of the nanny state, is what exacerbated it, and all but guaranteed us a long period of pain.

The only people that made out in the age of Obamanomics are the free loaders and the politicians that gain power by buying their votes with tax payer money. And we remain constantly assailed with more ridiculous and divisive class envy politics, intended to distract people from the reality of how disastrous the massive deficit spending and policies of the last 3 years have been, as Obama and the democrats remains focused on meaningless policies like the Buffet rule, free contraceptives, and racialist nonsense to distract the average Joe. I have no doubt that neither Obama nor the democrats can run on their “accomplishments”, that’s in quotes because most of us sane people consider the things we got from Team Blue to be unmitigated disasters: hence the circus atmosphere the LSM is helping them get away with.

Barney, you are offering too little too late. Likely because you are pissed you had to give up your lucrative deal milking the tax payers for all it was worth. Obamacare wasn’t the only thing the left fucked up on, although it certainly is the biggest of them, when you all dropped the ball on the economy. Then again, I am not sure what you think that you leftists would have done to better the economy. Stimulus Part Deux wasn’t going to fix anything, and I can not think that people that believe all solutions and answers come from government, and only government, would have done anything that would have helped the economy, either in the short or long term, in any way or form. And that’s what people need to remain focused on.

Wishful Thinking

So the consensus, even among liberals, is that Obamacare did not have a good week at the Supreme Court. It was so bad, in fact, that I heard people speculating that the Solictor General deliberately did a bad job to get it struck down.


The thinking is that if Obamacare is struck down, this will pave the way for … a single payer system. Seriously:

In the face of a total strike down, single payer probably becomes the best option. But it’s not an easy one. The hurdles to passing Obamacare were that Democrats needed to have a majority in the House, the presidency, and 60 senators. The good news to passing single payer is that they probably would only need 50 senators. (Single-payer could be done simply by expanding Medicare, a pure fiscal change that could be accomplished through a budget bill that can pass the Senate with a majority vote.)

I tweeted about the absurdity of the other night, but I thought I’d expand on that thought. The idea that striking Obamacare will pave the way for single payer is ludicrous. It is based on two bogus schools of thought that run through liberal thinking.

First, liberals are big believers in political determinism. They believe that their idea are so wonderful and fabulous that it is only a matter of time before everyone realizes it and we finally evolve into a liberal utopia. This line of thinking can be traced to Marxism, which posited that the forces of history were leading to the inevitable collapse of capitalism and the inevitable rise of communism. Just as the communists predicted that labor relations would get worse and worse until we had the inevitable worker revolution, liberals are now predicting (hoping) that our healthcare system will get worse and worse until we have the inevitable single payer revolution. All they had to do was stand back and let it happen.

But they are just as deluded as Trotsky was. First, it is not inevitable that our system will get worse without Obamacare. It is possible, if we allow competition across state lines and move people toward more consumer-controlled system, that we could turn the tide. And even it our system does continue to get worse, why would this lead to a surge in support for single payer? Why would people who have vehemently opposed single payer suddenly favor it in the wake of an Obamacare defeat? Liberals want single payer. Indeed, their biggest problem with Obamacare was that it was not single payer. But conservatives and libertarians opposed Obamacare because we saw it as leading to single payer.

The second problem with this line of thinking is that it completely misreads the political situation. To listen to the Left, Obamacare was passed over the fierce opposition of the health insurance companies, pharmaceutical companies and physicians. This is complete bullshit. The insurance industry favored Obamacare. Big Pharma was bought off with promises of no price controls. The doctors and hospitals were bought with promises of a permanent stay of the SGR cuts. All kinds of special interests favored Obamacare because they knew precisely what would happen: healthcare would become even more politicized. More money would flow to companies that were politically connected. Do you think Big Pharma is mad that HHS is mandating that their most expensive birth control pills be covered? Do you think the insurance companies hate it that people are being force to buy insurance? Give me a break.

Obamacare was a product of industry, a distillation of what they wanted out of healthcare reform. And they supported it heavily. They will not, however, have such a love affair with a single-payer system. Such a system will put private insurers out of business, set the stage for price fixing in all branches of healthcare and, given Medicare’s horrific finances, necessitate massive cuts in physician and hospital reimbursement. The special interests will unite against single payer just as they united for Obamacare.

At most, striking down Obamacare may set the stage for an Australian-type system where the government provides basic insurance and everything else is private. Or it may set the stage for the Ryan plan of breaking the federal monopsony that already controls half the healthcare system. But the idea that this sets the stage for single payer is pure Left Wing fantasy.

(And since we’re on this, it’s always worth pointing out that the contention that Medicare is more efficient than the private sector is bullshit.)

Thou Shalt Cover

As I said on Twitter, the Obama’s administration’s ridiculous fight against the ministerial exemption — a fight they lost 9-0 in the Supreme Court — suddenly make sense:

The Obama administration announced today it will wait for a year (coincidentally until after the elections) before requiring religious organizations to comply with an Obamacare mandate that they provide coverage for contraception — including controversial drugs that can abort an early pregnancy.

This started with a decision by the Obama administration last summer listing the “preventive” services that must be covered by health plans under Obamacare without charge to patients, and the list included contraception.

Look, I’m pro-birth-control. I believe in comprehensive sex education and subsidies for poor people (although birth control is not really that expensive). I believe colleges and universities should make birth control available for their students. I’m so pro-birth control, I wear a condom when I blog.

But there is some daylight between that position and thinking government should force religious institutions to cover birth control (which basically means providing it). In the first paradigm, you are increasing people’s choices and freedom. In the second, you are decreasing it, forcing people to spend money for things that they may morally object to.

Although I think National Review has a point on this being on attack on religious freedom, I don’t think this is “war on religion”, per se, despite Newt’s ranting on the subject. It’s more of a war for religion — the secular religion of statism; the belief that government knows best. It started about a decade ago, when Bush’s faith-based initiatives forced religious charities to put more money into drug treatment than they wanted to. It has continued with the fight over gay adoption, in which Catholic charities have ended adoption services rather than let gays adopt children. This is simply the next step: forcing religious institutions to provide birth control.

As I said when this issue first cropped up, the issue is simple: this is giving too much power to government. Making birth control available is sensible. But forcing employers to pay for it — for people who are insured and can likely afford it on their own — is simply a bridge too far.

Think of the precedent. If a Democratic President can force institutions to pay for services with which they have a moral qualm, where does it end? Can they force them to pay for stomach stapling? Can they force them cover stem cell treatments? What about sterilizing people who we decide shouldn’t reproduce — an idea that surface every few decades?

Think of what this means for the insurance paradigm: If a Democratic President can decree that all insurance will cover birth control why can’t a future Republican President decree that none will cover abortion? Once you inject government into these decisions, you have opened a can of worms.

Now this is supposed to save us money. But first of all, who died and made government God? (Answer: the Constitution). Even assuming birth control would decrease healthcare costs — and let’s put a pin in that — who is government to tell me I have to take the cheaper option? For some of these religious institutions, they would rather take on the higher insurance cost. Who are you to tell them how they may or may not spend their money? Birth control is a great idea; it’s not a fundamental right. This isn’t free speech were talking about.

Now, about saving money. Preventative care may save lives but it does not save money. Birth control may save parents money but it does not necessarily save their employers money. And to be told how to save money by … stop that laughing back there! … the government is asburd. Just take a look at this:

In the past two decades, Medicare’s administrators have conducted demonstrations to test two broad approaches to enhancing the quality of health care and improving the efficiency of health care delivery in Medicare’s fee-for-service program. Disease management and care coordination demonstrations have sought to improve the quality of care of beneficiaries with chronic illnesses and those whose health care is expected to be particularly costly. Value-based payment demonstrations have given health care providers financial incentives to improve the quality and efficiency of care rather than payments based strictly on the volume and intensity of services delivered.

In an issue brief released today, CBO reviewed the outcomes of 10 major demonstrations—6 in the first category and 4 in the second—that have been evaluated by independent researchers. CBO finds that most programs tested in those demonstrations have not reduced federal spending on Medicare.

That’s ten failures. You would expect one of those programs to have worked just by accident. But none have. And these are the guys we are going to listen to about controlling healthcare costs? These are the guys we want telling religious institutions what they shall and shall not pay for?


Politifact Politicized

I have a sort of like-dislike relationship with Politifact. I think they are useful for gathering facts and providing background. I actually find their long-form articles, where they hash out the details of claims and allow both sides to make their case, much more illuminating than their offhand ratings, which are a bit arbitrary. They are certainly superior to, say, Media Matters, which unabashedly touts the liberal line. But I do occasionally find they get tangled in minutiae, missing the forest for the trees.

However, liberals love Politifact. They especially loved Politifact when they branded — incorrectly in my view — the claim that Obamacare was a government takeover of healthcare as their “Lie of the Year” for 2010.

Well, they just got a lot less popular:

Republicans muscled a budget through the House of Representatives in April that they said would take an important step toward reducing the federal deficit. Introduced by U.S. Rep. Paul Ryan of Wisconsin, the plan kept Medicare intact for people 55 or older, but dramatically changed the program for everyone else by privatizing it and providing government subsidies.

Democrats pounced. Just four days after the party-line vote, the Democratic Congressional Campaign Committee released a Web ad that said seniors will have to pay $12,500 more for health care “because Republicans voted to end Medicare.”

After two years of being pounded by Republicans with often false charges about the 2010 health care law, the Democrats were turning the tables.

PolitiFact debunked the Medicare charge in nine separate fact-checks rated False or Pants on Fire, most often in attacks leveled against Republican House members.

Now, PolitiFact has chosen the Democrats’ claim as the 2011 Lie of the Year.

My view? Well, the Republicans kind of did try to end “Medicare as we know it”, replacing a single-payer system with something similar to Obamacare. But Politifact’s point is a little more nuanced, as they point out the large number of lies that were told in support of the claim that the GOP was ending Medicare. Go to their page and read the claims they include under the “end Medicare” umbrella. Many of them were ridiculously bad lies. Many of them were clearly designed to terrify seniors. Politifact was responding to a campaign, not a specific statement. As with all Politifact articles, you have to read it to know what they’re actually saying.

(A new version of Ryan’s plan is emerging now in cooperation with Ron Wyden. Suderman discusses it here. Klein’s take here. Imagine a continuum of plans that goes from a total free market to socalism. The spectrum might look like this.

1. Free market; no government interference

2. Mostly free market; some government support to poor people

3. Regulated market; government support to the poor.

4. Managed market with price supports.

5. Managed market with price supports and government option.

6. Single payer.

7. Socialized system (i.e., docs are government employees).

The NHS would be (7). Medicare is currently (6). Obamacare started as (5) and became (4). The system before that was (3). Ryan’s plan would have moved Medicare from (6) to (4). The Ryan-Wyden plan would move Medicare from (6) to (5). I’m ridiculously oversimplifying things but … you kind of have to sometimes to get the point: the Democrats are trying to increment up that scale; the Republicans are trying to increment down it.)

Anyway, Politifact has now hit he Democrats. And as you can imagine, the liberals — who have spent years praising Politifact to the skies — are apoplectic. Paul Krugman washes his hands of them here. Charles Johnson blasts them here. Daily Kos tries to blame the WSJ here.

It’s hilarious. When PF bashed Republicans, it was a bastion of integrity. Now that it’s bashed the Democrats’ latest Mediscare campaign, it’s a useless Right-wing tool.

And they say we live in an epistemic bubble.