Watts LTE in GJ Sentinel

The March 31, 2010 Grand Junction Sentinel has published Richard Watts' latest LTE on ObamaCare:

Emergency-room costs don’t justify health bill

This is regarding the article, "Local supporters cheer health vote," The Daily Sentinel March 22:

"We already decided health care is a right by the way we treat ERs," Michael Pramenko told the Sentinel.

Who decided? Not "we," but Congress, when it passed a law forcing emergency rooms to treat everyone, regardless of ability to pay. By what right? None.

Each person has a right to liberty, as the Declaration of Independence asserts. Any law forcing anyone to provide a good or service violates our liberty.

It is wrong for anyone to take others' earnings, achieved through their own efforts to spend by their own judgment. It is wrong to force anyone to serve others. That is why America abolished slavery.

Forced emergency-room treatment does not justify national health care. Rather, we should restore liberty. For more on this, please visit WeStandFIRM.org.

RICHARD WATTS
Hayden, CO

Thank you, Richard, for again speaking out in support of liberty and individual rights.

Quick Links: Ross, Catron, HSAs

Doug Ross describes "DemCare: a tidal wave of regulations, taxes, fees, bureaucracies, waiting lines, bankruptcies and seniors denied medical care are on the way". (Via Dr. Milton Wolf.)

David Catron reports, "Sebelius to Insurers: Forget the Law, I Make The Rules Now".

IBD hopes that maybe HSAs will still survive ObamaCare.

PJTV: Stripped of Your Freedoms in the Era of ObamaCare

PajamasTV has the latest video with Yaron Brook and Terry Jones, "Stripped of Your Freedoms in the Era of ObamaCare".



I particularly want to highlight their discussions of the massive restrictions on individual freedoms, and the resultant havoc ObamaCare will wreak on the US economy.

But watch the whole thing! (20 minutes.)

Wolf: Crushing One Company At A Time

Do you like life-saving medical innovation? Would you like to see businesses who create such products prosper and thrive?

If so, then read Dr. Milton Wolf's recent blog post: "Crushing one company at a time to destroy an entire health care system"

Then ask yourself if you want to live in that future.

Malanga: Welcome to NY, America!

Steven Malanga explains how ObamaCare will create a national-level mess, like the one that New York state has already endured.

Here's an excerpt from his 3/24/2010 piece, "Health Care Reform: Welcome to NY, America":

New York enacted a health reform package with these two mandates - known as guaranteed issue and community rating - in 1993, making it unique among the states (only five others have both mandates but none has requirements as strict as New York's). Back when the state instituted the reforms about 752,000 residents were buying health insurance directly from insurance companies in the individual market. But premiums immediately started to soar, and as residents realized they could purchase insurance at any time, even after they got sick, New York's individual health insurance market disappeared, shrinking by 95 percent all the way down to a mere 34,000 individuals. Meanwhile, the ranks of the uninsured spiked to 20 percent by 1997.

New York's response to its vast increase in uninsured residents was to offer more state-subsidized insurance. When the price tag on these plans began to weigh down the state budget, New York slapped new taxes on residents and businesses to pay for them, including a new $275 million assessment against insurance companies on top of some $3 billion in assessments they already pay in the state. All of this so that the state's uninsured rolls would soar as costs spiraled upward and then declined again as government stepped in with subsidized coverage.

...In a study of New York, the Manhattan Institute estimated that the Empire State's mandates increased the cost of health premiums by a whopping 42 percent to the highest in the nation (this was before RomneyCare spiked Massachusetts' premiums even higher). The study estimated that up to 37 percent of those who were uninsured in the state could afford coverage if the state junked its expensive mandates, especially the guaranteed issue and community rating mandates...

(Read the full text of "Health Care Reform: Welcome to NY, America".)

Those who do not learn from history are doomed to repeat it.

The Parable of the Satellite Dish

Today's must-read comes from DoctorZero: "The Parable of the Satellite Dish".

(Via Rand Simberg.)

Quick Links: Schwartz and Gramm

The March 27, 2010 Boulder Daily Camera has published Brian Schwartz's analysis of "The ObamaCare Scam".

The March 25, 2010 Wall Street Journal includes an OpEd by former Senator Phil Gramm on repealing ObamaCare, "Resistance Is Not Futile".

A key excerpt:

Republicans have a job to do. They must make it clear to the American people that this is only the beginning of the debate. There will be two congressional elections and a presidential election before the government takeover is implemented in 2014.

I believe that Republicans should take the unequivocal position that if they are given a majority in Congress in November, they will stop the implementation of the government takeover. And if a Republican is elected president in 2012, they will do with Mr. Obama's health-care bill what the American voters will have done to the Democrats: throw it out. If the voters demand change in November, even the Democrats who remain in Congress will help give it to them.

We'll see if the GOP is up to the task -- or if they disappoint Americans by once again capitulating to and compromising with the statists.

Damned If You Do...

As a result of ObamaCare, multiple corporations have recently issued statements about the harmful effects the new law will have on their bottom lines.

According to "The ObamaCare Writedowns" in the March 27, 2010 Wall Street Journal:

Yesterday AT&T announced that it will be forced to make a $1 billion writedown due solely to the health bill, in what has become a wave of such corporate losses.

...On top of AT&T's $1 billion, the writedown wave so far includes Deere & Co., $150 million; Caterpillar, $100 million; AK Steel, $31 million; 3M, $90 million; and Valero Energy, up to $20 million. Verizon has also warned its employees about its new higher health-care costs, and there will be many more in the coming days and weeks.

Several Washington politicians are mad, making threatening statements against these companies:

Commerce Secretary Gary Locke took to the White House blog to write that while ObamaCare is great for business, "In the last few days, though, we have seen a couple of companies imply that reform will raise costs for them." In a Thursday interview on CNBC, Mr. Locke said "for them to come out, I think is premature and irresponsible."

Meanwhile, Henry Waxman and House Democrats announced yesterday that they will haul these companies in for an April 21 hearing because their judgment "appears to conflict with independent analyses, which show that the new law will expand coverage and bring down costs."

But as the WSJ notes, these companies are required by federal law to do exactly what they are doing -- namely, to accurately report their financial situation according to their best judgment:

Black-letter financial accounting rules require that corporations immediately restate their earnings to reflect the present value of their long-term health liabilities, including a higher tax burden. Should these companies have played chicken with the Securities and Exchange Commission to avoid this politically inconvenient reality? Democrats don't like what their bill is doing in the real world, so they now want to intimidate CEOs into keeping quiet.

(Read the full text of "The ObamaCare Writedowns".)

Hence, the government is placing these companies in a damned-if-you-do-damned-if-you-don't position.

If they truthfully report how much ObamaCare will cost them, they're being "irresponsible" for not agreeing with the politicians' party line about how ObamaCare will save money -- and they could face Congressional hearings.

If they ignore reality and instead report falsehoods to suit the politicians' wishful thinking, then they could face legal punishment for violating SEC rules.

I can think of no worse perversion of the rule of law than for the government to force honest men into this kind of impossible situation.

Haynes on Dependency

Beth Haynes, MD, summarizes the essence of ObamaCare in her March 26, 2010 OpEd at American Thinker, "A Nation of Dependents":

...When health care funding is controlled by the state, medical care is dispensed by politicians -- and we as patients can only lobby, beg and hope that our "fair share" will be sufficient.

If we wish to escape dependence on government for our vital needs, we must insist upon freedom and personal responsibility for everyone. There is no short cut to security.

(Read the full text of "A Nation of Dependents".)

Another Silent Casualty of Health Care Reform

One of my PajamasMedia readers recently sent me a moving letter written by his high-school age niece who had been thinking of becoming a doctor but is not so sure after ObamaCare. For now, she wishes to be identified as "Alyssa Z". Her letter is entitled, "Do I Surrender My Rights?"

She was also going to send it to her Congressman. She has also given me permission to circulate it as widely as possible, so please feel free to blog about it, forward to friends, etc.:

"Do I Surrender My Rights?"

Dear Society,

I am writing you today to express my deep concern. I am but one of the many silent casualties of healthcare reform. Currently I am a high school junior who is considering my future. One path I am pondering is becoming a doctor. I am an honor student, active in sports, and am taking advanced placement college classes. The fact that I enjoy biology, chemistry, and helping others made me consider the long, arduous journey towards a medical degree.

Recently though, I heard a new phrase in the healthcare debate that gave me cause for concern, "healthcare is a right". My understanding of a right has always been that we were born with it, and it can never come at the expense of others' rights. How can you now lay claim to my hard work and future talents? I now feel that if I choose the medical profession I would become a second class citizen.

My dear American friend, after eight years of intense study, many more years of internship and residency, not to mention the hundreds of thousands in debt, I feel the price I am being asked to pay not just in dollars, but in my freedom is more than I can bear. I ask how many more silent voices in classrooms, from my fellow students with an equal passion for healing the sick, will never be heard in clinics and hospitals across this great country?

Alyssa Z

All Americans should be asking themselves these questions...

Hsieh OpEd in PJM: "The Real ObamaCare Fraud"

PajamasMedia has just published my latest OpEd: "The Real ObamaCare Fraud"

My theme is that the ObamaCare CBO score was based on a fraud. But hidden in ObamaCare is a more pernicious fraud: "bending the cost curve" by covert rationing.

Here is the introduction:

In the final days before the climactic ObamaCare vote in Congress, one hotly disputed issue was the reliability of the Congressional Budget Office's projection that the health plan would cost "only" $940 billion over 10 years. Critics charged that this figure was artificially low because it included a projected 21% cut in Medicare payments to physicians that Congress would later restore as a separate $247 billion "doc fix." In essence, ObamaCare critics charged that supporters were engaged in fraudulent accounting.

The critics are right. In the short term, politicians are unlikely to leave the draconian 21% Medicare cuts in place, because it would force many physicians to treat Medicare patients at a loss. Many doctors would drop their Medicare patients (or at least refuse to accept new ones), creating an outcry from the senior citizens' lobby. The projected cuts have already been postponed multiple times. Originally scheduled to take effect on January 1, 2010, Congress first postponed them until March 1, 2010, then until April 1, 2010, then again until October 2010.

However, such postponements won't solve the long-term problem of rising Medicare costs. Hence, under ObamaCare the federal government also plans on cutting Medicare spending through measures that don't overtly force doctors to lose money. Although these measures will be portrayed as steps to improve "quality" and "cost effectiveness," they will in fact have the opposite effects of reducing quality of care and leading to de facto rationing. These constitute the real fraud of ObamaCare...

(Read the full text of "The Real ObamaCare Fraud".)

Armstrong On Abortion Funding

Ari Armstrong has some pointed questions for both sides of the abortion debate in his recent blog post, "ObamaCare and Abortion".

His post his reprinted here in its entirety with his permission:

ObamaCare and Abortion

One of the big fights leading up to the vote on the Democratic health bill (ObamaCare) was over abortion funding. The basic dilemma is whether tax-subsidized health care -- and taxes already fund most U.S. health costs -- will cover abortions.

What both sides seem to forget is that, when politicians control health care, it turns out that politicians control health care. So whether politicians will permit tax funds to subsidize abortions depends entirely on which politicians get into power.

Anti-abortion Christians who think that an executive order or even an explicit legislative declaration can permanently prevent the tax subsidization of abortions are simply delusional. Various Catholic groups endorse politically run medicine but insist that it not subsidize abortions. But when you render unto Caesar the control of medicine, Caesar will dip into tax funds to pay for whatever medical procedures he damn well pleases. That U.S. medicine is controlled by thousands of pigmy Caesars who vote, bicker, and draft reams of regulations first does not alter that basic fact.

Leftists who wish to protect a woman's right to choose to get an abortion, but who deny to all women and men the right to associate freely to obtain medicine and insurance, should contemplate a possible future in which the religious right seizes control of the political machinery built by the left. Prohibitions on the tax funding of abortions will be the least of our worries.

I have some questions for the religious right. Do you really care, at all, about liberty in medicine? Does forcing somebody to finance a kidney transplant register a blip on your moral radar? Or are you perfectly fine with the forcible redistribution of wealth to fund health care, so long as it doesn't include abortions? If the left offered to completely ban abortions, in exchange for the complete political control of medicine, is that a bargain you'd happily accept?

I have only a couple of questions for the left. What sort of world do you think we'll be living in if the religious right takes over the Democratic health law? How is politically run health care remotely consistent with the exhortation to "keep your laws off of my body?"

I don't really expect either the religious right or the left to attempt to answer these questions. Even the attempt to answer them would indicate some residual concern with liberty and individual rights, which I do not believe that many on either side any longer possess.

(Original link to "ObamaCare and Abortion".)

Can States Opt Out of ObamaCare?

Ben Domenech asks that question in his 3/24/2010 New Ledger article, "The Individual Mandate: Can States Opt Out?"

Short answer: In theory, "yes". In practice, "almost certainly no".

Domenech explains:

Here's the answer on how the exemption would work: you could only get an exemption approved by the Secretary of HHS if you prove you can cover more people with your non-individual mandate plan, while also meeting their new requirements for coverage (in other words, not by turning to a catastrophic + HSA plan or something along those lines).

In other words, it is hard to see all but a few rare circumstances where a state would apply for this exemption and move toward a pro-market solution. You would have to prove that you would have a greater number of people purchase a product than you would by legally requiring them to purchase that product.

Plus, Domenech notes:

Nor can states be made exempt from the tax increases for individuals and employers, the cuts in Medicare, the newly expanded unfunded liabilities in Medicaid, and a host of other aspects of this bill. Of course states could set up their own programs to cover people, but that would be a waiver almost no state would want to accept, given that they can't prohibit their taxpayer dollars from going to fund this reform elsewhere.

So any talk of an "opt out" is really a sham.

Hsieh OpEd in DP: "Turning Medicine Into Political Football"

Update: Welcome KevinMD.com readers! And thanks to Dr. Kevin Pho for posting this piece as "Government-controlled health insurance may politicize health" (with the permission of the Denver Post).

The March 24, 2010 Denver Post has published my latest OpEd, "Turning Medicine Into Political Football".

My theme is that under government-controlled health insurance, medical coverage decisions will inevitably be based on political considerations, driven by special-interest lobbying and the "politics of pull". And ordinary Americans will pay the price.

Here is the piece:

Turning medicine into political football
Paul Hsieh; Denver Post, 03/24/2010

During President Obama's final push for "universal health care" legislation, his biggest obstacle was not Republicans but rather anti-abortion Democrats let by Congressman Bart Stupak (D-Michigan).

Stupak eventually reached a last-minute deal with the White House on federal funding of abortion services. But no one should be surprised that under government-controlled health insurance, medical coverage decisions will be based on political considerations. Rather, the recent wrangling over abortion will be a mere preview of special-interest battles to come as health care becomes a permanent political football.

Abortion has already been a political football in those sectors of health insurance under government control. In 1985, the Department of Defense denied abortion coverage for women with military health insurance unless the mother's life was in danger. In 1988, the DOD issued additional rules prohibiting women from obtaining abortions with their own private money at military facilities overseas. President Clinton reversed this ban in 1993, but anti-abortion lawmakers reinstated it in 1995 through the defense appropriations bill.

Women covered by the Federal Employees Health Benefits Program (FEHBP) have been similarly affected. Over the past thirty years, their abortion coverage has also swung from permitted to highly restricted depending on which political party was in power.

Nor will the problem of politicized health benefits be confined to abortion. ObamaCare gives the U.S. Preventative Services Task Force (USPSTF) the authority to determine which preventive health services must be covered by private insurance. The USPSTF is the same group that recently issued controversial guidelines recommending that screening mammography be restricted to women over age 50, despite the fact that medical organizations such as the American Cancer Society have long recommended routine mammography beginning at age 40, based on years of scientific research.

Due to public outrage, the Senate later amended its bill to override the USPSTF guidelines — in this particular case. As with abortions for military families, mammography coverage under government-controlled health insurance was determined primarily by politics and lobbying. Similar lobbying will occur as Americans start demanding coverage for other procedures not approved by the USPSTF, such as virtual colonography (a new method of detecting early colon cancer which President Obama himself recently underwent).

Such lobbying is already a constant feature under the Massachusetts system of mandatory insurance in place since 2006, which was the model for ObamaCare. Under any system of mandatory insurance, the government must necessarily determine what constitutes an "acceptable" policy. This creates a giant magnet for special interest groups seeking to include their favorite benefit in the mandatory package.

Massachusetts residents must therefore purchase numerous benefits they may neither need nor want, such as in vitro fertilization and chiropractor services. Since 2006, special interest groups have successfully lobbied to include 16 new benefits in the mandatory package (including lay midwives, orthotics, and drug abuse treatment) — and the state legislature is considering 70 more.

Although I am pro-choice on abortion, abortion opponents should not be forced to fund another woman's abortion. More broadly, individuals have the right to spend their own money for their benefit according to their values. ObamaCare would violate that right by forcing each person to spend his own money on terms set by lobbyists and bureaucrats, rather than based on his individual needs and values.

Instead of politically-controlled mandatory health insurance, we need free-market reforms that allow consumers to decide which benefits they wish to purchase. Such reforms include eliminating mandatory benefits, allowing insurers to compete across state lines, and allowing patients to use Health Savings Accounts for routine expenses, and low-cost "catastrophic-only" plans to cover rare expensive events.

Not only would these reforms reduce insurance costs by up to 50 percent, they would respect each individual's right to make insurance decisions for himself.

Government-controlled health insurance will mean politically-controlled medicine — not only with respect to abortion but for health services in general. ObamaCare will turn medicine into a game of permanent political football, where the politically favored perpetually pound ordinary Americans without special "pull." Until we replace ObamaCare with free-market reforms, Americans had better get used to being the permanent tackling dummies for special-interest groups.

Paul Hsieh, M.D., is co-founder of Freedom and Individual Rights in Medicine at www.WeStandFIRM.org. He practices medicine in the south Denver metro area.

Update: Welcome, Wolf Files readers!

Get Ready For the Lobbying

In the March 24, 2010 Washington Examiner, Paul Howard explains why government controls over insurance will make matters worse, not better.

Here's an excerpt from "Obamacare, The Day After":

Obamacare's defenders argue that reimbursement cuts and a new Medicare super-committee empowered to drive Medicare reforms from the top down will usher in productivity savings, as hospitals and doctors become more efficient to make up for lost revenue. In a market environment, where firms compete for consumer dollars based on price and quality, this might actually happen. But in Obama's post-reform world, the competition will be fought most fiercely on K Street, as interest groups lobby Congress, the Department of Health and Human Services, and Medicare officials to tilt the rules (and spending) in their favor.

Government-managed health care will mean constant political wrangling over money.

The constant fights over Medicare coverage reimbursements will be nothing compared to the ferocious battles to come when the health spending of entire American population (not just the seniors) will be controlled by the politicians.

Dr. Wolf Replies to AMA Request For Dues

Dr. Milton Wolf replies to the AMA request for dues:



As for why the AMA has betrayed doctors and patients, see "The AMA's Quisling Strategy" by David Catron.

Congress Exempts Its Staff From ObamaCare

No, really.

Get ready for two-tiered health care, depending on whether you're part of the ruling class or not.

Update: Ari Armstrong noted that the law exempts senior congressional staff (but not members of Congress themselves) from the ObamaCare mandatory insurance provisions. I've corrected the title accordingly.

20 Ways ObamaCare Will Take Away Our Freedoms

At Investor's Business Daily, David Hogberg lists "20 Ways ObamaCare Will Take Away Our Freedoms".

Here is a sample:

1. You are young and don't want health insurance? You are starting up a small business and need to minimize expenses, and one way to do that is to forego health insurance? Tough. You have to pay $750 annually for the "privilege." (Section 1501)

2. You are young and healthy and want to pay for insurance that reflects that status? Tough. You'll have to pay for premiums that cover not only you, but also the guy who smokes three packs a day, drink a gallon of whiskey and eats chicken fat off the floor. That's because insurance companies will no longer be able to underwrite on the basis of a person’s health status. (Section 2701).

4. Think you'd like a policy that is cheaper because it doesn't cover preventive care or requires cost-sharing for such care? Tough. Health insurers will no longer be able to offer policies that do not cover preventive services or offer them with cost-sharing, even if that's what the customer wants. (Section 2712).

6. You're a single guy without children? Tough, your policy must cover pediatric services. You're a woman who can’t have children? Tough, your policy must cover maternity services. You're a teetotaler? Tough, your policy must cover substance abuse treatment. (Add your own violation of personal freedom here.) (Section 1302).

10. You are an employer who offers health flexible spending arrangements and your employees want to deduct more than $2,500 from their salaries for it? Sorry, can't do that. (Section 9005 (i)).

11. If you are a physician and you don't want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. Of course, this will all be just for informational purposes. It's not like the government will ever use it to intervene in your practice and patients' care. Of course not. (Section 3003 (i))

14. You are a health insurer and you want to raise premiums to meet costs? Well, if that increase is deemed "unreasonable" by the Secretary of Health and Human Services it will be subject to review and can be denied. (Section 1003)

20. If you go for cosmetic surgery, you will pay an additional 5% tax on the cost of the procedure. Think you know how to spend that money you earned better than the government? Tough. (Section 9017).

(Read the full text of "20 Ways ObamaCare Will Take Away Our Freedoms".)

How many of these apply to you?

Quick Links From Wolf and Haynes

Milton Wolf, MD alerts us to Fire The 219.

Beth Haynes, MD has created a new protest symbol against ObamaCare:



As she states:

"With the passage of ObamaCare, I am in mourning over the damage done to our health care freedom and to the ability of physicians to put their patients' best interest ahead of the needs of the common good."

Hsieh PJM OpEd: "ObamaCare: The Coming Battles"

PajamasMedia has just published my latest OpEd, "ObamaCare: The Coming Battles".

Here is the opening:

Now that the House of Representatives has passed the Senate version of ObamaCare, what should Americans expect? If you are concerned about the future of your health care and the future of this country, here are a few things to prepare for in the short, medium, and long terms.

...[A]nyone who made a public promise to oppose their legislator in the November 2010 election if they voted for ObamaCare should follow through on that promise, and as publicly as possible. (Similarly, anyone who promised to support their congressman if they voted against ObamaCare should do so.)

Pelosi and company are banking on Americans having a short memory on this issue. If tea party protesters and like-minded Americans drop the ball and prove them right, then everyone will know that the tea party movement is just a toothless political "paper tiger."

Come November 2010, politicians and pundits will learn one of two lessons. Either they will learn that the tea party protesters are all talk and no walk — or they will learn that the tea party protesters are a force to be reckoned with, and that anyone who crosses them does so at great political peril. Which lesson they learn will be up to us...

Finally, in the long term, the primary battle will be one of ideas...

(Read the full text of "ObamaCare: The Coming Battles".)

Schwartz at PJM: "Get Ready for Health Insurance Slumlords"

Congratulations to Brian Schwartz for his latest OpEd at PajamasMedia:
"Get Ready for Health Insurance Slumlords"

Here is the opening:

If you dislike your health insurer now, just wait until politicians impose price controls that make your insurer act like a slumlord. Expect worse customer service, skimpier plans, and more claim denials.

Price controls on rental properties encourage landlords to become slumlords. Forbidden from making a profit by renting at market rates, to make a living landlords must skimp on quality and service rather than please customers. The same will result from insurance price controls: lousy policies for people with preexisting conditions or for anyone who might get sick.

That is, everyone...

(Read the full text of "Get Ready for Health Insurance Slumlords".)

Thank you, Brian, for making these important points.

(I personally think that any current government-subsidized "high-risk pools" should be phased out in favor of fully-privatized charities.)

But more broadly, as the problems with ObamaCare inevitably unfold, it will be important to remind Americans that they are caused not by private insurance, but by government interference with the rights of consumers and insurers to contract freely.

This will be the next front in the battle of ideas. Thank you for that fine opening salvo!

Hsieh and Gelberg articles in TOS

The contents for the Spring 2010 issue of The Objective Standard are now online.

It includes my article, "Government-Run Health Care vs. the Hippocratic Oath".

My article discusses how and why government-run "universal health care" will inevitably compromise doctors' ability to uphold their Hippocratic Oath to treat their patients according to their best judgment and ability.

I also highly recommend Sarah Gelberg's article, "The Virtue of Treating People Like Animals: Why Human Health Care Should Mirror Veterinary Health Care".

Her article shows that although veterinary and human medicine are extremely similar in terms of quality of care, the freer market for the former makes it substantially more affordable and accessible than the latter.

Non-subscribers can read the introduction to both articles online, but only subscribers can read the full pieces. Non-subscribers can also purchase PDFs of individual articles for $4.95. (Or if they like the samples of these and articles, they should subscribe to the journal!)

A shorter version of my article is also available to the public on the PajamasMedia website, under the title "ObamaCare vs. the Hippocratic Oath".

If ObamaCare Passes Later Today...

...here are a few links discussing what to expect in the aftermath.

First, there may be some procedural and legal challenges, both within Congress and in the court system:

"Not So Fast! Challenges Could Drag Out Health Bill Votes"
Fox News, 3/19/2010

Georgetown University law professor Randy Barnett discusses some of the constitutional issues that could arise:

"Is Health Reform Constitutional?"
Washington Post, 3/21/2010

For details on what changes individuals can expect (and when) in their own health coverage, see:

"Health Care 101: What happens if the bill passes"
Associated Press, 3/15/2010

PJM: Why America Hates Universal Health Care

Blogger "Zombie" has an essay up at PajamasMedia entitled, "Why America Hates Universal Health Care: The Real Reason".

One noteworthy excerpt caught my eye:

Now, I really don't care if you overeat, smoke like a chimney, hump like a bunny or forget to lock the safety mechanism on your pistol as you jam it in your waistband. Fine by me. And as a laissez-faire social-libertarian live-and-let-live kind of person, I would never under normal circumstances condemn anyone for any of the behaviors listed above. That is: Until the bill for your stupidity shows up in my mailbox. Then suddenly, I'm forced to care about what you do, because I’m being forced to pay for the consequences.

...What I don't like about the very concept of universal health care is that it compels me to become my brother's keeper and insert myself into the moral decisions of his life. I’d rather grant each person maximum freedom. I'd prefer to let people make whatever choices they want, however stupid or dangerous I may deem those choices to be. Just so long as you take responsibility for your actions, and you reap the consequences and pay for them yourself -- hey, be as foolish or hedonistic or selfish or thoughtless as you like. Not my business.

But if the bill for your foolishness shows up in the form of higher taxes on me, then I unwillingly start to care what you do. And, trust me on this, you don't want me turning my heartless judgmental eye on your foolish lifestyle. Because I'd have no qualms criticizing half the stuff you do.

Do you want that? No. Do I want that? No. And that's the point. Instituting a single-payer universal health-care system, or even a watered-down version as the government is now proposing, compels me to become a meddlesome busybody in your personal choices. And it will compel you to become a meddlesome busybody in everyone else's personal choices. It forever douses the beautiful flame of individualism -- freedom to act without interference, just so long as you are ready to accept the consequences, whatever they may be.

(Read the full text of "Why America Hates Universal Health Care: The Real Reason".)

Zombie is completely right on this point.

To see how this has played out in other countries such as Japan, Germany, and England, see my earlier piece from the January 7, 2009 Christian Science Monitor, "Universal Healthcare and the Waistline Police".

If/when ObamaCare passes, get ready for a "nanny state on steroids"!

Thoughts From Lucidicus and Grandpa Munster

Tweet from Lucidicus (Jared Rhoads):

10 years from now: "Daddy, when they tried to take over medicine, did you fight it?" Yes, we sure did.

Grandpa Munster endorses ObamaCare:

I support ObamaCare.

Mainly, because I'm already dead, have nothing to lose, and haven't paid taxes in 200 years.

Watts LTE in Denver Post

The March 19, 2010 Denver Post printed the following LTE by Richard Watts responding to Dan Haley's column on the Congressional contortions to pass ObamaCare:

The transfer of taxpayers' wealth

Dan Haley notes the congressional health bill is "larded up with special deals and gross kickbacks." True, but the bill is not merely wrong because of added pork. National health care is inherently wrong because it forcibly transfers wealth. Sure, it's immoral for Congress to take some people's money and shovel it to others as pork. But why? Because the money belongs to those who earned it, not to Congress, nor to anyone who accepts the loot.

If done in the private sector, such activities are known as theft, robbery and receiving stolen goods. These are just as wrong if government perpetrates them, and worse -- because it is government's responsibility to defend people's rights.

Richard Watts, Hayden

Regardless of how the big vote in Congress turns out this weekend, I'd like to thank Richard for this fine LTE which cut right to the heart of the issue. Richard has been a stalwart supporter of FIRM from the very beginning, when Lin Zinser founded it in January 2007.

Caterpillar and Congress

More "money and power" links:

Money: "Caterpillar Inc. said the health-care overhaul legislation being considered by the U.S. House of Representatives would increase the company's health-care costs by more than $100 million in the first year alone."

(The last thing we need in a depression is more job-killing government regulations. Link via @LyndsiM.)

Power: "Challenges Could Drag Out Health Bill Votes"

(Even if Pelosi wins the vote this Sunday, there are several legislative obstacles that could potentially still derail ObamaCare.)

Money and Power

Two quick political updates on ObamaCare.

Money:
"Five Reasons The CBO Figures Are Phony"
Ed Carson, Investor's Business Daily, March 18, 2010

(Gee, maybe it's going to cost more than the much-ballyhooed $940 billion...)

Power:
"Projections from the House's 'deem to pass' roll call"
Michael Barone, Washington Examiner, March 18, 2010

(After all the arm-twisting, Pelosi still might not have enough votes...)

Zawistowski LTE, Rhoads OpEd

Stella Zawistowski of ReasonPharm had a nice LTE published in the New York Times on President Obama's recent trip to Ohio to promote his health care plan (3/18/2010 edition, 4th one down):

President Obama is resorting to Natoma Canfield's sad story and saying that "every argument has been made" because he has not answered so many arguments against his plan. How, for example, when an insurance mandate has failed spectacularly in Massachusetts, will it work times 50?

I, too, feel sorry for Ms. Canfield, an uninsured woman with leukemia. But that does not justify brushing aside the facts and increasing government intervention in health care.

In fact, it is government intervention that places individually purchased insurance out of Ms. Canfield's price range in the first place.

Feelings of pity, however strong, must not get in the way of a reasoned debate. The only way to help Ms. Canfield and other Americans get health care is a fully free market.

Stella Zawistowski

Jared Rhoads of the Lucidicus Project has a new OpEd, "21 musings before the vote". Here are a few choice items:

2. According to preliminary numbers from the Congressional Budget Office, health reform will cost an estimated $940 billion. I'm sure we will see people proffer calculations of what that comes to for every man, woman, and child in the nation. But remember to multiply that figure by at least two in order to get your share, because over 40 percent of Americans pay no income tax.

8. The same people who advocate taxpayer-funded incentives for "healthy lifestyle decisions" also support disassociating risk from insurance pricing through community rating. Wouldn't risk-based pricing be the best incentive of all, and save us the IRS middleman?

14. A good test of a person's values these days is to bring up the Tea Party movement. Anyone can disagree, but if he calls it "astroturf" or uses the "teabag" epithet, then run the other way. You have nothing to gain from dealing with such a person.

(Read the full text of "21 musings before the vote".)

Hsieh OpEd in PJM: "ObamaCare vs. the Hippocratic Oath"

PajamasMedia has just published my latest health care OpEd, "ObamaCare vs. the Hippocratic Oath".

My theme is that ObamaCare would fatally compromise doctors' ability to uphold their Hippocratic Oaths to treat their patients according to their best judgment and ability.

This is adapted from my forthcoming article in the Spring 2010 issue of The Objective Standard. I'd like to thank Craig Biddle for giving me permission to excerpt and adapt more than the usual 600 words from that article to use in this PJM piece. In exchange, PajamasMedia included a link back to the TOS website at the end of this piece.

(Disclaimer: No one at TOS reviewed this PJM piece before publication. Hence, the responsibility for any errors or awkward formulations is purely mine.)

Here is the introduction:

ObamaCare vs. the Hippocratic Oath

President Obama's health care "reform" plan has been criticized for being economically unsustainable, politically unpopular, and constitutionally suspect. But for many practicing physicians like myself, his plan contains an even greater but seldom-discussed flaw that overshadows those others. ObamaCare would fatally compromise doctors' ability to uphold their Hippocratic Oath to treat their patients according to their best judgment and ability.

Whenever the government attempts to guarantee "universal health care," it must also control that service, if only to control costs. Hence, it will inevitably seek to control how doctors practice. Accordingly, the White House Council of Economic Advisors has recommended controlling costs through "performance measures that all providers would adopt." Physicians who strayed too far from government "comparative effectiveness” practice guidelines would be punished as "high end outliers."

This will place your doctor's medical conscience directly on a collision course with government bureaucrats...

(Read the full text of "ObamaCare vs. the Hippocratic Oath".)

Quick Links: Coburn, Turner, Carney

U.S. Senator Tom Coburn, M.D., tells us that "ObamaCare is Malpractice" (Yahoo! News, 3/17/2010).

Grace-Marie Turner recaps "The Failure of RomneyCare" (Wall Street Journal, 3/16/2010)

Tim Carney describes how drug-industry lobbyists are trying to influence the proposed government controls in their favor in exchange for throwing their weight behind ObamaCare. (Washington Examiner, 3/17/2010.)

Objectivists Speak Out Against ObamaCare

On his Facebook page, Andrew Bernstein makes this stirring pledge against ObamaCare:

"If the government takes over health care, I will refuse to buy their package, refuse to pay the fine imposed, and make them arrest me. I will broadcast my refusal to cave to socialism on my website, on Facebook, to my students, in my lectures, and on the radio. I will fight this in the courts--or will the DC Fascists suspend the right to trial by jury? I suspect--and hope--that millions of Americans will do the same."

Jared Rhoads of the Lucidicus Project has a new OpEd, "All Talk, No Debate".

Don Watkins of the Ayn Rand Center for Individual Rights discusses the basic moral issue, "You Are Not Your Brother's Health Care Provider".

Jeff Scialabba of the Ayn Rand Center for Individual Rights discusses: "Obama's Flawed Prescription for Health Care".

Reminder: It may be illegal in some circumstances to advocate someone else perform an illegal act. (I am not a lawyer and have no specialized knowledge about this.)

Note that Bernstein is announcing what he plans on doing (in the tradition of American civil disobedience to unjust laws). He also says he suspects and hopes others will also make a similar decision, but he does not explicitly advocate that other break the law.

Here at FIRM, we do not advocate that others perform violent illegal acts.

Americans Still Don't Want ObamaCare

PajamasMedia is reporting on a new survey conducted in partnership with the Center for Medicine in the Public Interest Advance (CMPI-A) showing that "Americans Really, Really Do Not Want ObamaCare".

In particular, a majority of Americans have deep concerns about both the substance of the proposed law as well as the process being used to pass it.

For details, see "Americans Really, Really Do Not Want ObamaCare". (Via @LyndsiM.)

If you want to know where your congressman stands, the Washington Post has a nice infographic showing their current position as well as how they voted back in November 2009.

In Praise of Retail Health Clinics

Ed Morrissey discusses the virtues of retail health clinics, showing how the proper free market incentives lower costs while preserving quality of care.

Here's an excerpt from "Retail health care and reform":

What are "retail health clinics"? Chances are, you've already seen them. These clinics have begun rapidly spreading to malls, big-box retail stores such as Wal-Mart and Target as concessionaires, and drug stores like Walgreens. Instead of hiding behind insurance co-pays, the clinics offer pricing up front to consumers, so that they can decide for themselves what to "buy" and how much they want to pay for service.

This is the same mechanism that works to keep prices down and supply consistent in other areas of health care that insurance plans do not traditionally cover. For instance, cosmetic surgery and Lasik rely entirely on consumer compensation. There are no third-party payers to get in the way of rationally allocating resources to demand. In those markets, producers and consumers find each other in the normal manner, advertising, discounts, and price competition, and the market attracts new providers when scarcity appears and prices rise.

As one would expect, the price transparency creates incentives for patients to shop prudently. Studies show that patients do exactly what, saving money without compromising the quality of care.

This has important implications for the broader health care debate, Morrissey notes:

Given the realities of pricing and competition, we should reform the health system not by building more all-encompassing insurance plans, but by returning health insurance to its rational place: as a bulwark against catastrophic loss. If consumers bought health-care services in a rational market, the price for the overwhelming majority of transactions would be well within the money we would recoup from ending comprehensive coverage policies.

People with pre-existing conditions, such as myself, could access catastrophic coverage a lot easier if insurers didn't have to pay for all of the maintenance services required. Prices would drop to a rational level where almost all families could afford coverage. Government regulation could protect consumers from suffering rejection and cancellation much as they do now.

[Emphasis mine. - PSH]

In the meantime, providers would get properly compensated, which would create growth in supply, especially in family practice, which faces a serious provider shortage.

If we want to reform care, bend the cost curve downward, and promote supply in the health-care industry, we need to learn the lesson from retail health clinics. The top-down reform proposed by Congress threatens to stop real reform and amplify everything that's currently wrong with the system.

(Read the full text of "Retail health care and reform".)

More Doctors Going Galt

The New England Journal of Medicine (hardly a right-wing rag) reports a recent poll showing:

46.3% of primary care physicians (family medicine and internal medicine) feel that the passing of health reform will either force them out of medicine or make them want to leave medicine.

24% of physicians think they will try to retire early if a public option is implemented.

21% of physicians would try to leave medicine if a public option is implemented, even if not near retirement age at the time.

(Via @BradMD.)

Maybe our politicians need to read Brian Schwartz's talking points on why ObamaCare is wrong and won't work.

Update: Thank you, HotAir, for the link!

Update 2: The NEJM has updated the text of the page to reflect that the poll data comes from The Medicus Firm.

They note:

The opinions expressed in the article linked to above represent those of The Medicus Firm only. That article does not represent the opinions of the New England Journal of Medicine or the Massachusetts Medical Society.

Two Doctors Speak Against ObamaCare

Two doctors speak out against ObamaCare in these videos from Docs4PatientCare.org.

Dr. Fred Shessel tells his patients: "You know, under ObamaCare I may not be able to take care of you to the best of my ability, or I am may not be able to see you at all."



Dr. Scott Barbour warns us: "There's gonna be only one choice for the government and that's gonna be to severely ration your care."



Let your Congressman know what you think, especially if he or she is one of these critical swing votes.

(Links via Bradley Hennenfent, MD.)

Hsieh in GCC: "What America Needs to Know What’s at Stake with Obama Care"

The Gold Coast Chronicle, a Florida-based publication, recently solicited opinion pieces from physicians opposed to ObamaCare. I'm glad to report that on March 15, 2010, they published my piece, "What America Needs to Know What’s at Stake with Obama Care". (Title theirs.)

Here's the opening:

President Obama is now determined to ram his health care bill through Congress by any means necessary, despite the fact that it will drive the government hundreds of billions of dollars further into debt and despite the fact the polls consistently show a majority of Americans opposed to his plan.

Why is this?

In a speech to Congress, he piously declared that health care was "a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."

President Obama is right, but not in the way that he means. Thousands of Americans at Tea Parties across the country have rallied precisely to oppose the fundamental principles behind the President's plan.

These protests were not just about health care, but about the proper scope of the government -- and ultimately, the future of America...

(Read the full text of "What America Needs to Know What’s at Stake with Obama Care".)

This is an updated version of my October 1, 2009 Denver Post piece, "The Real Stakes", republished with the consent of both papers.

Quick Links: Protests, HSAs

On March 16, 2010, Tea Party activists from across the country will converge on Washington, DC to rally against ObamaCare.

Dr. Evan Madianos explains, "How to Protest ObamaCare Nationwide in Front of Your Local Hospital".

Jared Rhoads of the Lucidicus Project urges all Americans concerned about their future health care to, "Hold A Sign and Speak Out".

Ron Bachman of the NCPA warns that the proposed ObamaCare legislation could severely limit (or effectively kill) Health Savings Accounts. Read more in his March 5, 2010 paper, "Congress Declares War on HSAs".

Interviews With Dr. Milton Wolf

Dr. Milton Wolf has been giving interviews explaining his opposition to ObamaCare.

Here is Part 1 of his March 11, 2010 interview with PJTV:



Here is Part 2, which contains the more substantial policy discussions, including some excellent free-market reforms:



Here is his March 12, 2010 appearance on "Fox & Friends":



Dr. Wolf also blogs at The Wolf Files.

Here's the March 11, 2010 Washington Times OpEd that vaulted him into national prominence: "WOLF: Obama family health care fracas".

Thank you, Dr. Wolf, for speaking out for American patients and doctors, as well as for American principles of freedom and individual rights!

Health Care Endgame

This upcoming week will be the critical week in the health care fight. Speaker Pelosi is expected to start the process for the House to hold its final vote to approve the Senate bill. The vote will probably take place at the end of this upcoming week.

Right now, they are probably still a few votes shy of the majority they need:

"Dem House vote-counter lacks health care votes now"
Associated Press, 3/14/2010

"Can Nancy Pelosi Get the Votes?"
Michael Barone, Wall Street Journal, 3/11/2010

This is an extremely risky move by the Democrats. Normally, a Speaker wouldn't plan on voting on such major legislation unless he or she was sure of having enough votes.

But the Democrats are also (correctly) concluding that time is not on their side. They have made the calculation that if they push for it now, then maybe then can squeeze out the last few votes via a combination of political carrots and sticks. For example, they have "sweetened" the deal for the wavering moderates by promising billions of dollars of new student loan subsidies.

On the other hand they recognize that if they wait much longer, then when these wavering Congressmen go back home for the Easter recess, they will get an earful from their constituents who are strongly opposed to the bill, and they'll lose even more support.

Hence, from the Left's perspective, it's now or never.

If you (like me) support free-market health reforms, this means three things:

1) We are winning. We have a chance to defeat this terrible bill.

In particular, do not uncritically accept the inevitable news stories about how the Democrats are "close to getting the votes" or how Pelosi is "confident she'll have the votes". She has to exude an aura of public confidence, otherwise her coalition will quickly unravel.

Polls repeatedly show Americans opposed to ObamaCare:

"Why Obama Can't Move the Health-Care Numbers"
Rasmussen and Schoen, Wall Street Journal, 3/9/2010

Similarly, head counts of House Democrats also show that they don't quite have enough votes yet:

"Scrambling for votes, Democrats face uphill climb to pass healthcare reform"
The Hill, 3/13/2010

"The Hill's 'Whip Count' on ObamaCare –- as of 3/13/2010"

If they had the votes, they'd have already passed it by now.

2) We must keep up the pressure.

The Democrats are pulling out all stops to find some way to get this through now, before the critical Easter recess.

At this point in time, the single most important thing you can do is contact your Congressman and tell him or her what you think:

http://www.usa.gov/Contact/Elected.shtml

This is especially important if your Congressman is one of the undecided or swing votes on these "Code Red" lists:

http://www.nrcc.org/CodeRed/targets/
Tea Party Patriots Code Red Alert

Even if your Congressman is a firm "Yes" and you disagree, it's still important to let them know where you stand. If even the liberal Democrats from "safe" seats consistently hear that their constituents are against it, it will give the wavering moderates more political cover to vote "No". They can then tell Pelosi, "Even your constituents hate this thing -- there's no way I can support it".

*** Our counter-pressure is our best weapon against the pressure that the statists will exert on these wavering Congressmen. ***

Your letter doesn't have to be long or eloquent. It just has to convey certainty, passion, and moral conviction. One short letter that I've seen against ObamaCare runs something like this:

"Please vote NO on this terrible health care plan! If you vote yes, you will destroy the ability of me and my family to receive good health care in the future. This is personal! If you vote yes, we will never forgive you for hurting our lives and trampling on our basic freedoms."

(Of course, you should express your opinion in a fashion that reflects your own style and values.)

Feel free to use all contact methods -- phone, fax, and e-mail. And please feel free to contact them multiple times over the upcoming week. In this context, repetition is a virtue!

And of course if you agree with your Congressman's position, then thank him or her. They also need our moral support.

3) If you have friends or family in other parts of the country, tell them to contact their Congressmen.

If you need intellectual ammunition for them, one of my personal favorites is from the AFCM website:

"Fifty Fallacies About Health Care" by Richard Ralston

Jared Rhoads' Lucidicus Project also has a good set of OpEds.

And of course, FIRM has its archive of articles and OpEds.

I personally think that the most important thing we can do in the next few days will be to directly contact our Congressmen and have friends/family do the same. LTEs and OpEds will still be important, but not as much as before. (That said, I'm still going to continue writing and/or disseminating some of my earlier writings to people I know around the country.)

This is the endgame, folks. Most political observers regard the health care bill as a 50-50 "toss-up" or "too close to call". It really could go either way. What happens this week will determine the course of this great country (for good or for ill) for decades to come.

Your voice could be the critical difference in swaying the right one or two minds. If you value your lives and your freedom, the time to speak up is now!

(Anyone is welcome to forward or repost this to any appropriate recipients or venues.)

Hennenfent on Death Panels

Dr. Bradley Hennenfent has been blogging up a storm lately.

In this recent post, he warns "'Death Panels' are Real and Exist Now":

Please stop ObamaCare. I have seen the "death panels." They are Medicaid, Medicare, and the Veterans Administration. They share one thing in common, they are run by the government. The "death panels" are government bureaucrats who come between you and your physician and, after being fiscally incompetent, ration, delay and deny care.

He also correctly warns against private insurers who have illegitimately achieved their dominant position in our marketplace via "crony capitalism" engaging in similar practices against patients and physicians.

In a related post, Dr. Hennefent quotes James Schott:

...[J]ust because the bill does not say specifically 'in our socialized medicine system there will be death panels' doesn't preclude a mechanism evolving that will make life and death decisions based on budget considerations, nor does it mean that the system won't become one where private health insurance cannot survive against the government's monopolistic tendencies, and in a few years we will have socialized medicine.

Both Dr. Hennenfent and Mr. Schott are completely correct on this important issue -- and we have been duly warned.

If you want to stop ObamaCare, call your Congressman.

The upcoming vote will be extremely close. If your Representative is one of these crucial swing votes, then your voice could make the difference.

Even if your representative is a firm "yes" or a firm "no", it's still important to let them know where you stand. Word gets around the Congressional grapevine, so if wavering Congressmen learn that Americans everywhere are consistently opposed to this bill (as polls consistently show), it will make a difference.

Contact your Congressman!

Will and Gratzer on the 12% Problem

In the March 11, 2010 Washington Post, George Will discusses some of the ideological underpinnings of Obama's political approach in "As a progressive, Obama hews to the Wilsonian tradition".

With respect to health care, Will also links to a nice piece by Dr. David Gratzer from 2/26/2010, "The Health Care Number You Didn't Hear".

Gratzer calls this "the 12% problem":

American health care is an accidental system. Private coverage -- the type most Americans have -- has its origins in the wage controls of the Second World War as employers offered rich health-insurance benefits in pre-tax dollars. Public coverage like Medicaid and Medicare, on the other hand, takes its inspiration from the Beveridge report in Britain, drafted in the early 1940s; Lord William Beveridge believed in zero-dollar health care -- that people ought to pay nothing at the point of use. Today's American health care fuses these two systems, but with a common economic flaw: people are overinsured, paying pennies directly on every dollar of health service they receive.

The end result: for every dollar spent on health care in the United States, just 12 cents comes out of the individuals' pockets. Imagine what food costs might be if your employer paid 88% of your grocery bill or what a trip to Saks might be like if your company covered the vast majority of the costs of the shopping spree.

Far from addressing the 12 cent problem, Obamacare would exacerbate it. With its rich subsidies, expansion of government programs, insistence that all insurance cover specific services (and some with no copayments at all), Obamacare would pour fuel on the fire of health inflation. It's one reason that even the chief actuary of the Centers for Medicare and Medicaid Services -- a federal employee -- predicts cost rises under the President's plan.

(Read the full text of "The Health Care Number You Didn't Hear".)

Gratzer is completely correct. Bad government policy creates perverse economic incentives, which give rise for yet more bad government controls to "fix" the problem.

This is why we need to take a step back and think about free-market reforms that repeal those prior bad laws. That's the only way we will get costs under control.

(Links via LT.)

Beware Both Parties

In the March 11, 2010 Investor's Business Daily, Larry Elder reminds us that "Collectivists Come With Both D's And R's".

Here's an excerpt:

The most disturbing part of the Obama-Care debate is not about where Republicans and Democrats disagree, but where they agree.

Take this issue of those with pre-existing illnesses. Many Republicans actually support government action to prevent insurance companies from refusing to insure them. Ignoring the benefits of cost-lowering free market competition and the role of charity, many Republicans believe it acceptable to force an insurance company — in business to insure against unknown risks -- to "insure" someone currently experiencing a known risk.

Sen. Tom Coburn, R-Okla., supports legislation to "eliminate pre-existing conditions" as a reason for a carrier to deny coverage. Sen. John Barrasso, R-Wyo., says government needs "to take care of things like pre-existing conditions so that that doesn't stop (people) from getting insurance."

Sen. Chuck Grassley, R-Iowa, supports prohibiting "insurers from denying coverage to people with pre-existing medical conditions or charging higher premiums to people who are sick."

But this should not surprise anyone who observes the allegedly "fiscally conservative," "pro-free market," "limited government" party in action. From the acceptance of the New Deal to government bailouts of private industry, Republicans — sooner or later -- go along.

Republican President George W. Bush, for a time, worked with a Republican House and Senate. Bush promised and delivered a prescription benefits bill for seniors. It expanded Medicare, the popular underfunded entitlement program passed — with Republican support, by the way -- in 1965. We like seniors. Seniors vote. So if they struggle with their drug bills, why, by all means make someone else help pay them.

On the 10th anniversary of the Americans with Disabilities Act, signed into law by his father, Bush bragged about the law's importance and effectiveness. That such an assault on private employers engenders praise says much about the GOP's acceptance of federal government's command and control.

Elder also reminds us that government policies such as medical licensing requirements and insurance controls drive up costs and are supported by members of both parties.

(For the record, I oppose medical licensing requirements as a violation of the rights of patients and providers to voluntarily contract to their mutual benefit. I agree with Alex Epstein's reasons.)

So as the health care debate rages, let us remember that "Collectivists Come With Both D's And R's".

Vote Count Update

Are there enough Democratic votes in the House to pass ObamaCare?

Speaker Pelosi says they're almost there.

They think they can do it, even without the anti-abortion Democrats.

Some analysts think that Pelosi is forging ahead, even though she may not have the votes from a combination of hope and fear -- hope that she'll pick up the final few votes once the process gets started, and fear that if she waits until after Easter recess, she'll lose even more votes.

The Hill reports, "House Democrats' 'no' votes are piling up on healthcare reform".

In the Wall Street Journal, Michael Barone thinks probably not.

I don't think anyone really knows yet...

President Obama's Cousin Opposes ObamaCare

Dr. Milton Wolf is a radiologist practicing in Kansas. He's also President Obama's second cousin once removed, and he's written a powerful opinion piece in the March 11, 2010 Washington Times explaining why he's opposed to the President's health care plan.

Here's an excerpt from "WOLF: Obama family health care fracas":

The justification for Obamacare has been to control costs, but the problem is there is little in Obamacare that will do that. Instead, there are provisions that will ration care and artificially set price. This is a confusion of costs and price.

As one example, consider the implications of Obamacare's financial penalty aimed at your doctor if he seeks the expert care he has determined you need. If your doctor is in the top 10 percent of primary care physicians who refer patients to specialists most frequently - no matter how valid the reasons -- he will face a 5 percent penalty on all their Medicare reimbursements for the entire year. This scheme is specifically designed to deny you the chance to see a specialist. Each year, the insidious nature of that arbitrary 10 percent rule will make things even worse as 100 percent of doctors try to stay off that list. Many doctors will try to avoid the sickest patients, and others will simply refuse to accept Medicare. Already, 42 percent of doctors have chosen that route, and it will get worse. Your mother's shiny government-issued Medicare health card is meaningless without doctors who will accept it.

Obamacare will further diminish access to health care by lowering reimbursements for medical care without regard to the costs of that care. Price controls have failed spectacularly wherever they've been tried. They have turned neighborhoods into slums and have caused supply chains to dry up when producers can no longer profit from providing their goods. Remember the Carter-era gas lines? Medical care is not immune from this economic reality. We cannot hope that our best and brightest will pursue a career in medicine, setting aside years of their lives - for me, 13 years of school and training - to enter a field that might not even pay for the student loans it took to get there.

More broadly, Dr. Wolf notes:

The problems in the American health care system are not caused by a shortage of government intrusion. They will not be solved by more government intrusion. In fact, our current problems were precisely, though unintentionally, created by government.

World War II-era wage-control measures -- a form of price controls - ushered in a perverted system in which we turn to our employers for insurance and the government penalizes us if we choose to purchase insurance for ourselves. You are not given the opportunity to be a wise consumer of health care and compare prices as well as quality in any meaningful way. Worse still, your insurance company is not answerable to you because you are not its customer. It is answerable to your employer, whose interests differ from your own.

Insurance companies have been vilified for following the perverse rules that government has created for them. But it gets worse. The government, always knowing best, deploys insurance commissioners across the land to dictate what the insurance companies must provide, whether you want it or not, and each time, your premiums increase. Obamacare will make all of this worse, not better.

Dr. Wolf also proposes a variety of genuine free-market reforms that would actually address correct the underlying problems (rather than ObamaCare's proposed new government controls which would only make things worse.:

One of America's founding principles is our trust in the people and their economic freedom to rule their own lives. We should decouple health insurance from employers and empower patients to be consumers once again. Allow them to determine the insurance plan that best meets their families' needs and which company will provide it. This will unleash a wave of competition that will drive costs down in a way that price controls never have. Eliminate the artificial state boundary rules that protect insurance companies from true competition and watch as voters demand that their state insurance commissioners get the heck out of the way. Innovative companies will drive down costs similar to how Geico and Progressive have worked for automobile insurance. And it won't cost taxpayers a trillion dollars in the process.

This free-market approach has worked for everything from high-definition TVs to breakfast cereals, but will it work for medicine? It already is. Take Lasik eye surgery, for example. Because patients are allowed to be informed consumers and can shop anywhere, doctors work hard for their business. Services, availability and expertise have all increased, and costs have decreased. Should consumers demand it, insurance companies -- now answerable to you rather than your employer - would cover it.

Read the full text of "WOLF: Obama family health care fracas".

Dr. Wolf is offering both an excellent diagnosis and an excellent prescription for our health care policy problems. Let's hope his cousin, the President, listens to him.

Hillman: "More health care 'help' we can't afford"

Former CO state senator Mark Hillman discusses more unintended consequences of health insurance mandates.

Here is an excerpt from his post, "More health care 'help' we can't afford":

Two years ago, my wife and I had our first child. We are both self-employed and buy policies through the individual market. We specifically chose not to buy pregnancy coverage, although coverage for "complications of pregnancy" were standard with our Assurant Health policy.

The reason we didn't want to buy coverage for a normal pregnancy is the same reason everyone should have that choice -- a normal pregnancy is not an "insurable event." An insurable event is defined as something that occurs without warning, is unlikely to occur, and is unwanted.

Consumers understand this concept well in every situation except health insurance. We buy home insurance to pay for losses due to fire, hail storms, tornadoes or theft -- not to pay for repainting the family room or updating the kitchen. We buy auto insurance to pay for accidents, storm damage or vandalism -- not to pay for a new set of tires or an oil change.

Over the years, health insurance has moved away from the concept of insurance and become a complicated financing scheme for everything related to health. That's why it's so expensive.

Hillman makes many additional excellent points in his piece. I strongly recommend reading the full text of "More health care 'help' we can't afford".

Quick Links: Williams, Boudreaux, America

The March 3, 2010 Investors's Business Daily carried Walter Williams' column, "Health Care A Right? More Like A Wish".

GMU economics professor Donald Boudreaux tells NPR why ObamaCare would merely mean more of the economic problems of Medicare, but on a vastly larger scale.

March 8, 2010 polling data from Rasmussen shows a majority of Americans still opposed to ObamaCare.

Mankiw on Deficit Neutrality

Harvard Professor Greg Mankiw notes the following fallacy about "deficit neutrality" when discussed by supporters of ObamaCare:

Imagine you have a friend who has a budget problem. Every month he spends more than he earns. His credit card bills are piling up. He is clearly on an unsustainable path. Then one day he comes to you with an idea.

Friend: I am going to take off a few days from work and fly down to Bermuda for a quick vacation.

You: But isn't that expensive? Won't that just add to your growing debts?

Friend: Yes, it is expensive. But my plan is deficit-neutral. I have decided to give up that half-caf, extra shot caramel macchiato I order at Starbucks twice every day. I really don't need that expensive drink. And if I give it up for the next three years, it will pay for my Bermuda trip.

You: Well, then, how are you going to solve the problem of your growing debts?

Friend: I am going to figure that out as soon as I return from Bermuda.

You: But in light of your budget problem, maybe you should give up Starbucks and skip the Bermuda vacation. Giving up Starbucks could be the easiest way to start balancing your budget.

Friend: You really aren't any fun, are you?

This conversation is meant to illustrate why claims of deficit-neutrality in the healthcare reform bill should not give much comfort to those worried about the U.S. fiscal situation...

ObamaCare Update and Odds

Some analysts think that the "reconciliation" strategy is just a ruse; instead, if the House passes the Senate version of the bill, then Obama will just sign it into law (despite promises to Congressional Democrats to the contrary), declare "victory", and move onto other issues:

Wall Street Journal, "Tinker, Tailor, Soldier, ObamaCare"

Susan Anne Hiller, "The House Vote on the Senate Healthcare Bill Is the Final Vote; Obama Will Sign It Into Law"

Phil Kerpen, "Forget Reconciliation -- Why the Real Fight Is In the House"

Such a move by the President would leave the Democratic Congressmen on the hook for having voted for all the provisions of the Senate Bill, including the Cornhusker Kickback, as well as the broader bad plans for mandatory insurance and draconian controls on private insurance, despite their personal misgivings.

If you wish to tell your Congressman what you think, you can contact him or her at:
http://www.house.gov/

Other analysts are essentially saying that the odds of ObamaCare passing are 50-50. In other words, neither victory nor defeat are a slam dunk.

For details of the various procedural and political convolutions and machinations, see:

Keith Hennessey, "Health Care Reform CPR".

Nate Silver, "Is Obamacare a Favorite to Pass?"

Brian Schwartz also covers the Intrade betting market on ObamaCare.

Buckle your seat belts! It's going to get real interesting now...

Mark Steyn: Obamacare worth the price to Democrats

In the March 5, 2010 Orange County Register, Mark Steyn warns that some Democrats are quite willing to incur voters' wrath by passing ObamaCare (including a temporary loss of control of Congress), because they know it will give the government a permanent stranglehold on the American people for the foreseeable future.

Here's an excerpt from his piece, "Obamacare worth the price to Democrats":

I've been saying in this space for two years that the governmentalization of health care is the fastest way to a permanent left-of-center political culture. It redefines the relationship between the citizen and the state in fundamental ways that make limited government all but impossible. In most of the rest of the Western world, there are still nominally "conservative" parties, and they even win elections occasionally, but not to any great effect (Let's not forget that Jacques Chirac was, in French terms, a "conservative").

The result is a kind of two-party one-party state: Right-of-center parties will once in a while be in office, but never in power, merely presiding over vast left-wing bureaucracies that cruise on regardless.

...Look at it from the Dems' point of view. You pass Obamacare. You lose the 2010 election, which gives the GOP co-ownership of an awkward couple of years. And you come back in 2012 to find your health care apparatus is still in place, a fetid behemoth of toxic pustules oozing all over the basement, and, simply through the natural processes of government, already bigger and more expensive and more bureaucratic than it was when you passed it two years earlier. That's a huge prize, and well worth a midterm timeout.

...Because government health care is not about health care, it's about government. Once you look at it that way, what the Dems are doing makes perfect sense. For them.

(Read the full text of "Obamacare worth the price to Democrats".)

The big question is how many House Democrats will buy into that logic. I don't think anyone knows yet. But we'll find out soon.

Steyn is right that once government programs are put into place, they almost never get repealed even by allegedly "conservative" politicians. (The American experiment with alcohol Prohibition is one of the few examples I can think of a successful political repeal.)

On the other hand, we must not commit the fallacy of treating laws of Congress as if they were laws of nature. Even if ObamaCare passes, Americans can and should demand that their politicians repeal it. It may be difficult but it's not metaphysically impossible. And whether it happens will depend on whether Americans have the courage, stamina, and determination to stand up for their individual rights.

Quick Links: Colorado and Indiana

Linda Gorman of the Independence Institute has two new commentaries on Colorado health legislation:

"Bill Summary: HB10-1330, the All-Payer Database: A Transparency Trojan Horse"

Gorman warns that this bill would, "give the Executive Director of Health Care Policy and Financing the power to create a database to collect and store unlimited information on everyone who provides or receives health care in Colorado whether or not the state pays for that health care and whether or not the transaction is a private one."

"Colorado House Bill 1008: Women Pay, But Not Because of Unfair Discrimination"

Gorman notes, "Some people in the Colorado legislature think that everyone should pay the same price for individual health insurance regardless of age, personal habits, or gender. They believe this even though women as a group use more health care than men. They cling tight to the belief that charging someone a lower price for health insurance simply because he uses less health care is, in the language of the bill, 'unfairly discriminatory and shall not be allowed.'"

Ironically she observes, "The Colorado legislature actually helps ensure that women's health insurance premiums cost more."

On a positive note, Indiana governor Mitch Daniels praises health savings accounts in his March 1, 2010 Wall Street Journal essay, "Hoosiers and Health Savings Accounts".

Daniels writes:

Are HSA participants denying themselves needed care in order to save money? The answer, as far as the state of Indiana and Mercer Consulting can find, is no. There is no evidence HSA members are more likely to defer needed care or common-sense preventive measures such as routine physicals or mammograms.

It turns out that, when someone is spending his own money alone for routine expenses, he is far more likely to ask the questions he would ask if purchasing any other good or service: "Is there a generic version of that drug?" "Didn't I take that same test just recently?" "Where can I get the colonoscopy at the best price?"

To the extent that the free market is allowed to operate, patient receive quality care for lower prices. Surprise, surprise!

(Links via PatientPower and JG.)