Wolf: Obamacare Shouldn't Be Replaced With Gingrichcare

Dr. Milton Wolf has another nice piece in the Washington Times, "Obamacare shouldn't be replaced with Gingrichcare".

He makes the crucial point that the central-planning and nanny-state approaches to health care are wrong, regardless of whether they are proposed by Democrats or Republicans.

Here is an excerpt:

Mr. Gingrich notes that in the 2,409 pages of the Obamacare law, the word "require" appears 198 times. Yet in his own book, the same word appears with a higher frequency, 80 times in the 356 pages. Add words like "encourage," "migrate," "incentivize" and their variants, and Mr. Gingrich's euphemistic requirements total 144. Mr. Gingrich may not like most of President Obama's requirements -- and neither do I -- but he sure loves his own.

On the Gingrich road to universal health care are many stops in the nanny state. Despite claims of "[n]o mandates," his so-called "pro-jobs, pro-growth" health care plan includes micromanaging elementary schools to assure they provide physical education classes five days a week, and he takes time to monitor school breakfasts and lunches and even vending machines. Mr. Gingrich evidently agrees with first lady and food cop Michelle Obama that the government, not parents, should decide what their children eat...

Are we to believe that big government by Mr. Obama is bad but big government by Mr. Gingrich is good?

(Read the full text of "Obamacare shouldn't be replaced with Gingrichcare".)

Americans did not vote for the GOP in the 2010 election because they wanted statism-lite. I'm glad men like Dr. Wolf are reminding them of this important fact.

Quick Links: Wolf, Levy, Hayek

PajamasMedia gives Dr. Wolf's new eBook a nice review. You can purchase it for $1.99 via this Amazon link: "First, Do No Harm".

Cato's Robert Levy has written a detailed position paper, "The Case Against President Obama's Health Care Reform: A Primer for Nonlawyers". Full PDF here.

There's a new Keynes vs. Hayek video!:



If you missed it, here's Part 1:

Quick Links: Forest, Krugman, MA, WI

The Obama administration is trying to blacklist the CEO of Forest Labs (a pharmaceutical company) without any form of due process.

Greg Scanlen rebuts Paul Krugman on consumer driven health care.

Sally Pipes summarizes, "RomneyCare's Unhappy Anniversary"

The Wisconsin State Journal reports, "UW doctors face penalties for writing sick notes for protesters".

We'll see if this will be a genuine penalty or merely a slap on the wrist (as some like David Catron suspect.)

Catron on the SCOTUS Delay

David Catron explains the importance of the Supreme Court decision not to permit an expedited decision on the ObamaCare legal challenges in his latest AmSpec piece, "Supreme Court Allows Obamacare to Metastasize".

Here's an excerpt:

While the lawyers argue over hopelessly arcane points of law and the judges issue dueling opinions, Obama administration apparatchiks will be working furiously behind the scenes to implement Obamacare. They have already introduced a voracious tape worm of regulations that will wind itself so thoroughly around the entrails of the health care system that removal will be a virtual impossibility in a year or so.

The latest example can be found in the rules promulgated by CMS administrator Donald Berwick concerning Accountable Care Organizations (ACO), the government's latest rebranding of the old HMO gambit. Although the section of the law calling for the creation of ACOs is a mere six pages long, Berwick's bureaucrats transmuted them into no fewer than 429 pages of regulations.

The landscape of medical practice is changing dramatically, as a result of such legal and economic pressures for doctors and hospitals to consolidate into large impersonal Accountable Care Organizations.

As the New York Times recently reported, this will lead to the withering away of solo and small primary practices.

Basically, the government is dictating the business model and the practice patterns of American medicine. And as Catron notes:

If Obamacare has another year to metastasize, it may well be impossible to eradicate the disease without killing or at least badly maiming the patient. In fact, it is conceivable that the DOJ will make that very argument when the case finally arrives before the Court, betting that the justices will be loath to strike down Obamacare -- or even the individual mandate -- knowing that such a ruling would create chaos in the midst of an election year.

(Read the full text of "Supreme Court Allows Obamacare to Metastasize".)

Hence, the importance of continued grass-roots educational and political efforts to slow down and/or "defund" the implementation as much as possible in the upcoming year...

Protecting Medical Innovation

Two recent OpEds highlight the importance of protecting free market medical innovation in this country:

"Medical Innovation Critical To Bringing Down Health Care Costs", Sally Pipes, Forbes, 4/18/2011.

"Don't Let Feds Stifle Next Medical Revolution", Joel White, Washington Times, 4/21/2011.

Medical innovation has (and could continue) to help doctors improve both the length and quality of our lives. Yet the Obama administration is punishing it, as I described in an PajamasMedia piece from last year, "The Deadly Tax on Medical Innovation".

If you want a worthy cause to fight for, the rights of medical device companies to innovate, create, and sell their products free from burdensome taxes and FDA regulations would be a great place to start. And the life you save may be your own...

Quick Links: SCOTUS, Levin, Black Ribbon Project

The Supreme Court has declined the request for an expedited review of the ObamaCare lawsuits. Related story here.

Mark Levin features David Catron's recent essay on the Medicare IPAB rationing panels.

Dr. Beth Haynes reports on her trip to DC with the Black Ribbon Project and Docs4Patient Care. (Disclosure: I used to be practice partners with one of the D4PC leaders, Dr. Jill Vecchio.)

John Lewis Talk on Socialized Medicine

On May 14, 2011, Duke University professor John Lewis will be coming to Denver to give a talk, "Government Medicine: The Metaphysical Attack on a Profession". Details below:

Please join us on Saturday, May 14th for a FROST Supper Talk by historian John Lewis:

• What: FROST Supper Talk by John Lewis on "Government Medicine: The Metaphysical Attack on a Profession"
• When: Saturday, May 14th, 2011, 5 pm cash bar and social, 6-7 pm dinner buffet, 7:15 lecture with Q&A and more socializing afterward, wrap up by 10 pm
• Where: Landry's Seafood, 7209 South Clinton Street, Englewood
• Cost: $65 for regular attendees; $35 for students
• RSVP by Monday, May 9th using the form below. Payment is due upon registration. We cannot accept payment at the door for this event, so please follow the instructions below to register and pay by Monday, May 9th.

About the lecture:

Many people agree that government control of medicine is a vicious attack on individual rights, and that the use of force against doctors is immoral as well as unconstitutional. But, this talk will maintain, the attack is far deeper: it is directed at the very nature of man as a thinking, goal-directed being. Government control of medicine undercuts the ability of doctors to use their minds in a first-handed way, and makes it impossible to project long-range goals on every level. This hard-hitting talk, motivated by first-hand personal experiences in medicine, will ask every thinking person to consider whether they want the United States to stay on a path leading to government control of their own personal health care.

Dr. Lewis is visiting associate professor in the Philosophy, Politics, and Economics Program at Duke University. He is an Anthem Fellow for Objectivist Scholarship, and adjunct associate professor of business at University of North Carolina at Chapel Hill. His recent book is Nothing Less than Victory: Decisive Wars and the Lessons of History (Princeton University Press, 2010).

Sign-up information at the registration page. I hope to see some Colorado-area folks there!

FIRM Blog Redesign

Many thanks to Diana for the FIRM blog redesign!

BTW, I've also added a "Featured Blogs" section on the right-hand sidebar for other health care bloggers who I read regularly. Please feel free to check them out!

Hsieh PJM OpEd on Rationing and IPAB

Today's PajamasMedia just published my latest health care OpEd, "We Call It 'Rationing,' Obama Calls It 'Medicare Independent Payment Advisory Board'".

The basic theme is that we shouldn't let either Obama's IPAB or Congress control our health care.

Here is an excerpt:

Suppose Congress asked Americans: which government officials should decide what foods you would be allowed to eat and what prices you had to pay at the grocery store -- Congress, or an unelected board of nutritional experts appointed by the president?

Most Americans would immediately reply, "Neither!" But that's precisely the debate between Congress and the White House regarding President Obama’s proposed Medicare Independent Payment Advisory Board...

Although the Obama administration stated that the IPAB would not ration medical care, its power to set payments to doctors and hospitals would give it de facto rationing power.

If the IPAB sets the reimbursement rate for services below the cost of providing it, then hospitals and doctors could no longer afford to offer such services -- even if the services are medically best for their patients. Life-saving medical procedures we currently take for granted, such as PET scans to detect early cancers or minimally invasive methods to safely open up blocked vital blood vessels without risky surgery, might no longer be available. Although those services might still theoretically be "covered" by Medicare, in practice doctors would no longer offer them, and their patients would no longer be able to receive them...

(Read the full text of "We Call It 'Rationing,' Obama Calls It 'Medicare Independent Payment Advisory Board'".)

Americans would never stand for the following false alternative: "Who should decide what foods you are allowed to eat—a panel of unelected bureaucrats or your elected Congressmen?"

We should similarly reject the same false alternative for our health care.

(PJM lightly edited my piece and changed the title, but left the basic meaning intact.)

Catron: IPAB Is an Acronym for 'Death Panel'

In today's AmSpec, David Catron cuts through all of the Obama administration's double-speak and explains why, "IPAB Is an Acronym for 'Death Panel'".

Here is an excerpt:

IPAB [Independent Payment Advisory Board] was created pursuant to section 3403 of the ironically named Patient Protection and Affordable Care Act (PPACA), and its ostensible purpose is to "control costs." In reality, it will do nothing at all about costs. Instead, the board's fifteen "experts" will impose old-fashioned price controls. Before Obamacare was signed into law in March of 2010, only Congress had the power to make changes to Medicare's reimbursement rates. But PPACA, for all intents and purposes, transfers that power to this tiny cadre of presidential appointees who will have no accountability to the voters.

In theory, IPAB can only propose changes to Medicare's payment rates. In practice, however, the board's proposals will take effect automatically unless Congress passes contrary legislation and the President signs it into law...

Catron notes how progressives like Jay Bookman support these price controls precisely because it will lead to rationing:

"Death panels exist, they will exist in any conceivable system of health-care delivery, and we all know they are necessary but prefer to ignore it."

For these people, it's either us or Granny: "Somebody has to say no to the terminal patient who refuses to acknowledge that he or she is terminal and demands hopeless if expensive treatment... Somebody has to have the power to rule that Procedure A or Drug A is more cost-effective than Procedure B or Drug B... Even Heaven has a gatekeeper."

(Read the full text of, "IPAB Is an Acronym for 'Death Panel'".)

In essence, the supporters of IPAB (and of ObamaCare in general) take the approach of, "Because government has to pay for everyone's health care, the government has to decide who is allowed to get what".

This is why medical rationing will be the dead end of any kind of government-run "universal health care" -- both figuratively and literally -- as Catron makes abundantly clear.

Colorado and Wisconsin Updates

Brian Schwartz reports on the current state legislation at, "Politically-controlled Colorado health benefits exchange bill reaches Senate".

Linda Gorman explains why this is a bad idea at, "Should Colorado Establish an ObamaCare Health Benefits Exchange?"

The Wisconsin doctors accused of writing fake sick notes are under investigation. More here.

The IPAB vs. Congress False Alternative

The New York Time reports that Congressmen of both parties are skeptical of President Obama's plan for an Independent Payment Advisory Board (IPAB) to determine payment and coverage decisions for Medicare: "Obama Panel to Curb Medicare Finds Foes in Both Parties".

But that's because the Congressmen want to retain that authority for themselves -- not cede it to the executive branch.

There are many problems with an bunch of unelected "independent" bureaucrats making such decisions for all senior citzens, as the Wall Street Journal points out in "The Other Medicare Cutters". The lack of accountability is dangerous and would quickly lead us down the road to explicit rationing.

But the solution is not to have these decisions made by politicians subjected to pressure-group tactics. That will merely lead to a feeding frenzy of lobbyists seeking to have their pet benefits covered by Medicare (and those of their competitors excluded from coverage).

In other words, there is a false alternative in the question, "Which branch of government should decide what health care benefits should be covered and what the payment should be -- the Congress or the executive branch?"

Instead, the answer should be, "Neither!" Government shouldn't be making such decisions at all. Rather doctors, patients, and insurers operating in free market should decide.

Massachusetts Unravelling

Because of the "unintended consequences" of the Massachusetts plan, costs continue to skyrocket.

Hence, the 4/15/2011 Washington Post notes, "Massachusetts, pioneer of universal health care, now may try new approach to costs".

But regardless of whether you call it "Accountable Care" or "bundled payments" or "integrated care", it all amounts to the same thing -- the government will mandate payment systems that reward limiting care to patients. Just don't call it rationing.

Of course, many doctors naturally recoil at the thought of such government pressures dictating how they are allowed to practice. The 4/17/2011 Boston Globe thus reports, "More doctors gravitate toward boutique practice".

And as more doctors opt out of the more heavily regulated sector of medicine, it will merely make the problems worse for those who remain. If these trends continue, cconomist Mark Perry predicts a coming doctor shortage -- not just in Massachusetts, but eventually in the rest of the country.

As always, under "universal health care" people will have theoretical "coverage". They just won't be able to get actual medical care.

Quick Links: Wolf, SCOTUS, Slush Fund

You can now pre-order Dr. Milton Wolf's ePamphlet, "First, Do No Harm: The President's Cousin Explains Why His Hippocratic Oath Requires Him to Oppose ObamaCare".

The US Supreme Court has delayed consideration of a request for expedited hearing of the ObamaCare lawsuit until later this week.

I'm sure this will in no way compromise their objectivity in health policy reporting: "Washington Post and CBS receiving money from Obamacare 'slush fund'". (Via Brian Schwartz.)

Latest FDA Gag Rule

Stella Zawistowski of ReasonPharm describes the latest FDA gag rule:

...I didn't know until today that the FDA's coercive power extends to journalists as well -- the agency forbids reporters from consulting outside experts with regard to embargoed news.

Let's talk about what a news embargo is, first. A company or organization wants certain news released, but it wants to control the timing of when that news is released. So it enters into voluntary agreements with reporters: You get the scoop in exchange for promising not to release that news until an agreed-upon date. So far, so good; we have a voluntary agreement between reporters and companies or trade groups...

But the FDA has decided to meddle with this process, forbidding reporters to consult with third-party experts about embargoed news. This means that the reporter, who is likely a well-educated layman with respect to the drug or device he's reporting on, is not allowed to verify the story he's about to print with someone who is more qualified to evaluate the claims being made.

As the Association of Health Care Journalists puts it, "Reporters who want to be competitive on a story will essentially have to write only what the FDA wants to tell the world, without analysis or outside commentary." That's a clear violation of free speech...

I hadn't heard of this restriction before, but I find it deeply disturbing.

Whenever the authorities forbids journalists from disseminating or discussing anything other than the government-approved version of an issue, we're one step closer to tyranny.

Wolf: Obama's Spray-On Hair Of Fiscal Policy

Dr. Milton Wolf's latest OpEd for the Washington Times debunks the latest Obama plan to "soak the rich". Here's an excerpt from, "Obama's spray-on hair of fiscal policy":

President Obama, in addition to his new Obamacare taxes, now calls for tax increases on "the rich" -- the very taxes he proudly prevented just four months ago. In a deeply dishonest speech, the class-warrior-in-chief proclaimed that "we cannot afford $1 trillion worth of tax cuts for every millionaire and billionaire in our society." He repeated, "We can't afford it."

First, Americans earning $200,000 are not "millionaires and billionaires." Second, to claim we can't afford to permit free citizens to keep their own earnings is to claim that those earnings belong not to the Americans who earned them but to the government that did not. And third, the "$1 trillion worth of tax cuts" is a flat-out fabrication. Tax revenues under President Bush were actually much greater than those collected under President Clinton -- nearly $5 trillion more.

Once again, economic reality makes fools of class-warfare politicians and their dishonesty about tax rates and tax revenues, but Americans are finally catching on.

(Read the full text of "Obama's spray-on hair of fiscal policy".)

Wolf's second point is especially critical. Wealth is created by private citizens who produce goods and services through rational thought and labor. It is not created by the government.

Punishing those who produce and create goods to redistribute to those who do not will not solve the federal debt. But it is a good way of destroying production and wealth-creation in any economy. Instead, the solution is to scale back government to its proper limited functions.

For a related take, see this video by Bill Whittle, "Eat The Rich":

Lucidicus On RomneyCare

The Lucidicus Project has a new video on the 5th anniversary of the Massachusetts RomneyCare plan, highlighting a few facts that the rest of America should know:



(Learn more about the Lucidicus Project.)

Catron SCOTUS Update

In today's AmSpec, David Catron has a nice explanation of the importance of tomorrow's Supreme Court hearing at, "Supreme Court to Consider Obamacare Case Friday".

We may find out soon whether the legal challenges to ObamaCare will be fast-tracked to the Supreme Court or not.

Scherz and Pipes on the Doctor-Patient Relationship

The 4/12/2011 Washington Examiner carried an OpEd by Dr. Hal Scherz (of D4PC) and Sally Pipes, "How Obamacare undermines the doctor-patient relationship".

One excerpt:

Finally, patient-doctor relationships are slowly deteriorating as physicians leave private practice for salaried employment at hospitals. Last year, for the first time ever, more doctors worked for hospitals than for themselves.

Physicians increasingly worry that a combination of government regulations and plummeting reimbursements for their services will force them out of business. Hospitals have seized upon this widespread fear and are buying up physician practices, placing the practice of medicine nationwide under their institutional control.

As a result, private practice as we know it could be extinct within a decade.

Obamacare is hastening these transactions by pushing for the creation of "accountable care organizations" whereby doctors and hospitals are paid not according to how much care they deliver but in bundles according to nebulous government "quality" standards.

ACOs are simply the 21st century version of HMOs. This time, though, doctors will be forced to serve their hospital paymasters -- not their patients...

(Read the full text of "How Obamacare undermines the doctor-patient relationship".)

A physician being employed by a hospital is not inherently bad. But when hospitals are subjected to financial sticks-and-carrots by the government to require their doctors to practice according to government algorithms, and when government also creates incentives to drive doctors away from private practice and into hospital chains (such as with burdensome new electronic medical record requirements), this can be a deadly combination.

In that case, the hospitals are merely the intermediaries for the government -- serving as the indirect agents of rationing. But for the patient, the end result will be just as bad.

Graham: Romneycare a Big Bust

In the 4/12/2011 Boston Herald, Michael Graham describes how the Massachusetts "RomneyCare" health plan has been a big bust.

A few excerpts:

As a health care plan, Romneycare is an unmitigated fiasco. It has caused costs to skyrocket, insurance premiums to soar and nonprofit providers like Blue Cross to suffer hundreds of millions of dollars in losses...

Taxpayers now spend $2.5 billion more on our state’s health care budget. The direct cost of Romneycare has gone from less than $100 million a year to at least $400 million -- and even that number is suspect...

If you want to know why Romneycare's costs keep rising, check out this simple statistic from the Patrick administration: In 2006, 85 percent of the insured in Massachusetts got their coverage through private group coverage at work. Today that’s down to 79 percent.

Meanwhile the percentage on the MassHealth dole has doubled, and more than 150,000 people are now subsidized through Commonwealth Care.

Romneycare supporters like Brandeis University health policy professor Stuart Altman brag that "the basic reason for the reform was to extend coverage, and on this, we have done amazingly well." But that's only if you use the phrase "extend coverage" to mean "the government forced you to buy your own insurance."

Romneycare hasn’t made that insurance more affordable -- just the opposite. Many people have seen their premiums double in the past five years. Supporters also never mention that when Romneycare was signed, Massachusetts already had one of the nation's lowest rates of uninsured...

(Read the full text of "Romneycare a Big Bust".)

Why would we ever want to adopt this failed scheme at the national level?

(Via Dr. Matthew Bowdish and Instapundit.)