Daily Archives: March 11, 2010
Yesterday it was reported that the House and Senate parliamentarians were asked to rule on what exactly the process needed to be for a reconciliation bill to get passed regarding ObamaCare. As I stated, also yesterday, if the answers to the questions, does the House have to pass the Senate bill and does Pres. Obama have to sign it before the reconciliation bill can be considered, are “Yes, Yes” then ObamaCare is officially dead:
In this scenario, the House would have to trust the Senate to agree to its fixes, that such fixes get through the reconciliation process, and that Obama signs them into law. Meanwhile, a perfectly functional health care law will be on the books which achieves what the Senate Democrats wanted, and what Obama has staked his entire presidency upon. That would require a great deal of faith.
I don’t think the progressive caucus, the Stupak group, or many other Representatives have anywhere near that much faith in the Senate and/or Obama. And if this reporting by Roll Call is accurate, they’re going to need a whole mess of it:
The Senate Parliamentarian has ruled that President Barack Obama must sign Congress’ original health care reform bill before the Senate can act on a companion reconciliation package, senior GOP sources said Thursday.
The Senate Parliamentarian’s Office was responding to questions posed by the Republican leadership. The answers were provided verbally, sources said.
House Democratic leaders have been searching for a way to ensure that any move they make to approve the Senate-passed $871 billion health care reform bill is followed by Senate action on a reconciliation package of adjustments to the original bill. One idea is to have the House and Senate act on reconciliation prior to House action on the Senate’s original health care bill.
Information Republicans say they have received from the Senate Parliamentarian’s Office eliminates that option.
Yes, Yes We Can’t!
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This is usually Bruce’s department, but I thought this was too good to pass up. Here’s Jazz Shaw relating what’s he’s discovered about the Tea Party movement by actually meeting Tea Partiers:
The point is, meeting with tea party supporters has been a surprising experience. It’s not politics as usual and the old rules about Red vs. Blue and D vs. R don’t apply. Like any large gathering, you’ll find a couple of people with some more fringe outlooks, and that seems to be who the television cameras focus on. (We had one couple at a recent meeting who were obviously birthers and wanted to ask about Obama’s birth certificate, but they were quickly shushed by the rest of the crowd.) But for the most part, each group seems to carry its own distinct flavor and topics of interest. The one thing they seem to have in common is that they are unhappy with the current leadership in D.C. and they have come to play a serious game. If you think you already know the tea party movement, there’s a good chance you don’t. It’s kind of like trying to say you know the ocean. It’s big, it’s powerful, it’s rarely the same twice, and you never know exactly what it’s going to do next.
I bolded that one sentence just because it really stood out for me as crystallizing the movement as a whole. The Tea Party is all about constituents finally paying very close attention to what their representatives in Washington are doing. I’ve said before that when Americans really start to pay attention to someplace (e.g. the Middle East) or something (Federal Government), they tend to radically change it forever. That’s the “serious game” I see being played all across the country. And I think that is an unalloyed good.
BTW, read the whole thing.
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Everyone’s favorite maniac congressman, Alan Grayson of Florida, introduced a bill yesterday that would quite simply open up Medicare to all citizens and legal residents of America. It is the purest “public option” proposed thus far. And it might just work.
Already the leftosphere is singing Hosannas. From Firedoglake:
As quixotic efforts go, I’ll take Alan Grayson’s HR 4789, a four page bill which “allows any American to buy into Medicare at cost.” You cannot possibly get more simple than that, it would not add one cent to the federal deficit, and it would offer people the option of purchasing Medicare (and its provider network) or purchasing an insurance product from a private company.
This evening Alan Grayson, Orlando’s spectacular and effective fighter for ordinary working families in a Congress that overwhelmingly caters to wealthy and powerful special interests, introduced the most real and straight forward healthcare reform bill that’s come up so far. Unless Obama makes the House leadership kill H.R. 4789– a distinct possibility– this should pass the House more easily than anything that’s been proposed for healthcare reform so far. And I bet it could even win cloture in the Senate! His bill offers the opportunity for everyone in the country to buy into Medicare. “Obviously,” said Grayson, “America wants and needs more competition in health coverage, and a public option offers that. But it’s just as important that we offer people not just another choice, but another kind of choice. A lot of people don’t want to be at the mercy of greedy insurance companies that will make money by denying them the care that they need to stay healthy, or to stay alive. We deserve to have a real alternative… The government spent billions of dollars creating a Medicare network of providers that is only open to one-eighth of the population. That’s like saying, ‘Only people 65 and over can use federal highways.’ It is a waste of a very valuable resource and it is not fair. This idea is simple, it makes sense, and it deserves an up-or-down vote.”
To the Huffington Post:
When Rep. Alan Grayson (D-Fla.) first became a father, his health insurance company refused to pay for the birth of the child, and Grayson had to pay $10,000.
Grayson told the House that story Tuesday during an impassioned and personal speech urging fellow lawmakers to support legislation that would allow Americans to buy into Medicare. Grayson introduced a four-page bill Tuesday that would make that a possibility. He asked would-be opponents to grant Americans the option to buy into the same health care plan that the federal government already offers.
And, of course, Daily Kos:
So instead of pontificating about how there is no SP or PO in the current HCR bill, he is solving the problem by offering a separate simple bill that would essentially do the same thing…allow Medicare for All…
There would be no pre-existing conditions and no medical underwriting, presumably the pools would be large enough to spread the risk.
There is no funding required for this since subsidies are not proposed for this bill. It would essentially be a PO starter. Then it could be added as an option to the exchange and subsidies could in theory be applied just like any other plan in the exchange.
We should support an “Up or Down” vote on this plan!!!
The bill’s genius is its simplicity, and specifically the promise to charge premiums to new enrollees, which would appear to make the bill deficit neutral. Here’s the entire text:
H. R. 4789
To amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States to buy into Medicare.
IN THE HOUSE OF REPRESENTATIVES
March 9, 2010
Mr. GRAYSON (for himself, Mr. FILNER, Mr. POLIS of Colorado, Ms. PINGREE of Maine, Ms. SHEA-PORTER, Ms. SCHAKOWSKY, Mr. FRANK of Massachusetts, Mr. KUCINICH, Ms. EDWARDS of Maryland, Ms. WATSON, and Ms. JACKSON LEE of Texas) introduced the following bill; which was referred to the Committee on Ways and Means
To amend title XVIII of the Social Security Act to provide for an option for any citizen or permanent resident of the United States to buy into Medicare.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Public Option Act’ or the `Medicare You Can Buy Into Act’.
SEC. 2. UNIVERSAL MEDICARE BUY-IN OPTION.
(a) In General- Part A of title XVIII of the Social Security Act is amended–
(1) in section 1818(a), by striking `or 1818A’ and inserting `, 1818A, or 1818B’; and
(2) by inserting after section 1818A the following new section:
`(a) In General- (a) Every individual who–
`(1) is a resident of the United States;
`(2) is either (A) a citizen or national of the United States, or (B) an alien lawfully admitted for permanent residence; and
`(3) is not otherwise entitled to benefits under this part or eligible to enroll under this part;
shall be eligible to enroll in the insurance program established by this part. An individual may enroll under this section only in such manner and form as may be prescribed in regulations, and only during an enrollment period prescribed in or under this section.
`(b) Enrollment; Coverage- The Secretary shall establish enrollment periods and coverage under this section consistent with the principles for establishment of enrollment periods and coverage for individuals under section 1818, except that no entitlement to benefits under this part shall be effective before the first day of the first calendar year beginning after the date of the enactment of this Act.
`(1) IN GENERAL- The provisions of subsections (d)(1), (d)(2), and (d)(3) of section 1818 insofar as they apply to premiums (including collection of premiums) shall apply to premiums and collection of premiums under this section, except that–
`(A) paragraphs (4) and (5) of section 1818 shall not be applicable; and
`(B) the estimate of the monthly actuarial rate under section 1818(d) shall be computed and applied under this paragraph based upon costs incurred for individuals within each age cohort specified in paragraph (2) rather than for all individuals age 65 and older.
`(2) AGE COHORTS- The age cohorts specified in this paragraph are as follows:
`(A) Individuals under 19 years of age.
`(B) Individuals at least 19 years of age but not more than 25 years of age.
`(C) Individuals at least 26 years of age and not more than 35 years of age.
`(D) Individuals at least 36 years of age and not more than 45 years of age.
`(E) Individuals at least 46 years of age and not more than 55 years of age.
`(F) Individuals at least 56 years of age and not more than 64 years of age.
`(d) Treatment- An individual enrolled under this part pursuant to this section shall not be treated as enrolled under this part (or any other part of this title) for purposes of obtaining medical assistance for medicare cost-sharing or otherwise under title XIX.’.
There are no hidden takeovers of medical reporting systems, individual mandates, abortion mandates, or anything else. Nor is anything about pre-existing conditions, “Cadillac plans”, or any of the other issues plaguing ObamaCare at the moment. If you want to buy in, you can. If not, then so be it. So simple it’s almost irresistible. Especially when one considers the popularity of a public option in most opinion polls done over the last year. To be sure, when people are confronted with the costs of a public option, or most anything else promised via ObamaCare, they lose interest. But Grayson’s bill doesn’t have that problem, seemingly, because it’s charging premiums, and there aren’t even any provisions calling for subsidies. Again, it’s almost irresistible.
However, if we game out how this would actually work, then we start to see the problems.
First off, since the vast majority of us get insurance for ourselves and our families through our employers, we won’t likely be buying into Medicare. Nothing about Grayson’s bill changes the employer/health insurance relationship, so as long as we stay employed, we’ll remain a part of that system. Seniors, of course, are already a part of this system, so there’s no change there as well. Those most affected will be part-time employees not otherwise covered, the self-employed, the unemployed and the basically uninsurable. Other than the self-employed, the remainder of these likely Grayson bill participants are not likely to be able to afford the full cost of Medicare premiums, assuming that the government actually charges full price. So the emergence of subsidies is almost guaranteed, which will cost taxpayers even more.
Secondly, the more people who enroll in Medicare, the more providers accepting Medicare payments that will be necessary to accommodate them. Since Medicare pays doctors at a lower rate than private insurers, doctors and hospitals won’t want to take on many of these new patients, who basically cost them money. Just by way of example, get out your trusty phone book, call around for a dentist in your area who takes Medicaid payments, and see if they have any openings in the next year or two. That’s what would happen with a Medicare-for-all plan as well. Oh, and don’t forget that Medicare turns down requests for reimbursement at a much higher rate than private insurers do.
Most significantly, with a public insurer in the market place, one who can dictate prices and standards to providers, and who does not have to turn a profit in order to stay in business, the entire health insurance dynamic will be irrevocably altered. In order to stay in business at all, private insurance companies will need to join the Medicare and Medicare Advantage network, and will subject to whims and vagaries of Congress when it comes to reimbursements, executive pay, and whatever else suits Capitol Hill’s fancy (which, naturally, will be a great source of graft). Restrictions on denying coverage to those with pre-existing conditions, and mandates for covering everything from toe fungus cream to abortion will be introduced to the menagerie of legislation supporting Grayson’s simple four-page bill, until one day the idea of just taxing taking contributions from everyone’s paycheck for Medicare insurance and giving it to them “for free” is but a small step that might be done in a three-page bill. Eventually, Medicare-for-all and universal health care will be indistinguishable, including the waiting lines, “death panels” and substandard care.
Just one small, simple, four-page step. That’s all it will take. And it might just work.
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What do doctors and florists have in common in the state of Louisiana? Both have to be licensed by the state. That’s right – the person who preforms heart surgery on you and the person who arranges the flowers you get afterward both have to meet licensing requirements set by the state.
A 7-decades-old state law requires florists to pass a test and get a license to arrange and sell flowers, making Louisiana the only state in the USA with such a requirement. Supporters of the law say it ensures florists know what they’re doing and deliver quality products.
“Know what they’re doing and deliver quality products?” I thought the market, i.e. customers, usually rewarded or punished those in that profession who didn’t “know what they’re doing and [don't] deliver quality products”.
So is this licensing requirement a) rational b) necessary and even c) constitutional? What it certainly is, though, is a bar to entry into the market imposed by government.
The arguments about licensing in general fall on two sides. Some see no reason to license anything – the market will sort out the good from the bad. Those that approve of licensing argue than in many cases lives and health are at stake and, in such cases, it is the role of government to step in and ensure those who pursue those professions are competent enough to do so.
Arranging flowers certainly doesn’t seem to fit the category of a risk to either the life or health of their clients.
What it certainly does is limit those who can enter the market. First, it imposes a $2,000 licensing fee. That will obviously keep a certain percentage who might otherwise become florists from attempting it because they don’t have the money. Certainly that might be a small percentage and you can make the argument that anyone who can’t afford the fee probably can’t afford to be a florist, but is that your or the state’s call? Instead it is an artificial barrier to entry in the market arbitrarily imposed by the state.
And, usually, when such a bar to entry is evident, you’ll find businesses who’ve met the bar to be the most ardent of supporters. Why? Because it is an artificial means to limit competition. For instance, this case:
The test to obtain a Louisiana florist license consists of an 80-question written exam and a four-part hands-on section, where aspiring florists are scored on how well they put together funeral wreaths, table bouquets and other arrangements, said Mike Rome, vice president of the Louisiana State Florists’ Association, which supports the law.
On the written exam, candidates are asked questions about floral arranging and flowers in general, including how to prolong the life of flowers, wiring methods and plant identification.
In the design section, the aspiring florists have four hours to arrange four designs: a wedding arrangement, corsage, funeral wreath and table bouquet.
Judges then score the designs using guidelines such as “Has the design the proper focal point?,” “Is the correct gauge wire used on flowers?” and “Is a corsage pin attached to the corsage in a way that will not injure anyone?”
Candidates are judged by a panel of three licensed florists. The average score of the written and floral arrangement sections needs to be 70% or higher to pass. The arrangements are judged more on technical competence than creativity, Rome said.
“The florist license gives the consumer a little more assurance that you get a quality product,” Rome said. “Florists are artists; they’re very opinionated. But sometimes you have to follow industry standards.”
“Industry standards?” What “industry standards”. Louisiana is the only state in the union that licenses florists. So whatever standards are imposed by a rather biased group, who apparently brook very little deviation from whatever arbitrary standards they’ve dreamed up, have control over who or who doesn’t join them in that state’s florist market.
As John Stossel reminds us:
Established businesses have always used government to handcuff competition. Years ago, small grocers tried to ban supermarkets. A&P was going to “destroy Main Street,” the grocers cried. Minnesota legislators responded to their lobbying by passing a law that forbade supermarkets to hold sales. Consumers were hurt.
And that is the result of this legal travesty.
As it turns out, 4 would-be florists have taken the requirement to court:
A lawsuit filed in U.S. District Court here last week is challenging the law’s constitutionality, claiming it infringes on a resident’s right to earn a living. The suit, filed by the Institute of Justice, a libertarian non-profit law firm based in Washington, D.C., lists as plaintiffs four local florists who have either failed the test or refuse to take it.
“Who is the state to tell me I’m not an artist?” said Monique Chauvin, 42, a plaintiff in the lawsuit.
Chauvin, owner of Mitch’s Flowers in New Orleans, failed the test in 2000 and has not retaken it. “It’s time for this archaic law to be off the books,” she said.
Chauvin, who has apparently owned a successful florist business in New Orleans for 10 years is defacto proof that the requirement is unnecessary. She’s obviously been successful enough in the marketplace (i.e. her customers find her floral arrangements satisfactory enough to keep her in business – even in a recession) without licensing to stay open for 10 years.
So, why is Chauvin bringing a lawsuit now? Enforcement:
Chauvin said her legal fight is about keeping her shop open through the economic recession. She now has two options: hire a licensed florist or take the test again. If not, she’ll be forced to close her shop.
The market, not a state panel, should be the final judge of her bouquets, she said.
“If a customer is not happy with what we do, he’s not going to come back to me,” Chauvin said. “That should be the quality control.”
Exactly. So in answer to the three questions above – a) it’s not rational. It imposes arbitrary requirements as well as artificial bars to entry on a profession which threatens neither life or health. b) it’s not necessary. Consumers don’t need government “protection” from florists. and c) it’s most likely not constitutional since most would agree it interferes with a person’s fundamental right to earn an honest living in profession which doesn’t threaten life or health.
Of course, my use of the words “life or health” imply I find the licensing of those who work in professions that can have a detrimental effect on life or health, such as the medical field, to be ok. Well, yes and no. I think, for instance, a market solution is possible for those professions as well. Think, for instance, if the American Medical Association, instead of being a shill for government health care reform, was a body that set minimal professional standards for the medical profession and anyone seeking membership had to demonstrate competence enough to meet those standards. If you were seeking out a doctor, most likely your first question would be “is he (or she) a member of the AMA?” And, in this day and time, you’d most likely be able to access an AMA data base to check doctor’s out before going to them. And your insurance carrier would certainly require you use such a doctor, wouldn’t it? In fact, you’d likely be leery of any doctor that wasn’t a member. Same solution as now exists done on a voluntary basis without government intervention. And certainly there might be other associations that would form which would also lend credibility to a doctor’s abilities than just the one.
Would the AMA have a reason to assure its members met their standards and continued to meet them? Of course it would. It’s very existence would depend on it, as would the credibility of every one of it’s members.
Of course that’s all been rendered moot by government deciding it should be the final arbiter in that regard. But it is food for thought, isn’t it?
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USA Today’s cover story today is entitled “Is the Global Warming movement cooling”. It features Penn State University professor Michael Mann who is puzzled, puzzled I tell you, over all the controversy. My favorite Mann quote:
“I look at it like this: Let’s say that you’re in your car, you open up the owner’s manual, and you discover a typo on page 225. Does that mean you stop driving the car? Of course not. Those are the kind of errors we’re talking about here,” Mann says. “Nothing has fundamentally changed.”
USA Today lists his research as:
Mann’s research, which used tree rings, coral and other historical indicators to estimate how temperatures have risen in recent centuries, has been used by the IPCC in its reports.
Not a word about the infamous “hockey stick”. Not. A. Word. Of course the “hockey stick” and cherry picked tree-ring and temperature data have been the foundation of the IPCC’s conclusions. All have been found to be highly suspect by other scientists.
But to return to Mann’s self-serving analogy, this isn’t about a typo in the car’s owner’s manual. This is about a fatal flaw in the engine. The Himalayan glacier nonsense may be considered a “typo”, but the hockey stick, tree ring and temperature data is the foundation of the “consensus” opinion.
The article goes on to note that despite the controversy the Obama administration agree’s with the Mann analogy.
Carol Browner, the White House’s director on climate and energy policy, says there are “thousands and thousands” of scientists whose work provides evidence of global warming. She told USA TODAY that, based on her frequent visits to Capitol Hill, recent questions over science have not changed a single vote in Congress on climate change legislation.
“It’s easy to misuse these isolated reports of problems to suggest that the science behind global warming is somehow wrong,” Browner says.
It is also easy to ignore it when not doing so works directly against the outcome and result you’d prefer to see – government restrictions against and regulation of so-called “greenhouse gases.” And I doubt Ms. Browner has her finger on the pulse of Congress. Even today, Democrats included, they’re considering legislation that would block the EPA from unilaterally imposing restrictions on CO2 output.
The article is quite long, and I suggest you read it, but one further item of note – a new excuse, I suppose, for the “typo” in the “owner’s manual”:
Tim Wirth, a former U.S. senator who is now president of the United Nations Foundation, defends the IPCC, stating it has an annual budget of “only” about $3 million and relies almost entirely on volunteers to produce and fact-check its content.
Wirth says the organization would be aided by adding more scientists to its full-time staff. Yet he also criticizes what he called “K Street (Washington) PR firms … who are hired to examine every (detail) of the IPCC report and find problems and then get them out into the public domain.”
“It’s not a fair fight,” Wirth says. “The IPCC is just a tiny secretariat next to this giant denier machine.”
“Giant denier machine?” It’s mostly been individuals and bloggers. Volunteers. The controversy broke in the UK, not in DC. Most of the global warming research was funded by governments, for heaven sake, which are able to outspend any outside group without breaking a sweat. And then we have Al Gore, a movie and entire movement spreading the gospel of AGW as well.
But to the larger point – these volunteer fact-checkers were apparently good enough for Wirth and the governments around the world to propose draconian taxes and restrictive policies, but now that the results are being called into serious question, suddenly the IPCC – the Nobel Peace Prize winning IPCC – is just a “tiny secretariat” staffed mostly by volunteers.
Seems to me that while the US media, in this case in the guise of USA Today, has finally determined it can’t ignore the Climate-gate controversy anymore, if this article is any indication of its thrust, you can expect to see the problem minimized and ignored, despite the word count.
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