Free Markets, Free People


Health Care Reform – Peeling The Onion

There are a number of things going on in the health care reform debate that are the reason Democrats are at odds with each other. One, obviously is cost. What should be apparent, even to rocket scientists like Nancy Pelosi, is that the American people are not buying into the premise that “government can expand coverage, improve care and do it for less”. It’s not happening.

And, of course, those on the blue side that are leading the “no way, no how” charge are the so called Blue Dogs. Bolstering the Blue Dog position is the CBO, or Congressional Budget Office – a non-partisan organization which “scores” proposed bills for cost and savings. In the last few weeks it has consistently found Democratic Congressional legislative proposals wanting – pointing out none delivered the promised savings over the long haul.

Predictably, the CBO has come under fire from the left, and yesterday the White House joined the fray. Peter Orszag, the White House budget director, Peter Orszag said – carefully – that the CBO’s recent analysis might be feeding a perception that its tendency is toward “exaggerating costs and underestimating savings.”

Given how the costs of most government programs skyrocket after implementation, I’m having difficulty buying into this supposed perception. And it may say more about Orszag, former CBO director, than it does about the CBO now.

However, what Orszag is talking about specifically is a proposal that is another part of the infighting going on among Democrats.

“The point of the proposal … was never to generate savings over the next decade,” Orszag said in a letter posted on Saturday.

“Instead the goal is to provide a mechanism for improving quality of care for beneficiaries and reducing costs over the long term.”

In fact, the proposal is about shifting power from Congress to the Executive Branch:

The new council, if approved, would replace the current Medicare Payment Advisory Commission, which is made up of doctors and health care experts. Once a year, it gives recommendations about coverage and reimbursement rates for Medicare but has no authority to enforce its ideas. Its report in March recommended that payments for primary care physicians be increased and home health services rates be decreased.

The proposed council would be comprised of doctors and health care experts making their recommendations based on extensive data and analysis of best health care practices, according to administration officials.

It would be an independent executive branch agency — which would give its recommendations more weight. The president would have to approve or disapprove the its recommendations as a package. If it is approved, the package would be enacted if Congress did not vote against it within 30 days.

This isn’t necessarily about “best health care practices” – this is about centralizing the decision making and making it harder and harder for Congress as a whole and individual Congressmen specifically, from excepting their district or certain constituent health care providers from some of the provisions. The White House wants to take that little perk away from them. And that’s another one of many stuggles going on within this fight to pass something.

A Democratic president trying to take power away from a Democratic congress is probably not the best way to try to pass something that the President can call “health care reform”. That’s not to say I support this council in either form – its more to point out how clumsily this administration is proceeding in all of this. If you want legislation passed so your signature issue doesn’t fail, it may be best not to try to take power away from a friendly Congress and take it yourself. Executive power grabs don’t just happen in the national security area as the Democrats constantly criticized Bush for attempting. They can occur in many other areas. We’ll see if the Dems will be as critical of this power grab as they were of the ones alleged of the previous administration.

~McQ

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7 Responses to Health Care Reform – Peeling The Onion

  • “exaggerating costs and underestimating savings.”
    I bleieve the CBO is using Medicare data to make this judgement, which is based on decades and a bipartisan group of Presidents that were never really able to do all that much to accomplish the target of lower costs and higher savings.  Nothing in the “LightWorker”-s CV leads me to believe that he has even a basic comprehension of economics, let alone a “Rosetta Stone” to cost savings.
     

  • I believe Obama will succeed in this if he convinces Congress that this is not a matter of taking power away from Congress, but is rather a matter of relieving them of responsibility, i.e. passing the buck. They seem to like that sort of thing.

    • timactual – “I believe Obama will succeed in this if he convinces Congress that this is not a matter of taking power away from Congress, but is rather a matter of relieving them of responsibility, i.e. passing the buck. They seem to like that sort of thing.”

      Ah, you beat me to it!

      McQ – “Peter Orszag, the White House budget director, Peter Orszag said – carefully – that the CBO’s recent analysis might be feeding a perception that its tendency is toward ‘exaggerating costs and underestimating savings.’”

      Yeah, because Uncle Sugar has been soooooo good in the past about keeping costs under control and always OVERESTIMATING how much things will cost, resulting in massive budget surpluses and scads of cash being returned to the taxpayers.

      / sarc

      Cap’n Ed has a good post about the newest way that the dems are trying to put lipstick on this pig:

      “After taking shots to the political solar plexus from the CBO on the costs of their health-care reform package, House Democrats have decided to drop the pretense of saving money through ObamaCare. Instead, The Hill reports that Democrats will argue that the new health-care system will be so good, that it will be worth spending a lot more money on it, and the savings will magically appear from … somewhere.”

      “We already have government programs for medical care that don’t work. If Congress wants to overhaul Medicare/Medicaid to make it financially viable, the VA to make it responsive, and Indian Health Service to make it do anything for its consumers, that would be enough for any Congress to do. Otherwise, we don’t need the Church of Democratic Spending asking us to ignore the evidence of massive irresponsibility and ask us to believe that they can perform some kind of transubstantiation to make it into cost savings for the American taxpayer.”

      http://hotair.com/archives/2009/07/27/new-dem-strategy-on-obamacare-ignore-the-evidence-and-just-trust-us/

      That raises a good point: after the apparent failure of Porkulus – and the dems’ frantic spinning that it wasn’t intended to actually STIMULATE the economy… er… at least, not in the short term – why in h*ll would ANYBODY believe anything that pack of lying incompetents say about ANYTHING???

  • Do you suppose any of the supporters of this monstrosity have asked themselves what it means in terms of certain activities people may participate in that the government run system may not appreciate any more -  Sky Diving?, Mountain Climbing? Motorcross?  Downhill Skiing?, etc, etc, etc.  I mean, after all, obviously certain ‘recreation’ activities are more likely to cause injury than fly fishing or tanning.  And those injuries will have to be treated when everyone has health care!
    Not to mention some of the activities that may lead to contracting HIV perhaps (whatever your persuasion).  Don’t want to go there yet, do we….but we will….eventually, once it’s turned over by the legislato’s to the pencilpushers.
    Oh yeah, all kinds of fun as we start finding things that the government doesn’t want you doing because you’re driving up the costs of health care for everyone with your recklessness.
     

  • But you see Congressional Democrats care more … just go to Page 389, line 24 through Page 390, Line 1 …
    “A hospital or a nursing facility or intermediate-care facility for the mentally retarded . . .”

  • The White House knows that the entire Democrat proposal in the House and Senate are doomed to failure, because enough Blue Dogs will oppose them to destroy its chances of passage. But because of Nancy Shmancy Pelosi, they will never move far enough away from the liberal delusion that the current package is to get those votes; otherwise, liberal support will collapse.

    The thing is doomed. Obama, Pelosi, Reid, and the American people saw to that. The August recess will be its undoing. A month from now, when the Congress comes back, HCR will be at 35% support rather than the 44% it has now. Or maybe lower.

    • “The thing is doomed. Obama, Pelosi, Reid, and the American people saw to that. The August recess will be its undoing. A month from now, when the Congress comes back, HCR will be at 35% support rather than the 44% it has now. Or maybe lower.”

      I hope you’re right about that!