The Health Care “I Told You So” Post
When your political opposition is self-destructing (even while in the majority and in control of the legislative and executive branches), most political observers would advise stepping back and allowing them to do so.
But not the Republicans. They’re going to be the “significant other” that gives this president a win on his signature issue and help him maintain both his momentum and the viability of the rest of his agenda.
The “I told you so” part of this is, as I (and many others) have said, Democrats will eventually pass something they can call “health care reform” and save the viability of Obama’s presidency. What you didn’t figure is the Republicans would be both complicit and key to that:
Sen. Olympia Snowe (R-Maine) confirmed that the three Republicans and three Democrats negotiating the Senate Finance bill are moving away from a broad-based mandate that would force employers to offer insurance. The senators instead are leaning toward a “free rider” provision that requires employers to pay for employees who receive coverage through Medicaid or who receive new government subsidies to purchase insurance through an exchange.
Snowe stressed the committee hasn’t reached a final agreement on any of the key provisions but said, “There is not a broad-based employer mandate. … There are approximately 170 million Americans that receive coverage through employers. That is a significant percentage of the population. We don’t want to undermine that or create a perverse incentive where employers drop the coverage because their employees could potentially get subsidies through the exchange.”
On the nonprofit insurance cooperative, Snowe also said no final decisions have been reached, but “it is safe to say it is probably one that will remain in the final document.”
This is what everyone who talks about it means when they say that Republicans “talk the talk but don’t walk the walk”. Here is a group, and I’d bet there are more that will sign on, who are involved in one of the biggest expansions of government undertaken since the “New Deal”. And when November of next year rolls around, this is the party that is going to want you to believe they are all for less government, less spending and less government intrusion.
And they’ll have this to point to as proof. [/sarc]
The reason the GOP is a shrinking party isn’t because it is the party of the Southern white male. It’s because no believes their nonsense any longer. Sometimes being the party of “no” is the right thing to do.
[Welcome RCP readers]
~McQ
Podcast for 26 Jul 09
In this podcast, Bruce, Michael, and Dale discuss the controversy over the Obama presser on Monday, and the state of health care reform’s passage in the Congress.
The direct link to the podcast is unavailable this week due to technical problems, so you’ll need to listen to it at BTR.

The intro and outro music is Vena Cava by 50 Foot Wave, and is available for free download here.
As a reminder, if you are an iTunes user, don’t forget to subscribe to the QandO podcast, Observations, through iTunes. For those of you who don’t have iTunes, you can subscribe at Podcast Alley. And, of course, for you newsreader subscriber types, our podcast RSS Feed is here. For podcasts from 2005 to 2007, they can be accessed through the RSS Archive Feed.
Making Health Care “Better”?
If health care is so darn terrible here, how does we manage rankings like this?
[T]he World Health Organization ranked the United States No. 1 out of 191 countries for being responsive to patients’ needs, including providing timely treatments and a choice of doctors.
Isn’t that the essence of good care?
Oh, but it is expensive and not everyone has insurance.
Well they have a plan to take care of the latter problem. Get it or government will fine you and assign you:
When you file your taxes, if you can’t prove to the IRS that you are in a qualified plan, you’ll be fined thousands of dollars — as much as the average cost of a health plan for your family size — and then automatically enrolled in a randomly selected plan (House bill, p. 167-168).
And of course the way to make it less expensive is to use less of it, right?
It’s one thing to require that people getting government assistance tolerate managed care, but the legislation limits you to a managed-care plan even if you and your employer are footing the bill (Senate bill, p. 57-58). The goal is to reduce everyone’s consumption of health care and to ensure that people have the same health-care experience, regardless of ability to pay.
Paying for all of this will be a breeze:
The price tag for this legislation is a whopping $1.04 trillion to $1.6 trillion (Congressional Budget Office estimates). Half of the tab comes from tax increases on individuals earning $280,000 or more, and these new taxes will double in 2012 unless savings exceed predicted costs (House bill, p. 199). The rest of the cost is paid for by cutting seniors’ health benefits under Medicare.
There’s plenty of waste in Medicare, but the Congressional Budget Office estimates only 1 percent of the savings under the legislation will be from curbing waste, fraud and abuse. That means the rest will likely come from reducing what patients get.
You did get that line in there where it says “the rest of the cost is paid for by cutting senior’s health care benefits?” And, as Dale pointed out, they have a wonderful idea of how to manage that:
One troubling provision of the House bill compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care (House bill, p. 425-430). The sessions cover highly sensitive matters such as whether to receive antibiotics and “the use of artificially administered nutrition and hydration.”
This mandate invites abuse, and seniors could easily be pushed to refuse care.
Because they’re usually in such robust physical and mental health at the time such “counseling” would take place that they’re sure to stick up for themselves and further treatment.
No matter how tight the cost though, you can count on layer upon layer of bureaucracy finding the money necessary to exist and flourish:
Shockingly, only a portion of the money accumulated from slashing senior benefits and raising taxes goes to pay for covering the uninsured. The Senate bill allocates huge sums to “community transformation grants,” home visits for expectant families, services for migrant workers — and the creation of dozens of new government councils, programs and advisory boards slipped into the last 500 pages.
Is it any wonder Obama wants all this passed quickly? It’s the jobs portion of his “stimulus” plan. Oh, wait, that can’t be right because none of this begins to take effect until 2013 (except the taxes, which begin in 2011), one year safely on the other side of the next presidential election. In fact it won’t be fully in effect until 2018.
So what’s the rush again?
This is a legislative turkey that needs badly to be led to the chopping block. We don’t have the problem we’re being told we have, nor is there such wide-spread dissatisfaction with what we have that the government must step in.
The most recent ABC News/Washington Post poll (June 21) finds that 83 percent of Americans are very satisfied or somewhat satisfied with the quality of their health care, and 81 percent are similarly satisfied with their health insurance.
There is absolutely no rush for any of this except politically. It comes under the heading of “using political capital while you have it” and right now Obama has it. The problem, and the reason for the rush, is there a hole in the political capital bag and the assets are draining out much more quickly than they thought they would.
I’m all for having them hold the bag and watch it empty without giving them the opportunity to wreck a system that for the vast majority of us seems to be working pretty well. If they want to do anything, they can remove the insurance mandates, pass the legislation to allow a real free insurance exchange to establish itself and get the hell out of the way.
~McQ
Health Care Warning Bells
Just a few of the gems beginning to come out of the Democratic health care reform proposals.
Keith Hennessey wonders if the Democrats really want to tax the uninsured because as the bill is structured a) not everyone will have insurance and b) not everyone will be able to afford it meaning c) they pay a tax. He gives 2 examples:
* Bob is a single 50-year old non-smoking small business employee who makes $50K per year before taxes and does not have health insurance.
* Bob cannot afford a $1,600 bare bones health insurance policy, much less a $3K — $5K policy.
* Bob would get no subsidies under this bill, and his employer would face no penalty for not providing him with health insurance.
* Bob would end up without health insurance and would have to pay $1,150 more in taxes.
Now, what you can expect is not that Democrats would stick with the provisions of the bill, but instead they’d find some way to fold Bob into the program further raising the cost.
Same with Freddy and Kelsey:
* Freddy and Kelsey are a 40-year old couple with two kids. They own and run a small tourist shop in Orlando, Florida.
* They are the only employees, and earn a combined $90K per year.
* They cannot afford even an inexpensive health insurance plan, and so the House bill would make them pay $2,050 in higher taxes.
So given those figures (and be sure to read the whole post by Hennessey) and the estimate of 8 million falling into this category, obviously the bill will cost more than projected.
When we first saw the paragraph Tuesday, just after the 1,018-page document was released, we thought we surely must be misreading it. So we sought help from the House Ways and Means Committee.
It turns out we were right: The provision would indeed outlaw individual private coverage. Under the Orwellian header of “Protecting The Choice To Keep Current Coverage,” the “Limitation On New Enrollment” section of the bill clearly states:
“Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day” of the year the legislation becomes law.
So we can all keep our coverage, just as promised — with, of course, exceptions: Those who currently have private individual coverage won’t be able to change it. Nor will those who leave a company to work for themselves be free to buy individual plans from private carriers.
While assuring everyone that the same choices we now have would still in the system, this was discovered a mere 16 pages into the 1,000 page monstrosity. I’m sure there are other gems to be had in there as well. But the obvious point here is this puts people who make the choice, for instance, to go into business for themselves, in a situation where they are unable to buy health insurance from a private carrier, whether they want too or not. Of course, that will go a long way toward killing any private market in that niche of the insurance industry. And where will these people eventually end up? On a subsidized public plan, of course.
If that’s not bad enough, there’s the planned expansion of Medicaid. What the federal government plans to do is expand insurance coverage under Medicaid by 11 to 20 million people depending on which percentage above the poverty rate the final bill has. But states pay a large portion of Medicaid expenses. The House version calls on the fed to pick up all the expenses while promising to enact big savings in the program. The Senate version has the fed paying the full freight for 5 years. The latter is more likely to be the version that would pass simply because they can hold the “cost” numbers down a bit by doing so.
But not so in the states where the mandated expansion of Medicaid will end up having to be funded by each state’s taxpayers.
Keep these in mind as you hear cost figures bandied about by the blowhards on the Hill. They give used car salesmen a bad name.
~McQ
Democrats Unveil Their “Affordable” Health Care Plan
And yes, that’s right, just because Democrats put “affordable” in the title doesn’t mean it is anything close to being affordable (unless another trillion in spending is something you find affordable). In fact, you can almost count on the opposite being true.
Another vitally important point to keep in mind is that trillion we’re batting around like we’re talking about spending ten bucks, is a government estimate. Anyone remember the government estimate about the cost of Medicare and how that turned out?
The Democrats are claiming the CBO “scored” this bill and it came up under the “affordable” column. But the RNC says the CBO didn’t actually score the language in the bill:
In the second paragraph of CBO’s letter, it says, “”It is important to note, however, that those estimates are based on specifications provided by the tri-committee group rather than an analysis of the language released today.” So they scored what Democrats asked them to score. Not the actual bill.
Yes, in this infernal rush to get a bill out, we obviously couldn’t be patient enough to have the CBO score what the bill actually said vs. what the committees declared the bill would say. And we all know how honest our Congress is about such things, don’t we? Last but not least, the politics of the thing. Here’s a graph to show you how the planned appropriation of your money will take place:
Note carefully when the costs will actually begin to kick in. Yes, when Obama is safely in his second term and hopefully, at least as the Democrats reason, still with a Democrat majority Congress (since both the 2010 and 2012 Congressional elections shouldn’t be effected). Note the slope of the curve after that. Philip Klein, who put the chart together, explains:
It’s important to keep in mind that the most costly aspects of the legislation involve providing subsidies to individuals to purchase health care ($773 billion) and to expand Medicaid ($438 billion), but it takes several years for those provisions to kick in. As you can see from the chart below, that means that the costs start out relatively modest but ramp up over time. In the first three years of the plan the cost of the subsidies and Medicaid expansion is just $8 billion; in the first five years, it’s $202 billion; but in the last five years, it’s $979 billion. Put another way, 17 percent of the spending comes in the first five years, while 83 percent comes in the second five years. What this means is that the American people see $1 trillion over 10 years and they think that means the bill would cost about $100 billion a year — but the reality is more than double that. In the final year of the CBO estimates, 2019, the spending hits $230 billion.
Another important note – at the end of 10 years, that line on the graph isn’t going to drop to zero. It’s going to continue to climb. That’s “affordable?” If so, Democrats have given new meaning to the word. And all of it to be paid for by taxing the rich.
Yes, in the midst of an economic crisis, the con artists in Washington are at it again. They’ve co-opted “affordable” to sell their snake oil, ignored the impact of such a bill in a weak economy but carefully weighed the politics of it, and have decided that funding it on the back of “the rich” won’t have any adverse consequences when it comes to the economy and its health.
You can see this train wreck coming from miles and miles away, can’t you?
~McQ
The Magic Of Paying For Healthcare
I‘m so glad that the Democrats have settled on how to pay for their latest government boondoggle even if it is the same old formula:
House Democrats will ask the wealthiest Americans to help pay for overhauling the health care system with a $550 billion income tax increase, the chairman of the tax-writing Ways and Means Committee said Friday.
The proposal calls for a surtax on individuals earning at least $280,000 in adjusted gross income and couples earning more than $350,000, said the chairman, Representative Charles B. Rangel of New York.
It would generate about $550 billion over 10 years to pay about half the cost of the legislation, Mr. Rangel said. As the proposal envisions it, the rest of the cost would be covered by lower spending on Medicare, the government health plan for the elderly, and other health care savings.
Tax the rich and squeeze the health care industry with lower Medicare payments. Sounds like a very “healthy” and stable way of paying for “health care reform” doesn’t it? A perfectly sure way to accomplish the stated Obama priorities of “expanding health insurance coverage to virtually all Americans and curtailing the steep rise in the cost of medical care while improving patient outcomes.”
Expand coverage, cut payments and improve outcomes.
Yup – “I believe!”
Gird Thy Self – With Health Care “Reform”, The Tax Man Cometh
It should be abundantly clear by now, to even the slowest among us, that the promise that 95% of Americans wouldn’t see their taxes raised by one dime during an Obama administration was a flat out lie.
Of course, given the promise of health care and the cap-and-tax proposal pushed by candidate and now President Obama, the 95% should have been able to figure out the lie well before the election. But they didn’t.
The Heritage Foundation has laid out the proposed taxes Congress is looking at to fund this 1.5 Trillion “Health Care Reform” legislation being proposed (note: consider this 1.5 Trillion estimate in light of the Medicare estimate back in the ’60s. It was a low ball load of blarney then and I have little doubt that this estimate is a low ball one as well).
Proposed tax hikes in this category[tax the rich - ed.] include: 1) capping the value of itemized deductions including gifts to charities; 2) a 3% surtax on households earning more than $250,000; and 3) a millionaires tax.
But the left is beginning to figure out that you can only squeeze so much revenue from class warfare taxation. So Congress is also considering a slew of other taxes that will, again, force Obama to break his not tax hike promise. These include: 1) a tax on soda; 2) a tax on beer; 3) an increase in employer and employee payroll taxes; 4) a flat tax on health insurance companies; 5) broaden the Medicare tax on investment income; 6) an employer mandate; and 7) a value added tax on everything but food, housing, and Medicare. And we’re sure we missed some.
There’s no other way to “save money on health care” than to tax the hell out of those who will be stuck with the system they cobble together.
Then add cap-and-trade’s impact (and taxes) to the mix and explain how an economy already reeling with a loss of 15 Trillion in wealth is going to recover when more and more of the private sector’s money (and wealth) goes to government?
~McQ



