Reform

Dr. Jeffrey S. Flier, Dean of the Harvard Medical School, gives ObamaCare a big fat F for not doing anything the Progressives / Statists (i.e. Obama and Co.) claim it will do.

I encourage you to read the whole article here.  But here's one part that hits the nail on the head:

Worse, currently proposed federal legislation would undermine any potential for real innovation in insurance and the provision of care. It would do so by overregulating the health-care system in the service of special interests such as insurance companies, hospitals, professional organizations and pharmaceutical companies, rather than the patients who should be our primary concern.

In effect, while the legislation would enhance access to insurance, the trade-off would be an accelerated crisis of health-care costs and perpetuation of the current dysfunctional system—now with many more participants. This will make an eventual solution even more difficult. Ultimately, our capacity to innovate and develop new therapies would suffer most of all.

The bottom line is that getting the government more involved in the Health Care industry is going to do what government involvement always does: Lower quality and increase costs.

Of course, Progressives don't care about that.  All they care about is government control.  Health Care is the lynchpin for Statist control of the populace.  There are some liberals who simply don't realize this.  When they do finally realize it, they usually become conservatives / libertarians.

A recent Gallup Poll showed that more people than ever before (since Gallup started tracking the question) are of the mindset that the Government doesn't belong in Health Care, so there's hope.  Let's hope that this enlightenment hasn't come too late to reverse all the damage that Progressives / Statists and the Progressive-lite Republicans have done over the last 100 years.

Pelosi did it. Health reform passed the house 220-215 late saturday. Whatever my personal disagreements with her I have to grudgingly admit she's a decent speaker, her arm twisting in this situation is exceptional. Thank god for Harry Reid. 

Nice round up of why it's the worst bill ever here.

Mark McKinnon says it's unsurprising that Obama has dropped the "change" charade.

[T]he presidency is all about politics. Obama did an artful job of creating an image of someone divorced from the nitty-gritty of hardball, brass-knuckled politics. But it’s far from reality. Obama got elected, in part, because he put a team around him of combat-proven veterans who know how to, as Bill Clinton once famously said, put his opponents’ teeth on the sidewalk. [...]

It was pretty clear to me early on that President Obama understood the importance of maintaining and fueling a political machine. He was presented with the option to kill the budget for the political operations that work out of the White House. It would have sent a powerful signal about ending politics as usual. But then he would have handicapped his ability to enact the kind of change he’d promised his supporters.

This is exactly right. Obama has been more artful at this "iron fist in a velvet glove" game than most, but he's always been a ruthless machine politician.  The appointment of Rahm Emanuel was a very clear signal that Obama had no intention of changing the game.

Obama knows his strength, his brand, is his ability to appear conciliatory, thoughtful and sympathetic.  He can't be the Bad Guy in his administration.  So Obama has hired a Chief of Staff who can handle the Enemies List.   Rahm Emanuel will be the ruthless guy who knocks heads, threatens opponents and generally does the dirty work, leaving Barack Obama to sweep in as the nice guy who wins friends and charms enemies.  Good cop, bad cop.  We won't necessarily see it happening, but it will happen over and over again.

I measure the seriousness of a politician by how willing they are to work against their own interests to enact good policy.  It is a rarity.  As McKinnon points out, Obama's unwillingness to close the political shop - to elevate governance above politics - is a sign that he'll probably be an effective advocate of his policies....but he certainly wasn't serious when he wrote "it's not enough to just change the players. We have to change the game."

Democrats have not changed the game.  They aren't even changing the players.

With a reported bump in public support for some variation on Obamacare after the President’s speech last week, there is no time to rest. Rather, it’s time to drive stakes into the heart of the “public option” vampire. And stakes we shall provide. The following are solid reasons why no version of the public option must be resurrected:

1. A government “competitor” can’t go out of business when it fails. Failing government entities only drains resources from more productive places—not to mention from taxpayers. (Witness the Postal Service.) The left has been particularly disingenuous with this constant doublespeak about the public options offering “competition and choice.” This is another example of the left trying cleverly to co-opt the language of the right. Call the b.s.  
2. Sooner or later any public option will be subsidized by the government. This will put private companies at a competitive disadvantage, which is not only unfair, but threatens the private market so many Americans currently enjoy (despite all the cost-drivers created by government).
3. A public option will create a new set of special interests and dependents. These supplicants will be beholden to the Democrats and Barack Obama. This is why government programs never go away. People who don’t think this is really about buying their power with our tax dollars are kidding themselves.
4. Co-ops are a ruse. We already have non-profit health insurance companies with their own special place in the tax code. They’re called Blue Cross Blue Shield. Talk of co-ops is but a ruse to reawaken the vampire. Co-ops too must be killed.
5. A public option will have different rules to play by.That’s not fair.  Believe it or not, the regulations and mandates that make premiums unaffordable in places like MA, NJ and NY are not as bad at the federal level. So the regulatory framework for the public option would be more favorable than for insurance companies in most states. Another reason private insurers would die off—preparing the way for a complete government takeover of healthcare.

There are fundamental asymmetries between government and private companies. Those asymmetries make government provision of most goods and services unfair and illiberal. Let’s take these stakes and kill the public option. (Lest cries of “you have no proposal” go up from the Left, this should keep you busy. And this.)

(Note: Baucuscare – i.e. Obamacare Plan B – has most of the elements of the failed Massachusetts plan. The MA plan jockeys for most expensive in the country with NJ and NY. All are more expensive due to regs Baucus is proposing for the whole country.) 

Ever heard the term useful idiots? Thousands of them gathered in the streets of D.C. at the height of the Iraq War. Pink-bedizened. Face paint. Bush/Hitler signs… strutting and fretting their 15 minutes on the stage. They were incapable of engaging in rational discussion. Arguments began with an effigy and ended with a ‘No Blood for Oil’ sign. America eventually turned against the War. Perhaps the idiots were useful. But when it came to “rational discourse,” there was no outcry from the establishment left.

These days, useful idiots comprise a small percentage of the town hall meetings and tea-parties of the center-right. This subset is loud, angry and not particularly conversant on the subject of health care. But they may be useful. Early on, the MSM tried to magnify this minority as a means of discrediting all opposition to healthcare nationalization. Turns out, they were more useful to the right for whipping up the base and expanding opposition to healthcare nationalization despite the MSM. For better or worse, people did a double-take.

Now that these idiots are being somewhat effective, the left (and even some libertarians) are whining about “rational discourse.” Part of me longs for an intelligent conversation. But as one who has witnessed way too much useful idiocy on the left – from Code Pink to the Hope and Change sheeple – I am no longer terribly eager to explain the nuances of end-of-life consultation now that the tables have turned. Democracy is warty. And tit was made for tat.

When it comes down to it, the right has been offering good ideas for healthcare reform for years—one of which was completely sandbagged in 2006. Saner rightwing voices are being marginalized by the MSM. The MSM's favorite narrative is that the right is being “obstructionist,” offering no reform ideas of their own. Nothing could be further from the truth. Now that a merry band of useful idiots is helping shut down the left’s aspirations for a “public option,” I’m okay with some of these folks being right for the wrong reasons. Until the left and the MSM are willing to a) acknowledge our reform ideas exist, b) discuss them intelligently before the public, and c) stop framing genuine opposition as nothing but a bunch of birthers, racists and troglodytes, I for one will sit back and smile whenever I hear a useful idiot say something like “death panel.” 

(Note: none of this is meant as my weighing on on the World Net Daily controversy. Some forms of idiocy are not useful.)

You’ve heard some chatter about scrapping the “public option” in favor of a co-op model. Remember: government healthcare by any other name smells just as bad. We can’t let them sneak in any variant on the original evil using doublespeak and legerdemain. As Harry Reid said: “We’re going to have some type of public option, call it ‘co-op’, call it what you want.”

Congress is also considering a federal mandate that would force insurers to cover people after they get sick or injured, called “guaranteed issue”. In states like New York and Massachusetts where this mandate is already the law, premiums are about four times the national average. This is simply unacceptable if Congress wants to make insurance affordable for people. (It’s not insurance if you can call and buy a policy after your house burns down. Likewise, it’s not insurance if you can call and buy a policy after you break your leg.) But they’re not interested in making insurance affordable. That’s never been the goal.

It’s always been about getting us to a socialized system. If you can drive up costs with government mandates, then turn around and blame insurance companies—that’s the quickest way to get what you want: single payer.

With this bill, Congressional Democrats are going to do anything they can to create dependant constituents and special interests. In other words, people, companies and providers will depend on them for resources. Creating dependents helps keep them in power, so they're happy to hop into bed with the very companies they publicly malign. This reform bill is, and has always been, a resources for votes-n-contributions deal. So they’re going to pull out all of the tricks. But it’s now clear: we won’t be duped. Let us go forward with Zen-like patience and continue to oppose anything these shifty politicians propose.

I received a copy of this request -- from UHCAN Ohio to promote government healthcare reform -- we must communicate our opposition!!!!

Request for Proposals for Targeted Media in Southwest Ohio UHCAN Ohio and the Ohio Consumers for Health Coverage is engaged in a campaign to inform the public about the importance of federal health care reform and reduce the fear that is being created by opponents of health care reform who are spreading misinformation. We are looking for a media/communications consultant who can secure for us earned media opportunities to spread a positive message on health care reform and inform the public on the many areas that are rife with confusion. Our target market is the eight counties of Adams, Brown, Butler, Clermont, Clinton, Hamilton, Highland and Warren. We desire to mount a media campaign over the next three months that will cross print, broadcast, cable, and internet media. We are looking for opportunities to reach a broad swath of the public and of interest groups, such as business or religious constituencies. The pace of federal health care reform efforts has dramatically accelerated since early June 2009. If meaningful health care reform is to happen two needs must be met:(1)   Voters need to remain positive about reform, even as contentious debate arises over details of reform (such as the public health insurance option and the financing of reform) and as opponents of reform undermine public support with fear mongering.(2)   Federal legislators need to hear from voters that they want to see federal action on health care this year and that they care about affordability, quality, and health care security for all Americans. For voters to remain positive about health care reform, they need to receive positive messages and reliable information that reinforces the benefits they will derive from health care reform.  Meeting the Need for Clear Messages that Reduce the Fear Being Engendered by the Opponents of Health Care Reform.  People get most of their information from broadcast, cable and internet media, as well as people (family, friends, co-workers and others) who repeat to them what they heard in the mass media. The opponents of health care reform are spending millions of dollars on persuading the public that health care reform will result in a “government takeover” and “get in between them and their doctor.” The proponents of health care reform need to find ways to gain earned media to let people know that health care reform will protect and improve their choices.  We are looking for a PR consultant local to Southwest Ohio who will secure opportunities in Southwest Ohio across media types for UHCAN Ohio and Ohio Consumers for Health Coverage staff and partners to discuss health care reform.  We need a PR consultant to secure for us these opportunities:1.      Appearances on radio talk shows2.      Appearances on “drive time” radio programs3.      Appearances on broadcast and cable TV4.      Articles in daily and weekly newspapers targeted at the general public5.      Articles in specialty newspapers, such as those targeted at religious communities or the business community6.      Connections made through social networking sites including the blogosphere Time Frame:·         This will be a three month contract taking place between August and October.  Contractor Responsibilities:·         Contractor will pitch stories and potential interviewees to the media. Contractor will identify blogs that discuss health care (among other topics) that have a readership in Southwest Ohio and refer Client to those blogs.  Client will be responsible for furnishing the person(s) to be interviewed, and for developing messaging around health care reform. Client works with a communications organization in Columbus, and has some outside technical assistance from the Robert Wood Johnson Foundation on messaging. Client primarily needs a consultant who has local connections and can secure media exposure.  Please submit a brief proposal to UHCAN Ohio stating(1)   Your history of securing media for small groups and not-for-profit groups(2)   Your history of handling communications that are part of a campaign(3)   Your history of working with health care professional or advocacy groups(4)   The plan you would undertake to secure significant earned media coverage in the next three months in Southwest Ohio on health care reform (including how you track media hits)(5)   Your fee. Ohio Consumers for Health Coverage is a consumer-based coalition seeking fundamental health care reform benefitting consumers. It is staffed by UHCAN Ohio. Information about UHCAN Ohio and OCHC can be found at their web sites:www.uhcanohio.orgwww.ohioconsumersforhealth.org Proposals should be submitted no later than 5 PM

Let’s put aside our right-leaning suggestion box for a moment and put the challenge straight to the left as follows… (Warning: intellectual honesty check.) Will your bill:

1. Control Costs? If you have any third-party payer system, you’ll have a situation in which people overconsume. Because they have no incentive to be bargain shoppers, they won’t shop for bargains. Costs will continue to go up. Subsidized healthcare ensures people will continue consume more of what they don’t have to pay for directly. That’s the major driver of costs in healthcare. How will you deal with this problem—which is the main problem (not “administrative costs”?)

2. Avoid Using Price Controls? Bureaucrats determining prices will, as it always has, mean gross distortions (that whole supply and demandt thing). In the absence of real prices, resources don’t get allocated properly, because prices are a way to deal with dispersed, complex information. This is the problem we saw in the Soviet Union and it’s a major problem for the Canadian system. Will your system use price controls?

3. Avoid a Special Interest Bonanza? Any subsidized, government-provided reform will mean healthcare becomes a Freddie and Fannie phenomenon. Private companies that serve the government insurer will become special interests. They will game the system and rape it, as they have in so many other spheres of our life when colluding with government. Their prices will go up (unless controlled) and their profits will remain private. Losses will get covered up by continued subsidies and cost-shifting through higher taxes. This may also mask the cost-spiral (for a while). Eventually, heavy rationing will ensue or taxes will go through the roof. Is this bill healthcare corporatism?

4. Avoid Rationing Healthcare (Limiting “Access”)? If the government really wants to control costs, it will have to ration care. The problem is, we need a system in which individuals ration their own care, not bureaucrats with little or no connection to the individual. I ration my own healthcare (by shopping with my HSA dollars) and I prefer to keep it that way, despite the protestations of leftish types who believe they can make better decisions about my healthcare than I. Rationing means quality goes down and access gets limited.

5. Avoid More Deficit Spending? President Obama seems to be betting on energy taxes (cap and trade) to pay for what would amount to massive increases in government spending on healthcare. If the cap and trade bill doesn’t pass, will the government be able to pay for healthcare reform by simply cost-shifting to the wealthy? Or will taxes go up for everyone and big time rationing happen? The American people are at their end with the record deficits. Are you willing to push the envelope?

If your healthcare bill can’t pass this simple 5 question test, it’s not a good bill.

The Right is floundering in the healthcare “reform” debate. It’s complicated, but it need not be. How do you make the water cooler case? Tell ‘em “before we let them do anything stupid, we could fix healthcare in 5 easy steps”:

1. Let people buy health insurance across state lines. I live in North Carolina. If folks in my state could buy insurance in Idaho, we would cut our premium almost in half. New Yorkers could reduce premiums by about 2/3 buying in other states. Everyone would have access to the lowest rates in the country. Competition would bring costs way down. Why won’t the government let us?

2. Give poor and working class people tax credits (vouchers) to buy insurance. It’s not hard. Help the poor. Keep the competitive market, too. But for goodness sake, don’t make us pay for rich people’s healthcare and bankrupt private insurance all at once. (A high-risk pool can help people with pre-existing conditions, btw.)

3. De-couple health insurance from our jobs. (Change the tax code.) This coupling is an artifact of WWII wage controls. When your company chooses your insurance, it limits competition and choices. It's very costly, but you don't see the cost. And under the current system, you lose your insurance if you lose your job. Wealthier, employed people get subsidized to get insurance. Unemployed or independent contractors get nothing. 

4. Give greater access to health savings accounts for use on the small stuff. They can save money for old age, or purchase out-of-pocket healthcare. They’ll be more careful with their spending. We’ll eliminate much of the “split-the-check” effect where people over-consume and cost-shift. (For example: Prilosec OTC costs $15 at the store. Prescription Nexium costs a $15 copay (but $150 in reality). These drugs are almost identical. Yet people choose Nexium without a second thought. Why shouldn’t they? Still, $135 unseen gets dinged to the risk pool, so premiums go up.)

5. Stop driving up costs with regs and mandates. In some states, the government forces insurance companies to charge everyone the same rate whether they’re young and healthy, or sick and old. This is terribly costly. High rates mean young people go uninsured. Also, forcing companies to insure people after the fact is not “insurance” and drive up costs even more. Again, carrots for consumers to get insurance are far better than sticks against insurance companies and employers. Of course, consumers pay for those sticks, anyway.

On No 5, the Left has consciously been using these kinds of regulations to drive up costs. This limits people’s “access.” They don’t care. They want medical socialism no matter the cost. The plan is, and always has been, either to hasten the destruction of the insurance market and/or to drive up costs so we’ll cry uncle. Once we cry uncle, they’ll usher in the age of bureaucare. Functionaries will make our healthcare decisions. Bureaucrats will decide if and when you need a drug. You will wait in medical bread-lines for care. Innovation will dry up. Just go to a Cleveland hospital. Find Canadians getting MRIs because Canada has made them wait. 

It has been about half a year since Election Day 2008.  In that time, we have heard a fair number of theories being put forth as to what Republicans need to do to regain the majority in Congress, or at least stop the bleeding.  To review.

- We need to purge the party of moderates in order to clarify the GOP "brand."  First, Arlen Specter.  Second, the immensely personally popular Colin Powell.  Sen. Olympia Snowe could be next.

- Most recently, Jonah Goldberg says we need to find a "Hispanic Ward Connerly" to give the same message on immigration that so turned off the Hispanic vote.

- We should have a "big tent," though the new entrants into said tent shouldn't be allowed to shift the party ideologically.  Why they would enter the tent isn't clearly explained.

- We should organize better.  Because voters go for the party that makes the most noise and holds the most meetings of the faithful.

- Twitter.  The narrative states that Libs won TV, Conservatives won radio and Libs won blogs/social networking.  Since Twitter is the newest internet fad, we should try to win that because it's obviously next in line.

- Rush says we should forget about a "listening tour" but should instead "teach" about conservatism.  How many people know that conservatives favor tax cuts?  It would be a revelation to millions!

- After TARP, NCLB and the rest of W's program, we should start acting like conservatives.  Dislike of the party and disgust with the previous administrations have to do entirely with the party not adhering to its ideological roots.

What do all of these arguments have in common?  They hold movement conservatism as defined and zealously guarded by National Review, Rush Limbaugh and the rest as blameless.  It's a philosophy "under glass," and any failure of the public to sign up for the program is because we're explaining it wrong or because we didn't adhere to the script closely enough.

This supremely self-serving argument holds that people who hold down-the-line conservative positions from abortion to taxes (sorry, couldn't think of a "Z") need not rethink their positions or comprimise on some issues in exchange for a better chance of enacting others. 

Thinking like this is lazy, egotistical and bound to fail.  Voters understand modern movement conservatism loud and clear and they don't like decent-sized chunks of it.  Democrats came to grips with that, moved welfare off the table and got on with the rest of their agenda, which is why we're talking about card check and socialized medicine today.  It's time we turn inward, not to purge, but to reflect.