Obamacare

I’m recycling an earlier post on health care. New comments are in red.

From Obama’s health care speech of Sept 9, 2009:

“But thanks to the bold and decisive action we’ve taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink. ”

Really? This doesn’t pass the smell test. Unemployment malingers on at 9.7%, higher than any of the administration’s worst-case scenarios and far, far worse than their projected numbers. We face a $56 trillion unfunded liability in Medicare/Medicaid/Social Security, we’re $12 trillion in debt and will need to raise the “debt cap.” (While a member of the opposition party in the Senate, Obama voted against raising the debt cap.)

March, 2010 and the numbers look even worse. The deficit has risen faster still. The economy is still tottering and Treasury Bills are now riskier investments than Proctor and Gamble.

“I am not the first President to take up this cause, but I am determined to be the last. ”

Really? The last? This is just sophomoric delusion. Politics is a battle of ideas, of principles and law. The arguments cycle and the debate rages on. That’s the point, people. The only way anything is ever “finally decided” is with a bullet. more than anything, this comment indicates that the administration is already–in its first year–caught up in its own hagiography.

“Some can’t get insurance on the job. Others are self-employed, and can’t afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.”

That’s because of the absurdist tax code! Nothing in the administration’s proposals would do anything to change this. Extend the tax deduction!

Extend the FREAKING TAX DEDUCTION! he said this and then urged Congress to pass a 40% excise tax on private insurance.

“We are the only democracy — the only advanced democracy on Earth — the only wealthy nation — that allows such hardship for millions of its people.”

All the cool kids are doing it! Really, we can be just like France! Or Sweden! Or Greece! They have great health care, fantastic rates of growth and thriving economies! Except they ration their health care, their growth is absymal and their debt is completely crippling and utterly unsustainable. I know, I know, facts will be in short supply in this speech.

Turned out, facts were in short supply during the debate and the vote as well.

“There are now more than 30 million American citizens who cannot get coverage. In just a two-year period, one in every three Americans goes without health care coverage at some point. And every day, 14,000 Americans lose their coverage. In other words, it can happen to anyone.”

Do the math. These numbers make no sense. If one in three “goes without” (for how long?) that’s 100 million over two years or 50 million a year. if 14,000 lose their coverage every day that’s only 5 million a year. He’s making it up.

“One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn’t reported gallstones that he didn’t even know about. They delayed his treatment, and he died because of it. Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne. By the time she had her insurance reinstated, her breast cancer had more than doubled in size. That is heart-breaking, it is wrong, and no one should be treated that way in the United States of America. ”

I’m guessing that both anecdotes will turn out to be slightly more complicated than presented here, but assuming we take the President at his word, these are examples of breach of contract and are the proper subject of litigation. If they do represent legitimate issues that could be addressed with regulation, then do that.

Anecdotes like these are vile. They substitute emotion for reason and play to the worst in both supporters and opponents of a particular policy. There’s an anecdote for every position and millions of anecdotes that never get told.

“Then there’s the problem of rising cost. We spend one and a half times more per person on health care than any other country, but we aren’t any healthier for it. ”

So let the government run it! It’ll be like the Post Office of Health Care! Or the GM of Health Care! Or the VA of health care!

“And it’s why those of us with health insurance are also paying a hidden and growing tax for those without it — about $1,000 per year that pays for somebody else’s emergency room and charitable care. ”

OK… wait a minute… he wants to increase that hidden tax! 40% excise tax!

“Finally, our health care system is placing an unsustainable burden on taxpayers. When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid. If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined. Put simply, our health care problem is our deficit problem. Nothing else even comes close. Nothing else. ”

That’s true. But his answer to that is to increase government liability without increasing funding. If he wants to control spending in Medicare and Medicaid, then do that! But adding an entirely new government entitlement does not lower costs.

The CBO score is the tortured product of pure fiction. The bill imposes costs immediately but delays benefits in an attempt to create the ridiculous figures. When the Doc fix is applied even the fictional savings evaporate.

Now, these are the facts. Nobody disputes them. ”

Oy. This has been a constant refrain and it’s purely and plainly despicable.

“There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada’s — (applause) — where we would severely restrict the private insurance market and have the government provide coverage for everybody. On the right, there are those who argue that we should end employer-based systems and leave individuals to buy health insurance on their own. I’ve said — I have to say that there are arguments to be made for both these approaches. But either one would represent a radical shift that would disrupt the health care most people currently have.”

Well… no. Extending the tax deduction would allow individuals to purchase health insurance. Allowing insurance companies to sell products across state lines would increase choice and opportunity. I’m not entirely sure how either proposal would disrupt anyone’s health care, unless they wanted it disrupted.

“Well, the time for bickering is over. The time for games has passed.”

Nice partisanship. Expressing deep reservations about a policy proposal is not “bickering.” Expressing deep reservations about a policy proposal is not “bickering,” it’s democracy. Perhaps the President is as confused as Friedman.

Well, the “bickering” didn’t end then and it won’t end now. The legislation was forced through in the most partisan manner imaginable. And how should we characterize the “deem and pass” strategy or the reconciliation method if not as legislative games?

“Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do. Rob the people blind, cheat on our own taxes, and ruin the economy for the benefit of politically connected cronies! (Sustained, rapturous applause)”

OK… I added that last bit. He didn’t actually say that. But he did do it. God help us all. He did it.

“And one more misunderstanding I want to clear up — under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.”

See, the federal money will have sparkles and hearts on it and will smell all fresh and tangy, like mountain mist on a mid-summer day. We won’t use the pretty money on abortions, we’ll use other money! Say your kid has two dollars and wants to buy a sandwich and candy. Each costs two dollars. You give him another two dollars and tell him that he can only buy the sandwich with the money you gave him and he has to use his own money on the candy. You just bought your kid candy. The money’s all the same, people. If you don’t want the feds to fund abortions, then you’ve got to keep the feds from funding health care. If they fund health care, they’ll fund abortions. It’s like pretending that because you can’t use WIC coupons on cigarettes that WIC money doesn’t ultimately support tobacco companies; it’s a fiction.

After all the backroom deals, the funding for regional airports and the shiny new executive order… ugh.

“Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors. … But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. ”

In fact, we’re going to REQUIRE you to buy insurance from them! That’s how we’re going to “control” them, by forcing you to buy their products! Ha! Take THAT insurance companies!

“First, I will not sign a plan that adds one dime to our deficits — either now or in the future. ”

Uh huh.

Bullshit then. Bullshit now.

“I will not sign it if it adds one dime to the deficit, now or in the future, period.”

Bullshit then. Bullshit now.

“And to prove that I’m serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don’t materialize.”

Bullshit then. Bullshit now.

“Now, part of the reason I faced a trillion-dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for — from the Iraq war to tax breaks for the wealthy.”

So, when faced with a trillion dollar deficit, Obama stared it down and did the most courageous thing he could; he doubled it. In six months.

“I will not make that same mistake with health care. ”

Like I made with the stimulus bill. And the cap and trade bill.

Bullshit then. Bullshit now.

“And that is why not a dollar of the Medicare trust fund will be used to pay for this plan.”

Bullshit then. Bullshit now.

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