How Obama Miscalculated on the Federal Healthcare Takeover

President Barack Obama continues to give lip service to his planned federal takeover of U.S. healthcare.  (Any pretext that this political football was about healing people vanished long ago. It's always been about the economy, stupid.)

But the president remains aloof and disconnected from the American people on this issue. According to the latest Rasmussen Reports Daily Tracking Poll, Pres. Obama now has a Presidential Approval Index rating of -17. Minus 17. That means that 25% of Americans (roughly the same number of people who identify themselves as hard-core liberals) strongly approve of the president's policies, while 42% (closing in on half of all Americans) strongly disapprove.

Although the president continues to make it clear that he would rather be a one-term president with accomplishments than a two-term ineffective president, that stubbornness does nothing to solve the healthcare problem, or anything else, for that matter. In point of fact, the only compromise to come out of this stance is that Mr. Obama is tracking to be a one-term ineffective president.

Did the president and the hard left in Congress miscalculate on healthcare? The answer is yes. Democrats are notoriously bad with numbers and healthcare is no exception. The president's healthcare death march had less to do with the drastically inflated number of uninsured people bandied about and more to do with the fact that healthcare amounts to 16% of the largest economy in the world. In healthcare he saw a chance to remake a big chunk of the economy in one shot.

Here are the real numbers that mattered in the healthcare debate. These are the numbers that the president and the left-leaning Congress forgot to take into account:

• The healthcare industry itself consists of nearly 350,000 locations.
• That industry employs 5.5 million people, all of whom would be affected by the president's plan and most of whom vote.
• There are a half million doctors and surgeons alone, not to mention over two million registered nurses.
• There are nearly 9,000 companies alone that make medical devices-nearly all of which would have been taxed to pay for the president's scheme.
• These 9,000 companies employ 360,000 people-again, all of whom would have been negatively affected and most of whom are voters.
• The president's plan as it stands finally ran off the rails in Massachusetts, with the special Senatorial election of Republican Scott Brown last week. The Bay State alone is home to more than 200 medical device companies. The president errs when he says the election didn't turn on healthcare. For these 200 companies and their employees, their friends and relatives, that's exactly what it turned on.

 According Daniel Henninger of the Wall Street Journal, who assembled these numbers, The ObamaCare dreamers were driven by the chance to finally fulfill FDR's New Deal hope for universal healthcare. But what they ignored was the fact that  the world in general, and healthcare in particular, is immensely more complicated today than it was 70 years ago. Recasting one-sixth of a $14 trillion economy made up of 300 million people residing in 50 different states spread out over an area 16 times that of France was never going to happen.

The president continues his strategy of creating a bogey for each of his pet policies--someone or some group that must be defeated and whatever legislation the president proposes is the only way to do it. In the case of healthcare the bogey is the ephemeral "special interests" who want to preserve the status quo. Again, the president misrepresents the debate. Anyone with any understanding of our healthcare system knows that change is necessary and change must come.  But in clinging to an outmoded dream that is impossible to fulfill, the president has lost valuable time-much in the same way that Democrats cost the nation 17 years and counting  when they were rebuffed with HillaryCare.

It's not the Republicans or conservatives who are holding up healthcare. It's the leftists who cling to a dream that died with FDR in 1945, when we entered a post-war world and economy more complex than anyone could have dreamed.

It's time we looked at the numbers and came up with a healthcare system that's an actual improvement, rather than one that might be theoretically better if only this were 1939.

Just thought you might like to know.

The Myth of ObamaCare

Congressional Democrats are meeting with the White House  to begin the final push toward their socialized healthcare bill: a bill that blends the best (or worse, depending on your perspective) of both the House and Senate versions of ObamaCare.

ObamaCare-Not the Democratic Bill, but the Undemocratic Bill

The Chicago mob that promised an open, transparent administration is meeting behind closed doors. No Republicans. And no ordinary citizens by way of television. C-SPAN has been turned down so far in its request to place cameras in the room. Just a group of Democrat pols doing what polls this morning show a majority of Americans (52%) don't want done: having a bogus healthcare bill jammed down their throats.

In 2008 Candidate Obama, in making healthcare the tall pole in his election tent, said on 8 occasions that the negotiations on the healthcare bill would be broadcast on C-SPAN so that he could "enlist the American people in the process" of healthcare reform.

Candidate Obama in August of 2008 told the San Francisco Chronicle again that the negotiations would be on C-SPAN and that "the public would be part of the conversation." Take a look:



If the American people are "part of the conversation" about healthcare, it's a decidedly one-sided conversation. Healthcare bills have been negotiated behind closed doors, with no input from the opposition party which this morning leads the Democrats by 9 points in the latest poll of likely voters in the 2010 Congressional election. Bloated, 2,000 page bills have been put to a vote without adequate time for the opposition to read them and help form the "debate" over healthcare. Votes have been held in the dead of night when anyone who might question the wisdom of the majority party leadership would be dead tired and less likely to object.

The Myth of ObamaCare-What's Really Behind the Bill and What's the Endgame?

But the myth of ObamaCare is that it was never really about healthcare. It was all about transforming the United States into a weaker country, one where its citizens are dependent on its government rather than themselves, one in which it cedes its global leadership in security by outsourcing our foreign policy to the U.N., and one in which America trades in its mantle of exceptionalism for the chance to be just another country, no better or worse than Sweden, Libya or Liechtenstein.

This is the agenda of a radical, fringe element of the Democrat party that is using healthcare as a wedge issue to break down the doors of American exceptionalism while they still have the chance.

If you don't think so, look at H.R. 3962, the ugly, bloated House version of healthcare reform. Although the Democrats continue to paint Republicans as opponents of healthcare reform, the fact is that just about everyone believes that we need systemic reform. Healthcare is expensive, drains certain portions of the economy and when delivered by government through Medicaid or Medicare lacks sufficient oversight and quality.

The so-called reform bills on the table right now only make the situation worse. Take a look at my state, Pennsylvania, expected to be a swing state in the 2012 election, and the likely consequences of H.R. 3962:

• If you don't purchase what H.R. 3962 refers to as "acceptable health care coverage" you'll be taxed 2.5% of your income as a penalty. Make no mistake: it's a tax. If your income is $35,000, your healthcare tax will be $875. If you couldn't afford healthcare on $35,000 a year, you sure won't be able to afford it on an income of $34,125.
• Think that's the only tax Americans will pay? Think again. If you happen to be one of the swells who make more than a half million bucks a year ($1 million if you have a family), you'll get a surtax of 5.4% to punish you for your economic success. The problem is that most of these high rollers aren't high rollers at all. They're small businesses that roll their personal and business taxes into one return. Small businesses employ most workers in the U.S. But probably not after ObamaCare. 42% of small business income will be subject to this confiscatory tax. The Heritage Foundation says in Pennsylvania alone over 30,000 businesses will suffer because of this. 
• Want more tax? The Dems have it for you. How about an 8% smackdown on employers who don't provide what Democrats think is "acceptable" insurance for their workers. 
• It's not just small businesses that will suffer. Life-saving medical devices from MRI equipment to stethoscopes will be subject to a new tax. Again, in Pennsylvania alone there are 600 medical device companies employing some 20,000 workers, according to Rep. Jim Gerlach (R-PA). These are well paying jobs that are now at risk because of the Democrats. (Full disclosure: Jim Gerlach is my congressman.)
• Rep. Gerlach, quoting the American Hospital Association,  says that hospitals in his district, which covers parts of four counties, will lose about $46 million each year under ObamaCare. What happens then? Hospitals will have to reduce services, cut jobs, or increase rates in order to offset the cuts.
• Neither of Pennsylvania's two senators, Democrats Bob Casey or Arlen Specter, had the chops or brains to do what Ben Nelson of Nebraska did--hold out to exempt his state from the unfunded Medicaid mandates that ObamaCare will inflict on the states. The result: Pennsylvanians will have to pony up an additional $2 billion over the next decade to pay for Medicaid, according to the National Conference of State Legislatures. In ten years Americans could be forking over nearly a billion dollars a year in additional Medicaid costs. Where does that money come from? From U.S. taxpayers.
• In order to keep this sinking ship afloat, Senate Democrats would take nearly $500,00 away from seniors enrolled in Medicare. A half-million bucks! In a program already underfunded. 
• According to Rep. Gerlach, 35,000 seniors in his district will be affected because they are enrolled in the Medicare Advantage plan. The Democrats hate Medicare Advantage like Dracula hated the crucifix. The reason is that the great Satan, George Bush, proposed it and shepherded it through Congress. The fact is that Medicare Advantage works. It is a cost effective plan that pays medical providers for keeping seniors well. But because it's a Republican-inspired concept, Democrats are making it difficult for seniors to keep it. (Except in Florida, where Sen. Bill Nelson (D-FL) sold his vote on ObamaCare by getting Democrat leadership to exempt Florida seniors from cuts in their Medicare Advantage plans.) In cutting Medicaid Advantage the Democrat leaders want to force seniors into a government-run system where the one ones who win are the tens of thousands of new bureaucrats who will control what care seniors will get. 
• For the same reason Democrats have an irrational hatred of Medicare Advantage they hate Health Savings Accounts. HSAs were created over the last decade as another way to help make family insurance more affordable by combining with high deductible health plans. And they work. But under the Democrats HSAs, a free market response to healthcare, do not qualify as acceptable coverage, according to Rep. Gerlach. In fact, the House's Ways and Means Committee actually rejected a Republican amendment that would hav specified that HSA owners could keep their accounts. The reason: HSAs are an instrument that allows families and individuals to have more control and management over their own healthcare decisions. And that is an anathema to the Chicago mob's plan to wrest control of healthcare from individuals and vest it with a bureaucratic central government. 
• H.R. 3962 would force many lower-middle income (LMI) families out of S-CHIP and into a new government program. These families today are able to insure their children through the bi-partisan S-CHIP program. But when S-CHIP goes away they will have higher out-of-pocket expenses, further eroding their meager earnings. 
• Perhaps the ultimate indignity heaped on the country by the Democrats and their sham health care bills is the fact that if you fail to comply with the bill you could face civil and criminal penalties, including fines up to $250,000, according to the government's own Joint Committee on Taxation. A quarter of a million dollars.

H.R. 3962, it's Senate companion, and the whole secretive process, exposes what ObamaCare is all about: Tightening the grip on the lives of Americans. Remaking American society into one less focused on opportunity and more focused on central control. It has nothing to do with your healthcare.

The Shame and the Tragedy of ObamaCare

Pres. Obama's empty threat as a candidate to "shame" legislators into an open debate on healthcare recalls for me the Army-McCarthy hearings.  In 1954 Joseph Welch was the lead attorney for the U.S. Army in the famous Army-McCarthy hearings, a circus begun by Wisconsin Senator Joseph McCarthy to investigate alleged communists in the U.S. government. It was the beginning of the end for Tail Gunner Joe when Mr. Welch faced the Wisconsin demagogue in a televised hearing and calmly asked the reckless senator "have you no sense of decency?"

Today I would ask Pres. Obama, not the "special interests" if he has any sense of shame over this process. Or any decency. Pres. Obama, Speaker Pelosi and Majority Leader Reid have made a mockery of the legislative process: conducting the final negotiations among a handful of pols behind closed doors. Locking out the opposition party. Arbitrarily eliminating the conference committee of Senate and House representatives that would normally fashion a compromise bill. Forbidding the public to see and hear the debate.

I would ask the question but I already know the answer. It's no. Because to have a sense of decency would require them to have some conscience over how they are trampling the Constitution and the institutions of government in a mad rush to remake the Republic.  And they have no such conscience. They have no decency. And they have no shame.

Just thought you might like to know.

Health Care Bill of Rights for Seniors

The Republican National Committee has just published what it is calling a "bill of rights" for seniors regarding health care. The six tenets of the proposal are:

1. Protect Medicare from cuts made in the name of healthcare reform
   
2. Prohibit intrusion by government in the doctor-patient relationship
   
3. Don't ration healthcare based on age
   
4. Don't let government interfere with end-of-life discussions between a patient and doctor
   
5. Allow seniors to keep their current coverage
   
6. Preserve current healthcare programs for veterans
   

Republican Party Chairman Michael Steele discusses the Seniors' Healthcare Bill of Rights on Fox News' Fox and Friends show below:

This is a good start for Republicans who were shamefully late in getting to the healthcare party. But, in my estimation, it does not provide enough thought leadership in the healthcare debate to counter the Democrat pitch which has been 15 years in the making. 

The first proposal is somewhat disingenuous for both parties since it was Republicans whom the Democrats excoriated in the 1980s when they tried to make cuts to rein in Medicare spending. Now the shoe is on the other foot. 

Proposal #4 is similarly problematic. House Bill 3200, the healthcare bill, does indeed reference end-of-life discussions. But the context is to allow doctors to be paid for the time it takes to carefully explain all options to a patient and his or her family. Anyone who has ever dealt with a terminally ill family member knows these discussions. They are useful for the patient, the patient's loved ones, and I suspect, the physician as well. Currently this time is not reimbursable by Medicare. This would allow physicians to get paid for their advice and counsel, which is the correct thing to do.

Here's where we get wrapped around the axle on end-of-life: Many of the people who support the bill in general do not share the pro-life beliefs that many of the bill's opponents hold. Proponents, for example, are more likely to favor euthanasia as an end-of-life choice, an anathema to anyone who favors life over death. The Blogosphere is replete with stories about Oregon and its assisted suicide law, and with tales of Oregonians who could not get life-prolonging drugs, but could easily get a prescription for euthanasia drugs. No wonder that so many pro-life people are wary of this end-of-life requirement. 

Proposals 3 and 5 are much more on target. Nationalized healthcare proponents point frequently to the British and Canadian healthcare systems as models we should follow. But these systems, because of their tremendous cost are forced to ration healthcare based on age. The National Health Service in the U.K. uses quality adjusted life years, or QALY scoring to calculate the cost benefit of a particular health intervention for a patient before agreeing to pay for it. 

This is similar to a company doing a cost-benefit analysis on the purchase of a piece of equipment: what is the cost of the purchase, how long will it take to recover the cost of the expense, and what will the purchase yield in terms of revenue.  QALYs analyze how old the patient is, how much the procedure will cost, how many years will it add to the patient's life and what the quality of those years will be. 

Those of us opposed to this kind of approach believe that when you're on the back nine of life you deserve the dignity of not being analyzed like a dump truck or a trash compactor. But it all comes down to money. Universal coverage is so expensive that hard decisions like this have to be made.

Proposal #5 addresses another real concern for seniors. Pres. Obama says repeatedly that under his socialized medicine plan you can keep your private coverage. But, either the President does not really understand the healthcare debate and is doing a really, really good job of faking it, or he's hiding the truth. Take your pick. Should ObamaCare become law you will be able to keep your policy. But as time rolls on, more and more people will be forced into the government's program. 

Businesses will probably be the first. Rather than pay a payroll tax or a large portion of their revenue in group healthcare insurance premiums, they'll just cancel their policies and force their employees into the "government option." These are the younger healthier people who use less healthcare than seniors. When the private sector insurance customers skew too much towards seniors who use a lot of healthcare, costs will escalate to the point that seniors will be forced into the government plan.

The President said in 2003 that he favored a single-payer plan, but admitted that it might take awhile to get there. So he's like the used car salesman who brags about the four new tires on that shiny '74 Cordoba, but "forgets" to tell you that the transmission has about another 500 miles of life.

ObamaCare is problematic for seniors, no doubt about it. But the Republican Healthcare Bill of Rights for Seniors is problematic for the party, exposing its basic weakness on healthcare and everything else, frankly. Its first official foray into the healthcare debate is on behalf of old white people. The Democrats are making their appeal to the two fastest growing segments of the population: Hispanics and young adults. Healthcare is  a game Republicans can't win on numbers alone. The President and his party simply have to wait them out, as Barack Obama said in 2003, unless the GOP can come up with something better than this.

Just thought you might like to know.