As good a description of the health care bill as I have seen.
Change Nobody Believes In
"And tidings of comfort and joy from Harry Reid too. The Senate Majority Leader has decided that the last few days before Christmas are the opportune moment for a narrow majority of Democrats to stuff ObamaCare through the Senate to meet an arbitrary White House deadline. Barring some extraordinary reversal, it now seems as if they have the 60 votes they need to jump off this cliff, with one-seventh of the economy in tow.
Mr. Obama promised a new era of transparent good government, yet on Saturday morning Mr. Reid threw out the 2,100-page bill that the world's greatest deliberative body spent just 17 days debating and replaced it with a new 'manager's amendment' that was stapled together in covert partisan negotiations. Democrats are barely even bothering to pretend to care what's in it, not that any Senator had the chance to digest it in the 38 hours before the first cloture vote at 1 a.m. this morning. After procedural motions that allow for no amendments, the final vote could come at 9 p.m. on December 24.
Even in World War I there was a Christmas truce.
The rushed, secretive way that a bill this destructive and unpopular is being forced on the country shows that 'reform' has devolved into the raw exercise of political power for the single purpose of permanently expanding the American entitlement state. An increasing roll of leaders in health care and business are looking on aghast at a bill that is so large and convoluted that no one can truly understand it, as Finance Chairman Max Baucus admitted on the floor last week. The only goal is to ram it into law while the political window is still open, and clean up the mess later.
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Health costs. From the outset, the White House's core claim was that reform would reduce health costs for individuals and businesses, and they're sticking to that story. 'Anyone who says otherwise simply hasn't read the bills,' Mr. Obama said over the weekend. This is so utterly disingenuous that we doubt the President really believes it.
The best and most rigorous cost analysis was recently released by the insurer WellPoint, which mined its actuarial data in various regional markets to model the Senate bill. WellPoint found that a healthy 25-year-old in Milwaukee buying coverage on the individual market will see his costs rise by 178%. A small business based in Richmond with eight employees in average health will see a 23% increase. Insurance costs for a 40-year-old family with two kids living in Indianapolis will pay 106% more. And on and on.
These increases are solely the result of ObamaCare—above and far beyond the status quo—because its strict restrictions on underwriting and risk-pooling would distort insurance markets. All but a handful of states have rejected regulations like 'community rating' because they encourage younger and healthier buyers to wait until they need expensive care, increasing costs for everyone. Benefits and pricing will now be determined by politics.
As for the White House's line about cutting costs by eliminating supposed 'waste,' even Victor Fuchs, an eminent economist generally supportive of ObamaCare, warned last week that these political theories are overly simplistic. 'The oft-heard promise 'we will find out what works and what does not' scarcely does justice to the complexity of medical practice,' the Stanford professor wrote."
And in case you're concerned this is all a right-wing conspiracy, Robert Samuelson from the Washington Post adds his two cents.
Yes, it's all about Obama
"Despite Obama's eloquence and command of the airwaves, public suspicions are rising. In April, 57 percent of Americans approved of his 'handling of health care' and 29 percent disapproved, reports the Post-ABC News poll; in the latest survey, 44 percent approved and 53 percent disapproved. About half worried that their care would deteriorate and that health costs would rise.
These fears are well-grounded. The various health-care proposals represent atrocious legislation. To be sure, they would provide insurance to 30 million or more Americans by 2019. People would enjoy more security. But even these gains must be qualified. Some of the newly insured will get healthier, but how many and by how much is unclear. The uninsured now receive 50 to 70 percent as much care as the insured. The administration argues that today's system has massive waste. If so, greater participation in the waste by the newly insured may not make them much better off.
The remaining uninsured may also exceed estimates. Under the Senate bill, they would total 24 million in 2019, reckons Richard Foster, chief actuary of the Centers for Medicare & Medicaid Services. But a wild card is immigration. From 1999 to 2008, about 60 percent of the increase in the uninsured occurred among Hispanics. That was related to immigrants and their children (many American-born). Most illegal immigrants aren't covered by Obama's proposal. If we don't curb immigration of the poor and unskilled -- people who can't afford insurance -- Obama's program will be less effective and more expensive than estimated. Hardly anyone mentions immigrants' impact, because it seems insensitive.
Meanwhile, the health-care proposals would impose substantial costs. Remember: The country already faces huge increases in federal spending and taxes or deficits because an aging population will receive more Social Security and Medicare. Projections the Congressional Budget Office made in 2007 suggested that federal spending might rise almost 50 percent by 2030 as a share of the economy (gross domestic product). Since that estimate, the recession and massive deficits have further bloated the national debt.
Obama's plan might add almost an additional $1 trillion in spending over a decade -- and more later. Even if this is fully covered, as Obama contends, by higher taxes and cuts in Medicare reimbursements, this revenue could have been used to cut the existing deficits. But the odds are that the new spending isn't fully covered, because Congress might reverse some Medicare reductions before they take effect. Projected savings seem 'unrealistic,' says Foster. Similarly, the legislation creates a voluntary long-term care insurance program that's supposedly paid by private premiums. Foster suspects it's 'unsustainable,' suggesting a need for big federal subsidies.
Obama's overhaul would also change how private firms insure workers. Perhaps 18 million workers could lose coverage and 16 million gain it, as companies adapt to new regulations and subsidies, estimates the Lewin Group, a consulting firm. Private insurers argue that premiums in the individual and small-group markets, where many workers would end up, might rise an extra 25 to 50 percent over a decade. The administration and the CBO disagree. The dispute underlines the bills' immense uncertainties. As for cost control, even generous estimates have health spending growing faster than the economy. Changing that is the first imperative of sensible policy.
So Obama's plan amounts to this: partial coverage of the uninsured; modest improvements (possibly) in their health; sizable budgetary costs worsening a bleak outlook; significant, unpredictable changes in insurance markets; weak spending control. This is a bad bargain. Health benefits are overstated, long-term economic costs understated. The country would be the worse for this legislation's passage. What it's become is an exercise in political symbolism: Obama's self-indulgent crusade to seize the liberal holy grail of 'universal coverage.' What it's not is leadership."
There's more in both pieces worth reading. But the most important problem, frankly, with the bill is Democrats' attempt to force Americans to trust legislation that they don't trust to resolve our problems with health care. Without even really listening to the concerns.
The advantage for opponents by this manner of governing is that it makes it all the easier to just kill this thing entirely with a new majority and start completely fresh.
Like Republicans before them, Democrats are about to learn a very serious lesson in governance. If you think that assertions of overwhelming power can trump substantive concerns in a democratic discussion and debate with voters who can elect otherwise, you got another think coming. And voters will throw your asses right out of office until your party gets the message.
Republicans got their message, in part. It will take several cycles.
But illiberal forces who think they can turn the clock backwards on genuine liberal progress, meaning progress that promotes greater liberty and responsibility, are in for a very rude awakening.
Because, as it turns out, Americans like their freedom. When they can finally see more up close and personal what the alternative looks like.
And they like it for good reason. Because for all of our bumbling and failures and, frankly, their creation of most of the problems in the current health care system, Americans are in a better position to make better choices about their health care and how to correct them than the Federal government ever was. And, ultimately, most of the problems in the system will need the kind of changes that only individual Americans can offer for their own lives, and not ones that can be coerced by anyone else.
Americans may not know what will work. But they can get a sense of what won't work. And Americans are right, by my lights, with so many variations of market distortion in this legislation, that this bill will make our health care woes worse, not better.
And what Democrats need to get clear about, right now, is that change you are forced to believe in is not change you will ever really believe in at all.