Not Everyone signing up for Obamacare is paying for Obamacare

Posted by PITHOCRATES - April 6th, 2014

Week in Review

The big question in the Obamacare signups recently released by the Obama administration is this.  How many people have actually sent a payment into their insurance company?  For signing up for health insurance doesn’t mean you have health insurance.  You have to pay for it first.  With ‘first’ being key.  As anyone who has paid a health insurance premium knows.  You pay for next month’s health insurance this month.  That is, it’s cash before delivery.  As the insurance companies need the cash before they can pay any benefits.  This is the way all insurance has worked since the dawn of insurance.  First money goes into an insurance pool.  Then said insurance pool pays insurance claims.  The money must come first.  There’s just no other way for it to work.

So, is the money coming first with Obamacare?  As it turns out, the majority of it is.  At least, according to a leading federation of Blue Cross and Blue Shield health plans (see Blue Cross group sees Obamacare premium payments at 80-85 percent by David Morgan posted 4/2/2014 on Reuters).

A leading federation of Blue Cross and Blue Shield health plans said on Wednesday that it is receiving premium payments from 80 to 85 percent of its new Obamacare health insurance customers.

The estimate, released by the Chicago-based Blue Cross Blue Shield Association, reflects enrollment activity among 35 Blue Cross Blue Shield plans in 47 of the 50 states, including plans sold by WellPoint Inc, from October 1 through February 1…

If the Blue Cross Blue Shield payment rates held true for enrollment across the board, between 5.7 million and 6 million of the 7.1 million would actually be enrolled in coverage.

So that means the Obama administration is overstating the enrollment numbers from 18.3% to 24.6%.  And between 1.1 million and 1.4 million haven’t paid for the Obamacare they signed up for.  Of course, that’s assuming that the 7.1 million were all new Obamacare enrollees into private health insurance plans.  And not those who signed up for Medicaid who will never write a check for their coverage.  Which will not help the insurance companies pay for the expanded benefits mandated by Obamacare.

So the Obama administration’s numbers are suspect to say the least.  As is the continued existence of the private insurers.  For if they don’t get 7+ million signing up for Obamacare (with a heavy concentration of the young and healthy who will file few claims) the cost of caring for the old and sick will bankrupt them.  Of course if this was the plan all along the Obama administration could at least claim something in Obamacare was working according to plan.

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Obamacare: Obama lied and People will Die

Posted by PITHOCRATES - December 14th, 2013

Week in Review

There are about 414 million people in the United States.  And Obamacare is supposed to insure them all.  But that’s not all.  The Affordable Care Act was going to make health insurance less costly while covering more people.  As well as providing more extensive coverage.  Obamacare promised more for less.  And if you liked your health insurance, your doctor and your medication you could keep them.  It just sounded too good to be true.  And, as it turned out, it was too good to be true (see Does the pre-existing condition program foretell broader problems for Obamacare? by PHILIP KLEIN posted 12/13/2013 on the Washington Examiner).

The program, known as the Pre-Existing Condition Insurance Plan, or PCIP, was a temporary measure within Obamacare meant to be a bridge to provide coverage to those with pre-existing conditions between the law’s 2010 passage and Jan. 1, 2014, when all plans will be required to offer coverage to those with pre-existing conditions…

What’s interesting about PCIP is that it ended up attracting much fewer Americans than expected while also costing more than expected. The reason was that those who did enroll ended up being those with extremely high medical costs — even by the standards of a program for those with pre-existing conditions.

By March 2013, HHS suspended enrollment in the program because it couldn’t afford to cover any new applicants.

As the New York Times reported in May, “The administration had predicted that up to 400,000 people would enroll in the program, created by the 2010 health care law. In fact, about 135,000 have enrolled, but the cost of their claims has far exceeded White House estimates, exhausting most of the $5 billion provided by Congress.”

The same story explained that HHS announced it “was cutting payments to doctors and hospitals after finding that cost overruns are threatening to use up the money available…”

But given the dismal enrollment numbers to date, it’s worth asking whether the exchanges could end up encountering similar problems to PCIP — only on a much bigger scale.

The plan that had only targeted 400,000 enrollees only got 135,000.  About two-thirds short of their target.  Why?  Insurance that covers preexisting conditions is very expensive.  Because it will pay a lot of claims.  The money people pay in as premiums pays those claims.  But the cost to cover these people is so great it took another $5 billion of taxpayer money.  And even then the program ran out of money with only 135,000 signing up for this insurance.  Showing the futility of buying insurance for a group with preexisting conditions.

Insurance by definition protects the financial assets of a policy holder from a possible loss.  This is the key that makes insurance actually insurance.  Not everyone that pays a premium for this protection will suffer a loss.  So there is a surplus of premiums to pay for the few that do.  The PCIP sells policies to a group of people who will all suffer a loss.  So people aren’t paying a premium to protect themselves from a possible loss.  They’re paying a premium to pay for a known loss.  And everyone in the pool will be paying and submitting claims.  So that the cost of insurance eventually equals the cost of health care per policy holder.  Which makes the insurance redundant.  And unnecessary.  While only serving to increase actual costs by introducing a third party into the process.

This is why the PCIP needed the $5 billion in taxpayer subsidies.  For without it people would not save any money by buying this insurance.  As many haven’t.  Even with the subsidies.  The taxpayers paid about $37,000 per person in addition to the cost of the premium pool.  Based on the number of months since the Affordable Care Act became law that’s about $842 per person per month in subsidies.  Based on the horror stories of what the young and healthy have to pay for their Obamacare health insurance the premiums for the PCIP are probably greater than the subsidies.  And it’s still not enough to cover their costs.  Which is why they’re cutting people off and cutting payments to doctors and hospitals.

Which will happen for the rest of us.  Once the enrollment numbers fall far short of their projections.  As they are.  And claims exceed premiums.  As they will.  Leaving them little choice but to cut costs.  Raise premiums.  Charge more for prescriptions.  Increase wait times.  And ration health care.  Not what President Obama promised.  Then again, he lied.  PolitiFact called it the Lie of the Year.  And because of the president’s lie people will have poorer quality health care.  Who may succumb to their health problems as they wait those longer wait times.  And can no longer afford the prescriptions that kept them healthy.  All because President Obama lied.

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Health Insurance Premiums and Deductibles

Posted by PITHOCRATES - October 21st, 2013

Economics 101

The Requirements of Obamacare force Insurers to Cancel their Less Costly Policies

We buy health insurance to protect our financial assets in case of a catastrophic health problem.  Such as a bad accident requiring costly hospitalization and rehabilitation.  Or a costly disease.  Like cancer or a heart attack.  As bad as those things are the good news is that most people don’t suffer from these health problems.  Which allows us to use insurance to protect our financial assets.

People in an insurance pool pay a small premium to pay for a potential loss.  Such as a catastrophic health problem.  Because not everyone in the pool will suffer from a catastrophic health problem the insurance premium can be much smaller than the cost of medical care for the few that do.  A premium small enough that individuals and families can budget this amount and rest comfortably knowing that a catastrophic health problem won’t cost them their home, their kids’ college fund, their retirement savings, etc.  A system that has worked well.  Until we started using insurance to pay for everything under the sun.  Which has caused insurance premiums to soar.  And Obamacare just doubles down on this trend and turns insurance into welfare.

Premiums before and after Obamacare R1

Obamacare raises the coverage requirements for all insurance policies.  To a ridiculous extent.  For example, couples whose children are grown adults still need pediatric coverage.  Obamacare requires a lot of standard coverage like this that is virtually impossible for some people to use.  Thus greatly raising insurance premiums.  In our example our fictitious insurance pool contains 10,000 individuals and 10,000 families.  To include everything the Obama administration wants to include raises individual premiums 240%.  And family premiums 257%.  Which causes a problem with President Obama’s promise to the American people.  That thing about keeping your current insurance if you like your current insurance.  As insurers have no choice but to cancel their less costly policies.

The Affordable Care Act makes Premiums Unaffordable by Requiring Insurers to Cover More

That promise was, of course, a lie.  Because you can’t buy more for less money.  You just can’t get more for less.  So if the policies cover more they cost more.  If they cover a lot more they cost a lot more.  Well, that creates a bit of a problem for the optics of the Affordable Care Act.  When you make the existing health care system ‘affordable’ you really can’t raise the cost of insurance by over 200%.  Even if you are giving more insurance coverage.  Because if it’s just too expensive people won’t have the money available to pay for it.  So they brought the premiums down from what they would need to be to do what they want them to do.  To something a little more affordable.  Like this.

Premiums before and after Obamacare Adjusted R1

Which brings the increases to 80% for an individual policy.  And 129% for a family policy.  These are still steep price hikes.  But with the more these policies cover and subsidies for those who need them they are an easier sell.  Of course, there is another problem.  Selling these policies at these lower prices won’t bring as much money into the insurance pool.  Which will limit what this pool can pay for.  Leading to rationing.  And longer waiting times.  As health care providers will have to tell patients ‘no’ because the insurer denied the treatment or procedure.  Which sort of defeats the purpose of Obamacare.  Affordable health care for everyone.

So what to do?  To cover everything under the sun requires hefty premiums.  But hefty premiums are not affordable.  There appears to be a paradox here.  And that’s because there is.  Because you can’t get more for less.  But Obamacare has a workaround for this paradox.  At least for the optics of Obamacare.

The Ultimate Goal of Obamacare may be to Fail to Clear the Way for Single-Payer National Health Care

There’s another part of health insurance.  The deductible.  The out-of-pocket portion of our health care expenses.  When insurance was truly insurance we paid for our routine health care expenses out-of-pocket.  We took our kids to the doctor for their vaccinations and the doctor billed us.  Then we paid the bill.  Using our insurance only for those catastrophic health problems that we couldn’t plan for.  Or budget for.  And it’s the deductible that makes Obamacare look more affordable than it is.  By making their deductible far exceed their premium.  So a lot of people pay into the pool but never collect from it.

Claims Individual and Family R1

In this example we look at some claims.  The money the insurance pool pays out.  The above numbers are net of the deductible.  So the annual claim per individual and family is money from the pool paying their bills.  Most people get little.  While the breakout with the fewest members have a catastrophic health care problem.  The total claims for this pool for both individuals and families come to $159,750,000.  While premiums total only $123 million at our adjusted premiums.  That’s a $36,750,000 shortfall.  Well, insurers can’t pay out more than they collect so they need to find another $36 million or so without making this affordable health insurance appear unaffordable.  So where can we find another $36 million?

By raising the deductible, of course.  If we raise the deductible for both individuals and families to $7,500 those claims at $7,500 or less are out-of-pocket.  They don’t come from the insurance pool.  If we add up the claims that become out-of-pocket they total $57,250,000.  More than enough to cover the shortfall.  As well as provide subsidies for the poor.  And all those new government jobs to run Obamacare.  With these higher deductibles AND higher premiums people will be paying far more for their health care than they did before.  Perhaps more than they can afford.  Thus making the Affordable Care Act unaffordable.  Which may be the ultimate goal of Obamacare.  To fail.  So the government can blame greedy insurers who the people will hate even more.  And setting the stage to get the people to acquiesce to a single-payer system.  Or national health care.  Which the left wanted all along.

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One Fifth of the NHS Budget set aside to pay for Poor Health Care Lawsuits

Posted by PITHOCRATES - July 20th, 2013

Week in Review

Britain’s aging population is playing havoc with the National Health Service (NHS).  More taxpayers are leaving the workforce than are entering it.  Leaving less money to pay for a growing number of retirees who are living longer.  Costs have grown so out of control that they are trying to find £20 billion ($30.54 billion) in efficiency savings over three years.  Perhaps the best way for them to do that would be to just improve the quality of their care (see ‘Jaw-dropping’ rise in NHS claims after scandals by Laura Donnelly posted 7/19/2013 on The Telegraph).

A total of £22.7 billion – nearly one fifth of the health service’s annual budget – has had to be set aside to pay compensation to thousands of people harmed by poor care…

In total, more than 16,000 patients lodged claims during 2012/13, compared with around 13,500 the previous year…

In December, 38 families were offered settlements from Worcestershire Acute Hospitals trust over a series of failings, including the case of a man who starved to death…

The highest individual pay outs are connected to NHS errors which have led to babies becoming brain damaged, with around 100 such cases occurring each year.

A man starved to death?  In a hospital?  How does that happen?  The man must be in a bed.  Nurses and doctors must look at the people occupying these beds.  Is there no chart showing what this patient ate?  And if nothing was written in under what the patient ate shouldn’t that have been a red flag that this patient didn’t eat?

I can understand trying to diagnose some diseases can be difficult.  For some diseases can be devious bastards.  Hiding deep with a patient’s myriad symptoms.  But hunger?

“Hello, random patient.  Bowels okay?”

“I haven’t had a BM in days because no one is feeding me.”

“Not feeding you, eh?  Well, we’d better do something about that?  Let me find your nurse.  She can give me the form to address that.  Then you’ll be right as rain, my good man.  Take care.  And do work on those bowel movements.”

The soothing warmth of red tape in a government bureaucracy.  Just makes you wish Obamacare would hurry up and get here already.

Forms.  Yes, forms.  Beautiful forms.  Filling in blanks.  Filing in triplicate.  The way health care was meant to be.  And the way it will be under Obamacare.

“Hungry?  Not to worry.  I have just the form here.  See?  Here we fill in what you ate.  And here we fill in what you passed.  Beautiful, yes?  And by studying the connection between the two we can fill another 1,000 positions in the health care authority.  Isn’t that wonderful?”

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Insurance and Risk Management

Posted by PITHOCRATES - April 2nd, 2012

Economics 101

By collecting a Small Fee from Many Policy Holders Insurance Companies can Afford to Pay for the Large Losses of a Few

Insurance has one purpose.  To protect wealth.  People work hard accruing wealth.  Buying a house.  Cars.  College fund for the kids.  Retirement 401(k)s and IRAs.  It takes a long time to earn the money that lets us have these things.  And they take a constant stream of payments to sustain them.  And we are always at risk of losing them.  Something can interrupt that stream of payments to sustain them.  An accident or illness that prevents us from working.  Burying us in a stack of unexpected bills.  A tree could fall onto the house during a bad storm.  You could total your car while driving to work in a thick fog.  A wife could lose her husband leaving her to raise their children on her own.

These are very real risks that we must manage.  Because we need to protect our wealth.  We buy house and car insurance so we can keep or replace our houses and cars because we can’t afford to buy new ones should we lose the old ones.  We buy life insurance to provide for our families should we die.  We buy health insurance so an accident or disease doesn’t wipe out our savings, college fund and retirement investments.  Because we do do these things we can manage the risks in life.  So that something unexpected and incredibly expensive doesn’t take everything away that we worked so hard for.

Managing our risks allows us to live our lives.  To plan for the future.  A future that has a price tag.  A future that takes a lifetime of accumulating wealth to pay for.  And to protect the wealth that provides for our families and our retirements we buy insurance.  Groups of people join together and pay a small fee for an insurance policy that will protect a very large amount of wealth.  So if we have an unexpected and very expensive event in our lives our insurance will protect our wealth by paying for our losses.  By collecting a small fee from hundreds of thousands of policy holders insurance companies can afford to pay for the large losses of a few.  Allowing life to go on.  As best as it can following these  unexpected events.  So even in the worst of events families can keep their homes.  Keep their kids in their schools.  Protect their kids’ future by keeping their college fund intact.  Replace their property.  Allowing life to go on as close to what it was before the event.  All thanks to insurance.

Bad Insurance Risks have an Advantage over Insurance Companies due to Asymmetric Information and Adverse Selection

Insurance companies provide this valuable service.  But it isn’t easy.  Because insurance isn’t a science.  But statistical analysis.  And risk analysis.  Which is how they determine the cost of their insurance policies.  A critical part for the survival of insurance companies.  So they can continue to provide this valuable service.

Insurance companies are at a disadvantage because of asymmetric information.  Meaning their customers know more about how great a risk they are than the insurance company.  For example, reckless drivers don’t offer that information when someone is quoting a policy for them.  For they want a low price.  Not a high price that reckless drivers normally get charged.  This is a problem mostly with young drivers.  Older drivers have a driving record.  If it’s a safe record they get a low quote.  If the record includes many points and at-fault accidents they will get a high quote.  Young drivers, though, don’t have a driving record yet.  This is where the statistical analysis comes in.  On average young men drive more recklessly than young women.  Based on the statistical evidence.  So they charge young men higher rates than they charge young women.  Problem solved.  But this causes another problem.

Not all young women are good drivers.  But by charging young women lower rates some bad women drivers are getting a rate lower than their risk warrants.  Which means insurance companies will lose money insuring these drivers at rates below their risk level.  In fact, this will attract more high-risk drivers.  Thus increasing an insurance company’s risk exposure.  And as they pay out claims that exceed the premiums they collect they have to raise insurance rates for all women drivers.  Thus discouraging some good drivers from buying insurance because of the higher premiums.  Thus increasing the percentage of high-risk drivers.  Which forces the insurance companies to raise their premiums again to cover these higher losses.  We call this problem adverse selection.  Where pricing plans to manage risk ends up increasing risk.  One way around this is by group coverage.  Like in health insurance.  Where everyone at a company buys insurance in exchange for a lower group rate.  Including the high-risk people.  And the low-risk people.  Thus avoiding adverse selection.

Economic Growth is the Creation of Wealth and our Insurance Protects that Wealth

When is insurance not insurance?  When it is health insurance.  At least as it is today.  It still acts like insurance for the unexpected and catastrophic accident or illness.  But it is anything but insurance for most everything else.  The latest example in the media these days being birth control.  Which is neither an unexpected nor a catastrophic expense.  For there are few expenses that are more expected and more affordable than birth control.  Unlike, say, chemotherapy.  Or trauma care in the emergency room.  Both of which are unexpected.  And very, very expensive.

When insurance pays for everything for everybody it is no longer managing risk.  Insurance companies are no longer collecting a small fee from all policy holders to pay for the large losses of a few.  Instead they’re collecting a large fee from everyone to pay for the costs of everyone.  Or more precisely, they’re collecting a large fee from the employers who provide health insurance to their employees.  So the recipients of all those free health care goodies don’t see their costs.  Which is how they’ve been able to include everything but the kitchen sink in today’s health care insurance policies.  Causing the price of health insurance to soar.  Hurting families.  Businesses.  And the economy as a whole.

A healthy economy allocates scarce resources to where we use them most efficiently.  When we do we create the most goods possible from these scarce resources.  Making society as a whole better off.  By improving the standard of living for society as a whole.  But by turning health insurance into a welfare program it increases the cost of doing business.  Which puts downward pressures on wages.  Preventing real wages from keeping pace with the rise in consumer prices.  Leaving workers with less disposable income.  Which translates into weak economic growth.  And a stagnant or declining standard of living.

Economic growth is the creation of wealth.  And our insurance protects that wealth.  When we convert that insurance into welfare, though, we put our wealth at risk.  By putting greater pressures on that stream of payments to sustain our wealth.  Our future plans.  And our families.

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Obamacare and H.R. 2 – The Perfect Match

Posted by PITHOCRATES - January 19th, 2011

When Healthcare Insurance becomes Welfare

Well, the Republican controlled House passed H.R. 2 (Repealing the Job-Killing Health Care Law Act).  But the Democrat controlled Senate is vowing to defy public opinion.  Harry Reid won’t even bring it up to a vote.  Probably because he’s afraid some of his Democrat colleagues worried about reelection in 2012 may vote to repeal it. 

So they’re rolling out the usual sob stories.  Repealing the bill will kill kids.  Plunge the country into a depression worse than FDR’s Great Depression.  You know, the usual stuff (see House votes on repeal of healthcare law by Michael A. Memoli, Washington Bureau, posted 1/19/2010 on the LA Times).

The move by House Republicans has spurred a vigorous defense of the law by many Democrats and the Obama administration, even as they were reluctant to do so in the fall campaign. They cited emotional stories of constituents who are benefitting from the law — particularly children who can no longer be denied insurance coverage for preexisting conditions.

Repeal, Democrats said, could cause more than 5 million Americans with preexisting conditions to be denied coverage, and add $230 billion to the deficit in the next 10 years.

Think for a minute why insurance companies exclude preexisting conditions.  Better yet, let’s say you own an insurance company.  You make money by collecting insurance premiums.  You pay claims out of those paid premiums.  Now, the key for this to work is that more people have to pay premiums than collect claims.  If not, you will run out of money and go out of business.  See?  It’s business.  Your income (paid premiums) has to be greater than your costs (claims).  Ergo the exemption of preexisting conditions.  If you didn’t exclude them, people would only buy insurance when they’re sick and need benefits.  Costs (claims) would be greater than your income (premiums).  And your insurance company would go out of business.

Allowing preexisting conditions.  It sounds nice.  In a touchy feely caring kind of a way.  But it will kill the insurance industry.  Then the government will have to step in and make healthcare insurance welfare.  Supported by an ever growing tax burden.  Like in every other nation with nationalized health care.  So they’re being a bit disingenuous by pulling on the old heartstrings.  Then they just flat out lie.

“Democrats have made a firm commitment that we would judge every proposal that comes to the floor by whether it creates jobs, strengthens the middle class, and reduces the deficit. The repeal of patients’ rights fails on all three counts,” House Minority Leader Nancy Pelosi (D-San Francisco) said before the vote.

The Economically Challenged:  Nancy Pelosi and her Constituents

What they call deficit reduction is a huge tax increase and a gutting of Medicare.  But raising taxes doesn’t create jobs.  If it did we would never cut them during bad economic times.  We cut them because lowering taxes creates jobs.  Even Obama admitted this in the big compromise to extend the Bush tax cuts.

When you kill jobs you crate unemployment.  With fewer people working there are fewer people paying taxes.  This is one of the reasons why we have record deficits now.  We have record unemployment rates that just go on and on and on with no end in sight.  (The other is the explosive government spending corresponding with this fall in tax revenue).  Making this problem worse will add to the deficit, not reduce it.

Higher taxes and unemployment and a reduction of Medicare benefits is not going to help anyone in the middle class.  It’s going to make their lives that much harder.  So Pelosi is wrong on all three counts.  Of course, it’s hard to blame her.  It must be the water in her district.  Makes people economically challenged.  For her constituents all think like she does.  At least the 80% or so that keeps voting for her.  No, passing H.R. 2 will be the best thing to happen to the middle class since the 2010 midterm elections.

Obamacare is so Good that it Insured the Uninsured – Even before it was Passed

And the lies keep coming.  This from Karen G. Mills, administrator of the Small Business Administration, on January 18, 2011.

Every day America’s entrepreneurs and small-business owners are finding more ways to access affordable health care insurance because of the Affordable Care Act. We have some very important data recently, which is that after years of dropping coverage, the number of small businesses offering health insurance to their workers is actually going up. This is according to the Kaiser Family Foundation: nine percent more small businesses with less than 200 employees provided coverage in 2010 compared with 2009, and for those with less than 10 employees, the expansion in coverage was even bigger. It was 13 percent.

Funny.  Because small business (and unions) have been asking for Mini-Med plan waivers.  Because the cost to comply with Obamacare would otherwise force some 1.5 million people off of their current health care plans.  So how does Ms. Mills reconcile this fact with the rosy statement above?  Why, you lie about polling results (see Small business and the health care repeal by Glenn Kessler posted 1/19/2011 on The Washington Post).

Mills, to her credit, cited her source, the Kaiser Family Foundation 2010 annual survey of Employer Health Benefits. And her statistics are correct. It’s just that they have nothing to do with the new health care law.

First, the survey was taken between January and May of last year, so much of the data was collected before the law even passed… Second, the Kaiser report specifically says the analysts were puzzled by the shift in small business figures, but were pretty sure it did not mean more firms were signing up to provide health insurance to their employees… “A possible explanation is that non-offering firms were more likely to fail during the past year, and the attrition of non-offering firms led to a higher offer rate among surviving firms.”… A third problem is that the data set for small firms is too small to be significant.

So the administrator of the Small Business Administration, Karen G. Mills, is making less than honest statements.  She’s saying that polling data shows Obamacare is already having a positive impact on small business.  With the poll numbers taken before the passage of Obamacare, this is just impossible.  It would appear that Ms. Mills, the Small Business Administration, is not a friend of small business.  Because she lied about the poll results.  Put the two together and one must conclude that Obamacare is not good for small business.  If not, why would she lie?

Yes, Nancy, Let’s Pass H.R. 2 to Find out what’s in It

Remember how they passed Obamacare.  Quickly.  With backroom deals (the Louisiana Purchase, the Corn Husker kickback, etc.).  And, of course, without reading it.  Nancy Pelosi said they’d have to pass it to learn what was in it.  Why?  Because they were afraid that if people knew what was in it the people would pressure their representatives and senators to not pass it.  What other reason could there be?

But in the new spirit of civility, let’s extend an olive branch to Nancy Pelosi.  Let’s follow her advice.  Let’s pass H.R. 2.  Then let’s see what will happen.  If the recession turns into depression, if the deficit continues to grow, then we’ll concede that she was right.  Then we can reinstate Obamacare.  Increase taxes.  Gut Medicare.  Ration health care.  And make this nation the liberal paradise they so long for.  But first let us pass H.R. 2 to see what’s in it.

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