Tom Daschle (who was almost HHS Secretary) weighs in on Obamacare

Posted by PITHOCRATES - January 22nd, 2011

Daschle:  Let us Build on what Unites Us

Tom Daschle would have been on point for Obamacare if he didn’t have some IRS issues.  Health care reform was to be his baby.  He was going to be secretary of Health and Human Services (HHS).   But, alas, it was not to be.  So he is keen in seeing Obamacare remain in law.  Health care is his spécialité.

Though out of the Senate these days, he is still finding a forum for his voice.  The New York Times.  He gives some talking points to President Obama for his state of the union address.  For he thinks there is a lot of agreement on health care reform in general.  And that there are just some minor disagreements on some specifics (see The Final Health Care Debate by Tom Daschle posted 1/22/2011 on The New York Times).

“Let us build on what unites us — by constructing marketplaces for health insurance that offer greater choice at less cost; creating organizations that coordinate care efficiently and bring down the unacceptable rate of medical mistakes; continuing to encourage scientists to find new ways to prevent and cure disease; and empowering cities and counties to develop new solutions to the perplexing problems of health care in America now.

Constructing marketplaces for health insurance that offer greater choice at less cost?  As far as the market place, there’s an easier way to accomplish that.  Just let insurance companies compete across state lines.  They could right now and make health care more affordable.  If it wasn’t for a law preventing them from competing across state lines.

Unacceptable rate of medical mistakes?  Actually, there are fewer mistakes in a private health care system than a public one.  Because private enterprises are accountable.  Government isn’t.  The bigger problem out there increasing health care costs is the cost of litigation.  Tort reform would go a long way in reigning in costs.  A simple ‘loser pays’ would prevent most of the frivolous suits.  Or perhaps some sort of bonding requirement for law suits.  Highly suspect lawsuits would require a high bonding and discourage it from proceeding.  A very legitimate case would require a low bonding and numerous non profits would probably pick that up pro bono. 

Encourage scientists to find new ways to prevent and cure disease?  We already have that.  We call it the patent system.  It encourages private enterprise to pour bazillions of dollars into research and development to find those preventions and cures.  And in return for that huge investment, they get an exclusive patent on the pills they create.  That’s why those pills are so expensive.  Because we give patents to help people get rich by working miracles in modern science.  We call that an incentive system.  And this incentive system is working so well that Medicare and Social Security are going broke.  Because people are living longer than anyone every anticipated.  Thanks to those miracle pills.

Empowering cities and counties?  Why, that’s going in the other direction of a national solution, isn’t it?  Obamacare is centralizing, not devolving.  Like the British did.  When they nationalized their health care.  Of course, these days, the Brits are backtracking a bit.  Now they’re trying to devolve power to the cities and counties.  Because their national solution isn’t working all that well.

Is there Enough Bipartisanship for a Bipartisanship Commission?

No, we’re not as united as Mr. Daschle would have us believe.  The Republicans see little in Obamacare they want to save.  Especially with that mandate from the 2010 midterm election to overturn Obamacare.  So there is little point in having a sit-down with both sides to discuss ways of saving Obamacare.  But that’s exactly what Mr. Daschle suggests.

“To that end, I propose that we create a bipartisan commission to examine the best ways to carry out, oversee and, where appropriate, revise the health care reform law. Made up of members of Congress, governors and members of my administration, this commission would provide invaluable guidance and solutions going forward.

Again, he’s offering these words for President Obama.  A bipartisan commission?  I’m not sure what the point of that is when there is little bipartisan support for Obamacare.  Congress passed Obamacare when Democrats held majorities in both the House and the Senate.  Pretty much along party lines.  Now that the Republicans have resumed majority power in the House, the House voted to repeal Obamacare (H.R. 2).  But the Democrats still hold the Senate.  So the repeal may not make it through the Senate.

Bipartisan?  There’s nothing bipartisan about Obamacare.  Never has been.  And never will.  To think so is only wishful thinking.  Or a grasping of straws.

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Health Care and the Deficit: Government Bureaucracy vs. Market Forces

Posted by PITHOCRATES - December 12th, 2010

Birth Control and Abortion Bankrupting our Nation

Health care is expensive.  When it comes to the federal budget, nothing costs more.  And its cost will only increase (see Health Care and the Deficit editorial published 12/11/2010 on The New York Times).

This year, Medicare, Medicaid and a related children’s health insurance program will account for more than 20 percent of all federal spending — higher than Social Security or defense. Unless there are big changes, by 2035 federal health care spending — driven by rising medical costs and an aging population — is projected to account for almost 40 percent of the budget.

Politicians are whores who steal from the American people.  Earmarks, kickbacks, patronage, fat pay and benefit packages, uber generous pensions, whatever.  The bottom line is that they’re screwing us while they live a far better life than we ever will.  And as bad as their screwing of us is, their screwing of us ain’t the worse of it.  It’s the entitlement spending that’s gonna bankrupt us.  Especially healthcare spending for old people.

Thanks to birth control and abortion, the American people shrunk their family size starting with the boomer generation.  Instead of 10 kids in a family we started to have only 2 or 3 kids.  And it is this reduction in family size that will ultimately bankrupt our nation.

Cutting Medicare Because Nothing else is Big Enough to Cut

Thanks to birth control and abortion, we have an aging population.  The kids of families with 10+ kids are aging and reaching retirement.  But the kids of families with 2-3 kids are paying their Social Security and Medicare benefits.  More people are collecting benefits than are paying taxes to fund those benefits.  BIG problem.

When FDR implemented the great Ponzi scheme, Social Security, a bunch of people were supporting each beneficiary.  As the population ages, fewer and fewer people are supporting each beneficiary.  So they have to keep raising taxes on each individual.  But there is a limit.  Eventually, an individual will have to pay more in taxes to support a retiree than they spend on their own family.  And few people will whistle a happy tune when more of their hard-earned pay goes to someone else instead of their own family. 

If we’re not having more babies, then we gotta cut costs.  There’s no ifs, ands or buts about it.  So they’re talking about cutting costs.  By making us pay more for our benefits.

The White House commission, headed by Erskine Bowles and Alan Simpson, proposes to wring nearly $400 billion from health care spending between 2012 and 2020, of which the biggest single element — $110 billion — would come from increased cost-sharing by Medicare beneficiaries. The second commission, an independent panel headed by Pete Domenici and Alice Rivlin, seeks to save $137 billion from Medicare cost-sharing.

So even though Obama denied it over and over again, they’re going to cut Medicare.  Why?  It’s the 800 pound gorilla in the room.  To make any significant cost savings you gotta cut something big.  And few things are bigger than Medicare.

Taxing our Health Care Benefits

They’ll cut Medicare.  And raise taxes.

The Domenici-Rivlin panel, the more aggressive on health care, would also phase out the exclusion that exempts workers from paying taxes for employer-subsidized insurance, a benefit that also encourages excessive use of medical care. The long-term gain in tax revenue could be huge — more than $3 trillion between 2012 and 2030 and almost $10 trillion by 2040.

Few people don’t realize how much their employer pays for their health insurance.  They will now.  Though they won’t be getting a big pay raise, they will pay taxes as if they had.  That’s right, they will tax the total cost of your health care benefits as taxable income.  Even if you never see a doctor.

Wither on the Vine

You know things are bad when they propose something their enemy once proposed.

The Domenici-Rivlin panel has a far-reaching proposal to give Medicare enrollees vouchers to buy coverage from Medicare or a competing private plan offered on a Medicare exchange. The voucher would increase in value at roughly half the likely rate of medical inflation. If the cost of coverage rose faster than that, the beneficiary would have to pay an extra premium to cover the difference or seek a cheaper plan.

Sound familiar?  Newt Gingrich proposed this.  Back in the 1990s.  He said that as more people voluntarily enrolled in private insurance Medicare would wither on the vine.  Of course, the political opposition said Gingrich was just trying to kill senior citizens.  So his proposal was defeated.  And here we are.  Same problem.  Only more costly to solve now.

Competition Makes Everything Better

The big problem with health care is that there is no competition.  No market forces.

The commission believes that competition on the exchanges will cause insurance plans to find ways to lower premiums. It also believes beneficiaries will restrain their own spending. The panel projects savings from premium support and its near-term cuts and cost-shifting could be huge — more than $2 trillion through 2030 and more than $7 trillion through 2040.

Competition makes everything better.  And there’d be more competition now.  If the government didn’t forbid it.  For it is the government that forbids insurance companies from competing across state lines.

Can you Say Death Panels?

A spending cap is just another way to say rationing. 

The health care reform law already seeks to cap the growth in Medicare spending per beneficiary to roughly half the rate it has been increasing in recent decades. It empowers a new board to find savings should the target be breached, subject to Congressional veto. The Bowles-Simpson commission would expand that approach by placing a cap on total federal spending for health care — not just Medicare and Medicaid but the subsidies on new exchanges and tax exemptions. But the commission punts on what to do should the growth cap be exceeded, as many experts deem likely.

This board will have the power of life and death.  They will say who will live.  And who will die.  They can deny it but that’s what rationing is.  We have enough healthcare services for one person today.  Who will get it?  The 39 year old factory worker who has many taxpaying years left (so the government can recoup its ‘investment’)?  Or the old retired guy?  Hmm.   The old retired pain in the ass who won’t hurry up and die?  Or the young guy that we can squeeze more taxes out of for another 20 years or so?

Cut Out the Middle Man

They have big hopes for Obamacare.

The best way to lower health care spending is to reform the dysfunctional health care system whose costs seem unrelated to the quality of care delivered. The reform law makes a good start, sponsoring research to determine which treatments are effective and which are not, starting pilot projects to change the way care is delivered and paid for, and setting up new organizations to rush successful approaches into wide use in Medicare and ultimately the private sector.

The problem with health care is that we approach it from a cost standpoint rather than a quality of care standpoint.  No law or board will change that.  Real competition would.  Such as allowing insurance companies to compete across state lines.

One thing not mentioned by the New York Times is tort reform.  If we keep the jackals off of the doctors, they can spend more time administering health care instead of enriching ambulance chasers.

Perhaps the greatest cost control measure we can take is to cut out the middle man.  Have people pay for the services they receive.  Health care insurance is supposed to be insurance.  Not welfare.  It is to protect us from unexpected catastrophic medical expenses.  Like cancer.  Not to pay for a doctor appointment because we have the sniffles.

We Need more Market Forces.  Not more Government.

Increasing the size of a bureaucracy never made anything more efficient.  Price caps never made anything more plentiful.  And having someone else pay your bills never gives you the best quality.  That’s why we say beggars can’t be choosy.  Because we give beggars crap.

To fix our health care insurance woes we need to introduce market forces.  Not more government.  Medical savings accounts and tort reform would go a long way in fixing our problems.  As will competition across state lines.  And, of course, repealing Obamacare.

And we need to pay for our health care services.  For when we pay we seek the best value for our money.  Because we give a damn.  Unlike a disinterested government bureaucrat.

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