It is appropriate that the Democratic leadership of the U.S. House of Representatives unveiled their latest attempt at health care reform shortly before Halloween. It has the countenance of a rather sinister looking phantom as it slowly begins to emerge from the mists of back door Congressional deals between special interests, Speaker Pelosi, and the Obama White House.
Even before the fog totally lifts to expose the full form of the legislation, it is obvious that some features that really would work to reign in costs of a new health care system are totally missing. Most obvious—and unsurprising—is the lack of any tort reform measures that would reduce the expensive practice of defensive medicine currently being practiced by medical service providers to reduce their exposure to expensive lawsuits.
The nation’s trial lawyers didn’t even have to work up a sweat to prevent any medical malpractice reform language from entering the House bill. The majority party that relies heavily on contributions from well-heeled plaintiffs attorneys successfully carried out its role as lap dog of the plaintiff’s bar and kept any vestige of tort reform out of the legislation.
Allowing health insurance to be purchased across state lines also failed to be included in the House version of the health care reform legislation. The Pelosi team has continually harped on the need to make sure that there is enough competition in the health insurance marketplace to keep the insurance companies honest.
Unfortunately, they don’t want that competition to be unleashed into the private sector. They prefer to create a public insurance option instead—one that will be directly or indirectly backed by the full faith and credit of the U.S. government and will have undeniable competitive advantages over the private sector.
What is very clear as the beast emerges from the mists is that Congress’s penchant for playing the taxpayers as fools is alive and well on the Potomac.
Pelosi and Company gleefully proclaimed that the cost for their legislation comes in slightly under $900 million and doesn’t add to the deficit. The validity of that claim was questioned immediately by those who pointed out that the House bill removes the $250 billion doctor and hospital “fix” that would prevent them from being exposed to the drastic Medicare cuts in reimbursement that the current law calls for.
In order to prevent an avalanche of opposition from those providers, the House leadership—in a testimony to cynicism—plans to introduce a separate bill to do the “fix.” The official scorer of the fiscal impact of legislation, the Congressional Budget Office, was not authorized to include the cost of the “fix” in the health care reform legislation since it is not in the health care reform bill. But it will happen and when it does it will result in a further expansion of the huge federal deficit.
Perhaps the most serious flaw—and there are many—in the House bill is the relatively small penalty individuals will have to pay if they do not purchase health insurance. If younger individuals only have to pay a relatively small penalty for not having health insurance, they will take the easy way out and simply pay the penalty. If they get seriously ill, they will then opt in. If the final legislation allows this option, higher premiums for the vast majority of the privately insured are inevitable.
The House bill is ill-conceived and scary. It is a witches’ brew of partisan politics and special interest favoritism. It needs to re-enter the mist and come back in a more fair and affordable form.
Wednesday, November 11, 2009
Sunday, November 1, 2009
Lord Action Was Right
The popular 19th century English nobleman, Lord Acton, is perhaps best remembered for the statement: “Power corrupts; absolute power corrupts absolutely.” History is littered with public figures that are appropriately described by those words. Considering some of the shenanigans going on with the health care legislation in Washington, Senate Majority Leader Harry Reid can certainly be added to the list.
There is no doubt that Reid is in a tough spot. President Obama has stacked up a huge pile of political poker chips, betting on a winning hand on health care reform. He will be harmed politically if he loses, and his fellow Democrats in Congress will feel the collateral damage. But it is not easy to muster the votes necessary to make significant changes to one-sixth of the U.S. economy—as Harry Reid has learned. Adding to Reid’s difficulties is the fact that he has to run for re-election next year, and polling data indicate that he is far from being a shoo-in.
The last thing Reid needs is to be a major factor in passing legislation that will push the crumbling budget of the State of Nevada further into the abyss. One of the central features of the proposed legislation could do just that. It would allow millions of individuals whose income levels currently preclude them from qualifying for Medicaid to meet eligibility requirements for the program. But there is a rub: states must put up a five percent match to help cover the additional costs.
Reid has made no bones about what he plans to do to avoid any political fallout back home. He has stated unequivocally that he will not allow a health care bill to come to the floor if it increases Medicaid costs for Nevada. He seems to be getting his way. The Senate Finance Committee bill would exempt four states—Michigan, Oregon, Rhode Island, and (yes) Nevada—from the requirement to pay the five percent funding match. The alleged justification for making the exception is that those states have been the hardest hit by the recession.
The Senate should rebel against Senator Reid feathering his own nest.
Other states shouldn’t have their budgets savaged by another huge unfunded mandate coming down from Washington while watching Reid and a handful of his cronies grin like bandits counting their loot. If states are going to have to be fiscally penalized to make the numbers work for the health care reform legislation, then all states should have to bear the burden.
The health care reform debate is starting to focus attention on what happens when arrogance meets partisanship. It is almost impossible to pass legislation that will cover all of the uninsured, reduce the overall cost of health insurance, and “not add a dime” to the deficit as President Obama promised. There are going to be winners and losers—and some very big losers—if the legislation passes. The likely losers will be young Americans and healthy policy holders who will have to pay much higher costs to insure or subsidize the elderly, the uninsured, and individuals with health problems or unhealthy life styles.
The main science driving the health care debate at this juncture is political science. After watching the political class making hash out of health care legislation, voters might want to ponder another quote from Lord Acton: “It is easier to find people fit to govern themselves than people to govern others. Every man is the best, the most fit judge of his own advantage.”
Senator Reid is living proof of the wisdom in those words.
There is no doubt that Reid is in a tough spot. President Obama has stacked up a huge pile of political poker chips, betting on a winning hand on health care reform. He will be harmed politically if he loses, and his fellow Democrats in Congress will feel the collateral damage. But it is not easy to muster the votes necessary to make significant changes to one-sixth of the U.S. economy—as Harry Reid has learned. Adding to Reid’s difficulties is the fact that he has to run for re-election next year, and polling data indicate that he is far from being a shoo-in.
The last thing Reid needs is to be a major factor in passing legislation that will push the crumbling budget of the State of Nevada further into the abyss. One of the central features of the proposed legislation could do just that. It would allow millions of individuals whose income levels currently preclude them from qualifying for Medicaid to meet eligibility requirements for the program. But there is a rub: states must put up a five percent match to help cover the additional costs.
Reid has made no bones about what he plans to do to avoid any political fallout back home. He has stated unequivocally that he will not allow a health care bill to come to the floor if it increases Medicaid costs for Nevada. He seems to be getting his way. The Senate Finance Committee bill would exempt four states—Michigan, Oregon, Rhode Island, and (yes) Nevada—from the requirement to pay the five percent funding match. The alleged justification for making the exception is that those states have been the hardest hit by the recession.
The Senate should rebel against Senator Reid feathering his own nest.
Other states shouldn’t have their budgets savaged by another huge unfunded mandate coming down from Washington while watching Reid and a handful of his cronies grin like bandits counting their loot. If states are going to have to be fiscally penalized to make the numbers work for the health care reform legislation, then all states should have to bear the burden.
The health care reform debate is starting to focus attention on what happens when arrogance meets partisanship. It is almost impossible to pass legislation that will cover all of the uninsured, reduce the overall cost of health insurance, and “not add a dime” to the deficit as President Obama promised. There are going to be winners and losers—and some very big losers—if the legislation passes. The likely losers will be young Americans and healthy policy holders who will have to pay much higher costs to insure or subsidize the elderly, the uninsured, and individuals with health problems or unhealthy life styles.
The main science driving the health care debate at this juncture is political science. After watching the political class making hash out of health care legislation, voters might want to ponder another quote from Lord Acton: “It is easier to find people fit to govern themselves than people to govern others. Every man is the best, the most fit judge of his own advantage.”
Senator Reid is living proof of the wisdom in those words.
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