We Stand FIRM

Thoughts From Lucidicus and Grandpa Munster

2010-03-20T16:05:00.000-06:00

10 years from now: "Daddy, when they tried to take over medicine, did you fight it?" Yes, we sure did.

I support ObamaCare.

Mainly, because I'm already dead, have nothing to lose, and haven't paid taxes in 200 years.

Watts LTE in Denver Post

2010-03-20T00:05:00.002-06:00

The March 19, 2010 Denver Post printed the following LTE by Richard Watts responding to Dan Haley's column on the Congressional contortions to pass ObamaCare:

The transfer of taxpayers' wealth

Dan Haley notes the congressional health bill is "larded up with special deals and gross kickbacks." True, but the bill is not merely wrong because of added pork. National health care is inherently wrong because it forcibly transfers wealth. Sure, it's immoral for Congress to take some people's money and shovel it to others as pork. But why? Because the money belongs to those who earned it, not to Congress, nor to anyone who accepts the loot.

If done in the private sector, such activities are known as theft, robbery and receiving stolen goods. These are just as wrong if government perpetrates them, and worse -- because it is government's responsibility to defend people's rights.

Richard Watts, Hayden

Regardless of how the big vote in Congress turns out this weekend, I'd like to thank Richard for this fine LTE which cut right to the heart of the issue. Richard has been a stalwart supporter of FIRM from the very beginning, when Lin Zinser founded it in January 2007.

Caterpillar and Congress

2010-03-19T11:59:00.000-06:00

More "money and power" links:

Money: "Caterpillar Inc. said the health-care overhaul legislation being considered by the U.S. House of Representatives would increase the company's health-care costs by more than $100 million in the first year alone."

(The last thing we need in a depression is more job-killing government regulations. Link via @LyndsiM.)

Power: "Challenges Could Drag Out Health Bill Votes"

(Even if Pelosi wins the vote this Sunday, there are several legislative obstacles that could potentially still derail ObamaCare.)

Money and Power

2010-03-19T00:15:00.002-06:00

Two quick political updates on ObamaCare.

Money:
"Five Reasons The CBO Figures Are Phony"
Ed Carson, Investor's Business Daily, March 18, 2010

(Gee, maybe it's going to cost more than the much-ballyhooed $940 billion...)

Power:
"Projections from the House's 'deem to pass' roll call"
Michael Barone, Washington Examiner, March 18, 2010

(After all the arm-twisting, Pelosi still might not have enough votes...)

Zawistowski LTE, Rhoads OpEd

2010-03-19T00:05:00.005-06:00

Stella Zawistowski of ReasonPharm had a nice LTE published in the New York Times on President Obama's recent trip to Ohio to promote his health care plan (3/18/2010 edition, 4th one down):

President Obama is resorting to Natoma Canfield's sad story and saying that "every argument has been made" because he has not answered so many arguments against his plan. How, for example, when an insurance mandate has failed spectacularly in Massachusetts, will it work times 50?

I, too, feel sorry for Ms. Canfield, an uninsured woman with leukemia. But that does not justify brushing aside the facts and increasing government intervention in health care.

In fact, it is government intervention that places individually purchased insurance out of Ms. Canfield's price range in the first place.

Feelings of pity, however strong, must not get in the way of a reasoned debate. The only way to help Ms. Canfield and other Americans get health care is a fully free market.

Stella Zawistowski

Jared Rhoads of the Lucidicus Project has a new OpEd, "21 musings before the vote". Here are a few choice items:

2. According to preliminary numbers from the Congressional Budget Office, health reform will cost an estimated $940 billion. I'm sure we will see people proffer calculations of what that comes to for every man, woman, and child in the nation. But remember to multiply that figure by at least two in order to get your share, because over 40 percent of Americans pay no income tax.

8. The same people who advocate taxpayer-funded incentives for "healthy lifestyle decisions" also support disassociating risk from insurance pricing through community rating. Wouldn't risk-based pricing be the best incentive of all, and save us the IRS middleman?

14. A good test of a person's values these days is to bring up the Tea Party movement. Anyone can disagree, but if he calls it "astroturf" or uses the "teabag" epithet, then run the other way. You have nothing to gain from dealing with such a person.

(Read the full text of "21 musings before the vote".)

Hsieh OpEd in PJM: "ObamaCare vs. the Hippocratic Oath"

2010-03-18T04:00:00.004-06:00

PajamasMedia has just published my latest health care OpEd, "ObamaCare vs. the Hippocratic Oath".

My theme is that ObamaCare would fatally compromise doctors' ability to uphold their Hippocratic Oaths to treat their patients according to their best judgment and ability.

This is adapted from my forthcoming article in the Spring 2010 issue of The Objective Standard. I'd like to thank Craig Biddle for giving me permission to excerpt and adapt more than the usual 600 words from that article to use in this PJM piece. In exchange, PajamasMedia included a link back to the TOS website at the end of this piece.

(Disclaimer: No one at TOS reviewed this PJM piece before publication. Hence, the responsibility for any errors or awkward formulations is purely mine.)

Here is the introduction:

ObamaCare vs. the Hippocratic Oath

President Obama's health care "reform" plan has been criticized for being economically unsustainable, politically unpopular, and constitutionally suspect. But for many practicing physicians like myself, his plan contains an even greater but seldom-discussed flaw that overshadows those others. ObamaCare would fatally compromise doctors' ability to uphold their Hippocratic Oath to treat their patients according to their best judgment and ability.

Whenever the government attempts to guarantee "universal health care," it must also control that service, if only to control costs. Hence, it will inevitably seek to control how doctors practice. Accordingly, the White House Council of Economic Advisors has recommended controlling costs through "performance measures that all providers would adopt." Physicians who strayed too far from government "comparative effectiveness” practice guidelines would be punished as "high end outliers."

This will place your doctor's medical conscience directly on a collision course with government bureaucrats...

(Read the full text of "ObamaCare vs. the Hippocratic Oath".)

Quick Links: Coburn, Turner, Carney

2010-03-18T00:05:00.004-06:00

U.S. Senator Tom Coburn, M.D., tells us that "ObamaCare is Malpractice" (Yahoo! News, 3/17/2010).

Grace-Marie Turner recaps "The Failure of RomneyCare" (Wall Street Journal, 3/16/2010)

Tim Carney describes how drug-industry lobbyists are trying to influence the proposed government controls in their favor in exchange for throwing their weight behind ObamaCare. (Washington Examiner, 3/17/2010.)

Objectivists Speak Out Against ObamaCare

2010-03-17T19:45:00.005-06:00

On his Facebook page, Andrew Bernstein makes this stirring pledge against ObamaCare:

"If the government takes over health care, I will refuse to buy their package, refuse to pay the fine imposed, and make them arrest me. I will broadcast my refusal to cave to socialism on my website, on Facebook, to my students, in my lectures, and on the radio. I will fight this in the courts--or will the DC Fascists suspend the right to trial by jury? I suspect--and hope--that millions of Americans will do the same."

Jared Rhoads of the Lucidicus Project has a new OpEd, "All Talk, No Debate".

Don Watkins of the Ayn Rand Center for Individual Rights discusses the basic moral issue, "You Are Not Your Brother's Health Care Provider".

Jeff Scialabba of the Ayn Rand Center for Individual Rights discusses: "Obama's Flawed Prescription for Health Care".

Reminder: It may be illegal in some circumstances to advocate someone else perform an illegal act. (I am not a lawyer and have no specialized knowledge about this.)

Note that Bernstein is announcing what he plans on doing (in the tradition of American civil disobedience to unjust laws). He also says he suspects and hopes others will also make a similar decision, but he does not explicitly advocate that other break the law.

Here at FIRM, we do not advocate that others perform violent illegal acts.

Americans Still Don't Want ObamaCare

2010-03-17T12:10:00.000-06:00

PajamasMedia is reporting on a new survey conducted in partnership with the Center for Medicine in the Public Interest Advance (CMPI-A) showing that "Americans Really, Really Do Not Want ObamaCare".

In particular, a majority of Americans have deep concerns about both the substance of the proposed law as well as the process being used to pass it.

For details, see "Americans Really, Really Do Not Want ObamaCare". (Via @LyndsiM.)

If you want to know where your congressman stands, the Washington Post has a nice infographic showing their current position as well as how they voted back in November 2009.

In Praise of Retail Health Clinics

2010-03-17T00:15:00.000-06:00

Ed Morrissey discusses the virtues of retail health clinics, showing how the proper free market incentives lower costs while preserving quality of care.

Here's an excerpt from "Retail health care and reform":

What are "retail health clinics"? Chances are, you've already seen them. These clinics have begun rapidly spreading to malls, big-box retail stores such as Wal-Mart and Target as concessionaires, and drug stores like Walgreens. Instead of hiding behind insurance co-pays, the clinics offer pricing up front to consumers, so that they can decide for themselves what to "buy" and how much they want to pay for service.

This is the same mechanism that works to keep prices down and supply consistent in other areas of health care that insurance plans do not traditionally cover. For instance, cosmetic surgery and Lasik rely entirely on consumer compensation. There are no third-party payers to get in the way of rationally allocating resources to demand. In those markets, producers and consumers find each other in the normal manner, advertising, discounts, and price competition, and the market attracts new providers when scarcity appears and prices rise.

As one would expect, the price transparency creates incentives for patients to shop prudently. Studies show that patients do exactly what, saving money without compromising the quality of care.

This has important implications for the broader health care debate, Morrissey notes:

Given the realities of pricing and competition, we should reform the health system not by building more all-encompassing insurance plans, but by returning health insurance to its rational place: as a bulwark against catastrophic loss. If consumers bought health-care services in a rational market, the price for the overwhelming majority of transactions would be well within the money we would recoup from ending comprehensive coverage policies.

People with pre-existing conditions, such as myself, could access catastrophic coverage a lot easier if insurers didn't have to pay for all of the maintenance services required. Prices would drop to a rational level where almost all families could afford coverage. Government regulation could protect consumers from suffering rejection and cancellation much as they do now.

[Emphasis mine. - PSH]

In the meantime, providers would get properly compensated, which would create growth in supply, especially in family practice, which faces a serious provider shortage.

If we want to reform care, bend the cost curve downward, and promote supply in the health-care industry, we need to learn the lesson from retail health clinics. The top-down reform proposed by Congress threatens to stop real reform and amplify everything that's currently wrong with the system.

(Read the full text of "Retail health care and reform".)

More Doctors Going Galt

2010-03-16T21:30:00.005-06:00

The New England Journal of Medicine (hardly a right-wing rag) reports a recent poll showing:

46.3% of primary care physicians (family medicine and internal medicine) feel that the passing of health reform will either force them out of medicine or make them want to leave medicine.

24% of physicians think they will try to retire early if a public option is implemented.

21% of physicians would try to leave medicine if a public option is implemented, even if not near retirement age at the time.

(Via @BradMD.)

Maybe our politicians need to read Brian Schwartz's talking points on why ObamaCare is wrong and won't work.

Update: Thank you, HotAir, for the link!

Update 2: The NEJM has updated the text of the page to reflect that the poll data comes from The Medicus Firm.

They note:

The opinions expressed in the article linked to above represent those of The Medicus Firm only. That article does not represent the opinions of the New England Journal of Medicine or the Massachusetts Medical Society.

Two Doctors Speak Against ObamaCare

2010-03-16T00:15:00.001-06:00

Two doctors speak out against ObamaCare in these videos from Docs4PatientCare.org.

Dr. Fred Shessel tells his patients: "You know, under ObamaCare I may not be able to take care of you to the best of my ability, or I am may not be able to see you at all."

Dr. Scott Barbour warns us: "There's gonna be only one choice for the government and that's gonna be to severely ration your care."

Let your Congressman know what you think, especially if he or she is one of these critical swing votes.

(Links via Bradley Hennenfent, MD.)

Hsieh in GCC: "What America Needs to Know What’s at Stake with Obama Care"

2010-03-16T00:05:00.004-06:00

The Gold Coast Chronicle, a Florida-based publication, recently solicited opinion pieces from physicians opposed to ObamaCare. I'm glad to report that on March 15, 2010, they published my piece, "What America Needs to Know What’s at Stake with Obama Care". (Title theirs.)

Here's the opening:

President Obama is now determined to ram his health care bill through Congress by any means necessary, despite the fact that it will drive the government hundreds of billions of dollars further into debt and despite the fact the polls consistently show a majority of Americans opposed to his plan.

Why is this?

In a speech to Congress, he piously declared that health care was "a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."

President Obama is right, but not in the way that he means. Thousands of Americans at Tea Parties across the country have rallied precisely to oppose the fundamental principles behind the President's plan.

These protests were not just about health care, but about the proper scope of the government -- and ultimately, the future of America...

(Read the full text of "What America Needs to Know What’s at Stake with Obama Care".)

This is an updated version of my October 1, 2009 Denver Post piece, "The Real Stakes", republished with the consent of both papers.

Quick Links: Protests, HSAs

2010-03-15T22:00:00.001-06:00

On March 16, 2010, Tea Party activists from across the country will converge on Washington, DC to rally against ObamaCare.

Dr. Evan Madianos explains, "How to Protest ObamaCare Nationwide in Front of Your Local Hospital".

Jared Rhoads of the Lucidicus Project urges all Americans concerned about their future health care to, "Hold A Sign and Speak Out".

Ron Bachman of the NCPA warns that the proposed ObamaCare legislation could severely limit (or effectively kill) Health Savings Accounts. Read more in his March 5, 2010 paper, "Congress Declares War on HSAs".

Interviews With Dr. Milton Wolf

2010-03-15T00:05:00.006-06:00

Dr. Milton Wolf has been giving interviews explaining his opposition to ObamaCare.

Here is Part 1 of his March 11, 2010 interview with PJTV:

Here is Part 2, which contains the more substantial policy discussions, including some excellent free-market reforms:

Here is his March 12, 2010 appearance on "Fox & Friends":

Dr. Wolf also blogs at The Wolf Files.

Here's the March 11, 2010 Washington Times OpEd that vaulted him into national prominence: "WOLF: Obama family health care fracas".

Thank you, Dr. Wolf, for speaking out for American patients and doctors, as well as for American principles of freedom and individual rights!

Health Care Endgame

2010-03-14T14:15:00.008-06:00

This upcoming week will be the critical week in the health care fight. Speaker Pelosi is expected to start the process for the House to hold its final vote to approve the Senate bill. The vote will probably take place at the end of this upcoming week.

Right now, they are probably still a few votes shy of the majority they need:

"Dem House vote-counter lacks health care votes now"
Associated Press, 3/14/2010

"Can Nancy Pelosi Get the Votes?"
Michael Barone, Wall Street Journal, 3/11/2010

This is an extremely risky move by the Democrats. Normally, a Speaker wouldn't plan on voting on such major legislation unless he or she was sure of having enough votes.

But the Democrats are also (correctly) concluding that time is not on their side. They have made the calculation that if they push for it now, then maybe then can squeeze out the last few votes via a combination of political carrots and sticks. For example, they have "sweetened" the deal for the wavering moderates by promising billions of dollars of new student loan subsidies.

On the other hand they recognize that if they wait much longer, then when these wavering Congressmen go back home for the Easter recess, they will get an earful from their constituents who are strongly opposed to the bill, and they'll lose even more support.

Hence, from the Left's perspective, it's now or never.

If you (like me) support free-market health reforms, this means three things:

1) We are winning. We have a chance to defeat this terrible bill.

In particular, do not uncritically accept the inevitable news stories about how the Democrats are "close to getting the votes" or how Pelosi is "confident she'll have the votes". She has to exude an aura of public confidence, otherwise her coalition will quickly unravel.

Polls repeatedly show Americans opposed to ObamaCare:

"Why Obama Can't Move the Health-Care Numbers"
Rasmussen and Schoen, Wall Street Journal, 3/9/2010

Similarly, head counts of House Democrats also show that they don't quite have enough votes yet:

"Scrambling for votes, Democrats face uphill climb to pass healthcare reform"
The Hill, 3/13/2010

"The Hill's 'Whip Count' on ObamaCare –- as of 3/13/2010"

If they had the votes, they'd have already passed it by now.

2) We must keep up the pressure.

The Democrats are pulling out all stops to find some way to get this through now, before the critical Easter recess.

At this point in time, the single most important thing you can do is contact your Congressman and tell him or her what you think:

http://www.usa.gov/Contact/Elected.shtml

This is especially important if your Congressman is one of the undecided or swing votes on these "Code Red" lists:

http://www.nrcc.org/CodeRed/targets/
Tea Party Patriots Code Red Alert

Even if your Congressman is a firm "Yes" and you disagree, it's still important to let them know where you stand. If even the liberal Democrats from "safe" seats consistently hear that their constituents are against it, it will give the wavering moderates more political cover to vote "No". They can then tell Pelosi, "Even your constituents hate this thing -- there's no way I can support it".

*** Our counter-pressure is our best weapon against the pressure that the statists will exert on these wavering Congressmen. ***

Your letter doesn't have to be long or eloquent. It just has to convey certainty, passion, and moral conviction. One short letter that I've seen against ObamaCare runs something like this:

"Please vote NO on this terrible health care plan! If you vote yes, you will destroy the ability of me and my family to receive good health care in the future. This is personal! If you vote yes, we will never forgive you for hurting our lives and trampling on our basic freedoms."

(Of course, you should express your opinion in a fashion that reflects your own style and values.)

Feel free to use all contact methods -- phone, fax, and e-mail. And please feel free to contact them multiple times over the upcoming week. In this context, repetition is a virtue!

And of course if you agree with your Congressman's position, then thank him or her. They also need our moral support.

3) If you have friends or family in other parts of the country, tell them to contact their Congressmen.

If you need intellectual ammunition for them, one of my personal favorites is from the AFCM website:

"Fifty Fallacies About Health Care" by Richard Ralston

Jared Rhoads' Lucidicus Project also has a good set of OpEds.

And of course, FIRM has its archive of articles and OpEds.

I personally think that the most important thing we can do in the next few days will be to directly contact our Congressmen and have friends/family do the same. LTEs and OpEds will still be important, but not as much as before. (That said, I'm still going to continue writing and/or disseminating some of my earlier writings to people I know around the country.)

This is the endgame, folks. Most political observers regard the health care bill as a 50-50 "toss-up" or "too close to call". It really could go either way. What happens this week will determine the course of this great country (for good or for ill) for decades to come.

Your voice could be the critical difference in swaying the right one or two minds. If you value your lives and your freedom, the time to speak up is now!

(Anyone is welcome to forward or repost this to any appropriate recipients or venues.)

Hennenfent on Death Panels

2010-03-13T11:35:00.000-07:00

Dr. Bradley Hennenfent has been blogging up a storm lately.

In this recent post, he warns "'Death Panels' are Real and Exist Now":

Please stop ObamaCare. I have seen the "death panels." They are Medicaid, Medicare, and the Veterans Administration. They share one thing in common, they are run by the government. The "death panels" are government bureaucrats who come between you and your physician and, after being fiscally incompetent, ration, delay and deny care.

He also correctly warns against private insurers who have illegitimately achieved their dominant position in our marketplace via "crony capitalism" engaging in similar practices against patients and physicians.

In a related post, Dr. Hennefent quotes James Schott:

...[J]ust because the bill does not say specifically 'in our socialized medicine system there will be death panels' doesn't preclude a mechanism evolving that will make life and death decisions based on budget considerations, nor does it mean that the system won't become one where private health insurance cannot survive against the government's monopolistic tendencies, and in a few years we will have socialized medicine.

Both Dr. Hennenfent and Mr. Schott are completely correct on this important issue -- and we have been duly warned.

If you want to stop ObamaCare, call your Congressman.

The upcoming vote will be extremely close. If your Representative is one of these crucial swing votes, then your voice could make the difference.

Even if your representative is a firm "yes" or a firm "no", it's still important to let them know where you stand. Word gets around the Congressional grapevine, so if wavering Congressmen learn that Americans everywhere are consistently opposed to this bill (as polls consistently show), it will make a difference.

Contact your Congressman!

Will and Gratzer on the 12% Problem

2010-03-12T09:25:00.002-07:00

In the March 11, 2010 Washington Post, George Will discusses some of the ideological underpinnings of Obama's political approach in "As a progressive, Obama hews to the Wilsonian tradition".

With respect to health care, Will also links to a nice piece by Dr. David Gratzer from 2/26/2010, "The Health Care Number You Didn't Hear".

Gratzer calls this "the 12% problem":

American health care is an accidental system. Private coverage -- the type most Americans have -- has its origins in the wage controls of the Second World War as employers offered rich health-insurance benefits in pre-tax dollars. Public coverage like Medicaid and Medicare, on the other hand, takes its inspiration from the Beveridge report in Britain, drafted in the early 1940s; Lord William Beveridge believed in zero-dollar health care -- that people ought to pay nothing at the point of use. Today's American health care fuses these two systems, but with a common economic flaw: people are overinsured, paying pennies directly on every dollar of health service they receive.

The end result: for every dollar spent on health care in the United States, just 12 cents comes out of the individuals' pockets. Imagine what food costs might be if your employer paid 88% of your grocery bill or what a trip to Saks might be like if your company covered the vast majority of the costs of the shopping spree.

Far from addressing the 12 cent problem, Obamacare would exacerbate it. With its rich subsidies, expansion of government programs, insistence that all insurance cover specific services (and some with no copayments at all), Obamacare would pour fuel on the fire of health inflation. It's one reason that even the chief actuary of the Centers for Medicare and Medicaid Services -- a federal employee -- predicts cost rises under the President's plan.

(Read the full text of "The Health Care Number You Didn't Hear".)

Gratzer is completely correct. Bad government policy creates perverse economic incentives, which give rise for yet more bad government controls to "fix" the problem.

This is why we need to take a step back and think about free-market reforms that repeal those prior bad laws. That's the only way we will get costs under control.

(Links via LT.)

Beware Both Parties

2010-03-12T08:30:00.005-07:00

In the March 11, 2010 Investor's Business Daily, Larry Elder reminds us that "Collectivists Come With Both D's And R's".

Here's an excerpt:

The most disturbing part of the Obama-Care debate is not about where Republicans and Democrats disagree, but where they agree.

Take this issue of those with pre-existing illnesses. Many Republicans actually support government action to prevent insurance companies from refusing to insure them. Ignoring the benefits of cost-lowering free market competition and the role of charity, many Republicans believe it acceptable to force an insurance company — in business to insure against unknown risks -- to "insure" someone currently experiencing a known risk.

Sen. Tom Coburn, R-Okla., supports legislation to "eliminate pre-existing conditions" as a reason for a carrier to deny coverage. Sen. John Barrasso, R-Wyo., says government needs "to take care of things like pre-existing conditions so that that doesn't stop (people) from getting insurance."

Sen. Chuck Grassley, R-Iowa, supports prohibiting "insurers from denying coverage to people with pre-existing medical conditions or charging higher premiums to people who are sick."

But this should not surprise anyone who observes the allegedly "fiscally conservative," "pro-free market," "limited government" party in action. From the acceptance of the New Deal to government bailouts of private industry, Republicans — sooner or later -- go along.

Republican President George W. Bush, for a time, worked with a Republican House and Senate. Bush promised and delivered a prescription benefits bill for seniors. It expanded Medicare, the popular underfunded entitlement program passed — with Republican support, by the way -- in 1965. We like seniors. Seniors vote. So if they struggle with their drug bills, why, by all means make someone else help pay them.

On the 10th anniversary of the Americans with Disabilities Act, signed into law by his father, Bush bragged about the law's importance and effectiveness. That such an assault on private employers engenders praise says much about the GOP's acceptance of federal government's command and control.

Elder also reminds us that government policies such as medical licensing requirements and insurance controls drive up costs and are supported by members of both parties.

(For the record, I oppose medical licensing requirements as a violation of the rights of patients and providers to voluntarily contract to their mutual benefit. I agree with Alex Epstein's reasons.)

So as the health care debate rages, let us remember that "Collectivists Come With Both D's And R's".

Vote Count Update

2010-03-12T00:05:00.004-07:00

Are there enough Democratic votes in the House to pass ObamaCare?

Speaker Pelosi says they're almost there.

They think they can do it, even without the anti-abortion Democrats.

Some analysts think that Pelosi is forging ahead, even though she may not have the votes from a combination of hope and fear -- hope that she'll pick up the final few votes once the process gets started, and fear that if she waits until after Easter recess, she'll lose even more votes.

The Hill reports, "House Democrats' 'no' votes are piling up on healthcare reform".

In the Wall Street Journal, Michael Barone thinks probably not.

I don't think anyone really knows yet...

President Obama's Cousin Opposes ObamaCare

2010-03-11T10:01:00.002-07:00

Dr. Milton Wolf is a radiologist practicing in Kansas. He's also President Obama's second cousin once removed, and he's written a powerful opinion piece in the March 11, 2010 Washington Times explaining why he's opposed to the President's health care plan.

Here's an excerpt from "WOLF: Obama family health care fracas":

The justification for Obamacare has been to control costs, but the problem is there is little in Obamacare that will do that. Instead, there are provisions that will ration care and artificially set price. This is a confusion of costs and price.

As one example, consider the implications of Obamacare's financial penalty aimed at your doctor if he seeks the expert care he has determined you need. If your doctor is in the top 10 percent of primary care physicians who refer patients to specialists most frequently - no matter how valid the reasons -- he will face a 5 percent penalty on all their Medicare reimbursements for the entire year. This scheme is specifically designed to deny you the chance to see a specialist. Each year, the insidious nature of that arbitrary 10 percent rule will make things even worse as 100 percent of doctors try to stay off that list. Many doctors will try to avoid the sickest patients, and others will simply refuse to accept Medicare. Already, 42 percent of doctors have chosen that route, and it will get worse. Your mother's shiny government-issued Medicare health card is meaningless without doctors who will accept it.

Obamacare will further diminish access to health care by lowering reimbursements for medical care without regard to the costs of that care. Price controls have failed spectacularly wherever they've been tried. They have turned neighborhoods into slums and have caused supply chains to dry up when producers can no longer profit from providing their goods. Remember the Carter-era gas lines? Medical care is not immune from this economic reality. We cannot hope that our best and brightest will pursue a career in medicine, setting aside years of their lives - for me, 13 years of school and training - to enter a field that might not even pay for the student loans it took to get there.

More broadly, Dr. Wolf notes:

The problems in the American health care system are not caused by a shortage of government intrusion. They will not be solved by more government intrusion. In fact, our current problems were precisely, though unintentionally, created by government.

World War II-era wage-control measures -- a form of price controls - ushered in a perverted system in which we turn to our employers for insurance and the government penalizes us if we choose to purchase insurance for ourselves. You are not given the opportunity to be a wise consumer of health care and compare prices as well as quality in any meaningful way. Worse still, your insurance company is not answerable to you because you are not its customer. It is answerable to your employer, whose interests differ from your own.

Insurance companies have been vilified for following the perverse rules that government has created for them. But it gets worse. The government, always knowing best, deploys insurance commissioners across the land to dictate what the insurance companies must provide, whether you want it or not, and each time, your premiums increase. Obamacare will make all of this worse, not better.

Dr. Wolf also proposes a variety of genuine free-market reforms that would actually address correct the underlying problems (rather than ObamaCare's proposed new government controls which would only make things worse.:

One of America's founding principles is our trust in the people and their economic freedom to rule their own lives. We should decouple health insurance from employers and empower patients to be consumers once again. Allow them to determine the insurance plan that best meets their families' needs and which company will provide it. This will unleash a wave of competition that will drive costs down in a way that price controls never have. Eliminate the artificial state boundary rules that protect insurance companies from true competition and watch as voters demand that their state insurance commissioners get the heck out of the way. Innovative companies will drive down costs similar to how Geico and Progressive have worked for automobile insurance. And it won't cost taxpayers a trillion dollars in the process.

This free-market approach has worked for everything from high-definition TVs to breakfast cereals, but will it work for medicine? It already is. Take Lasik eye surgery, for example. Because patients are allowed to be informed consumers and can shop anywhere, doctors work hard for their business. Services, availability and expertise have all increased, and costs have decreased. Should consumers demand it, insurance companies -- now answerable to you rather than your employer - would cover it.

Read the full text of "WOLF: Obama family health care fracas".

Dr. Wolf is offering both an excellent diagnosis and an excellent prescription for our health care policy problems. Let's hope his cousin, the President, listens to him.

Hillman: "More health care 'help' we can't afford"

2010-03-11T00:05:00.002-07:00

Former CO state senator Mark Hillman discusses more unintended consequences of health insurance mandates.

Here is an excerpt from his post, "More health care 'help' we can't afford":

Two years ago, my wife and I had our first child. We are both self-employed and buy policies through the individual market. We specifically chose not to buy pregnancy coverage, although coverage for "complications of pregnancy" were standard with our Assurant Health policy.

The reason we didn't want to buy coverage for a normal pregnancy is the same reason everyone should have that choice -- a normal pregnancy is not an "insurable event." An insurable event is defined as something that occurs without warning, is unlikely to occur, and is unwanted.

Consumers understand this concept well in every situation except health insurance. We buy home insurance to pay for losses due to fire, hail storms, tornadoes or theft -- not to pay for repainting the family room or updating the kitchen. We buy auto insurance to pay for accidents, storm damage or vandalism -- not to pay for a new set of tires or an oil change.

Over the years, health insurance has moved away from the concept of insurance and become a complicated financing scheme for everything related to health. That's why it's so expensive.

Hillman makes many additional excellent points in his piece. I strongly recommend reading the full text of "More health care 'help' we can't afford".

Quick Links: Williams, Boudreaux, America

2010-03-10T00:05:00.001-07:00

The March 3, 2010 Investors's Business Daily carried Walter Williams' column, "Health Care A Right? More Like A Wish".

GMU economics professor Donald Boudreaux tells NPR why ObamaCare would merely mean more of the economic problems of Medicare, but on a vastly larger scale.

March 8, 2010 polling data from Rasmussen shows a majority of Americans still opposed to ObamaCare.

Mankiw on Deficit Neutrality

2010-03-09T16:05:00.000-07:00

Harvard Professor Greg Mankiw notes the following fallacy about "deficit neutrality" when discussed by supporters of ObamaCare:

Imagine you have a friend who has a budget problem. Every month he spends more than he earns. His credit card bills are piling up. He is clearly on an unsustainable path. Then one day he comes to you with an idea.
Friend: I am going to take off a few days from work and fly down to Bermuda for a quick vacation.

You: But isn't that expensive? Won't that just add to your growing debts?

Friend: Yes, it is expensive. But my plan is deficit-neutral. I have decided to give up that half-caf, extra shot caramel macchiato I order at Starbucks twice every day. I really don't need that expensive drink. And if I give it up for the next three years, it will pay for my Bermuda trip.

You: Well, then, how are you going to solve the problem of your growing debts?

Friend: I am going to figure that out as soon as I return from Bermuda.

You: But in light of your budget problem, maybe you should give up Starbucks and skip the Bermuda vacation. Giving up Starbucks could be the easiest way to start balancing your budget.

Friend: You really aren't any fun, are you?
This conversation is meant to illustrate why claims of deficit-neutrality in the healthcare reform bill should not give much comfort to those worried about the U.S. fiscal situation...

ObamaCare Update and Odds

2010-03-09T00:05:00.003-07:00

Some analysts think that the "reconciliation" strategy is just a ruse; instead, if the House passes the Senate version of the bill, then Obama will just sign it into law (despite promises to Congressional Democrats to the contrary), declare "victory", and move onto other issues:

Wall Street Journal, "Tinker, Tailor, Soldier, ObamaCare"

Susan Anne Hiller, "The House Vote on the Senate Healthcare Bill Is the Final Vote; Obama Will Sign It Into Law"

Phil Kerpen, "Forget Reconciliation -- Why the Real Fight Is In the House"

Such a move by the President would leave the Democratic Congressmen on the hook for having voted for all the provisions of the Senate Bill, including the Cornhusker Kickback, as well as the broader bad plans for mandatory insurance and draconian controls on private insurance, despite their personal misgivings.

If you wish to tell your Congressman what you think, you can contact him or her at:
http://www.house.gov/

Other analysts are essentially saying that the odds of ObamaCare passing are 50-50. In other words, neither victory nor defeat are a slam dunk.

For details of the various procedural and political convolutions and machinations, see:

Keith Hennessey, "Health Care Reform CPR".

Nate Silver, "Is Obamacare a Favorite to Pass?"

Brian Schwartz also covers the Intrade betting market on ObamaCare.

Buckle your seat belts! It's going to get real interesting now...