Health Care Reform: Just Everybody Calm Down

12 Sep

Just so we are all on the same page the Health Care Reform bill signed into law by the President yesterday is not the dawning of a socialist America. This isn’t the start of some kind of Obama-led socialist movement, or even the beginnings of rationed care. Just so we’re all clear.

This bill was a fairly basic attempt to expand health care coverage in the US. A simple and potentially positive step towards the goal of affordable and easily accessible health care for every citizen in this great Country. Let the cheering commence.

There is of course one question: How do you pay for it?

Well, that’s where the rub is really. To pay for expanding health care coverage the Health Care Reform bill (hereafter referred to HCR) you have to raise revenues, especially with the growing deficit, this means more taxes. It is that simple in my mind, but to correctly establish the goodness or badness of the bill you have to break a few more things down.

First, the cost. The cost has been estimated at $940 billion over ten years.  Which is a lot of money, especially after we just spent $787 billion on a stimulus bill which didn’t exactly do much stimulating. In reality was more like jumping out of a building onto a moon bounce, you didn’t die and you hopped around a bit but you don’t end up back in the building.

Well, okay, but health care costs were out of control and would become a serious economic drain on the country. Good point! Thank you.

This bill would expand coverage to 32 million uninsured, bringing this country to roughly 95% covered, after the bill takes full effect in 2014. So that’s good right? A large, but defined, cost met with an equal raise in the number of people covered by health care would hypothetically reduce costs in the long term. The Congressional Budget Office (CBO) estimated that the bill would reduce the deficit by $134 billion over the next decade.

So this looks like a simple numbers game… spend $940 billion to save $134 billion. Wait. We’re still losing money, but we’re paying more money in taxes. How is this a win?

It really isn’t a public policy win. The epic nature of the public health crisis in this country was never going to be solved by one piece of legislation. And I’m talking about a my big fat greek bitch size problem. Health care costs have been rising for several years, in 2008 the US spent $2.3 trillion on health care, more than three times the $714 billion spent in 1990, and over eight times the $253 billion spent in 1980.

$2.3 trillion?!?

We could build a death star for that kind of money.

Star Wars references aside. The HCR is more significant for being the first step in tackling the mammoth problem of health care. Most people that hate it seem to not understand it, but I would say the same thing for the people chanting, “Yes We Can!”

True, now insurers can’t deny you coverage for having a preexisting condition, or deny you coverage for not reporting a mole when you were 6 and then having skin cancer. All good things.  But you won’t make a real dent in the health care problem, both medically and fiscally, until you can get people in to invest in their health care by finding a primary care doctor and actually going to them, and then listening to them.

If we’re going to have public hospitals that are required to treat people, than we must have public health care to ensure that I don’t have to pay for the guy who doesn’t have anywhere else to go when he thinks he has swine flu or whatever the illness of the moment is on CNN  that day. We are paying for people’s health care now, whether it’s through universal insurance coverage or by paying for a public hospital, we’re paying for it.

The HCR isn’t a bad bill, it just isn’t a good bill. We need to tackle tort reform to drive down insurance costs, we need to expand health care education so people actually go to their doctors and we need to most of all realize that getting people health insurance isn’t 1917 and the President isn’t Lenin. Vladimir not John.


5 Responses to “Health Care Reform: Just Everybody Calm Down”

  1. cynthia March 24, 2010 at 10:03 pm #

    I am slightly disappointed you didn’t mention the random child Biden is hugging

  2. Jay the Yankee Conservative March 25, 2010 at 2:17 am #

    I am particularly upset you did not mention the sweeping away of the last vestiges of any restraints on Congressional power via the Commerce Clause.

    The federal government was specifically designed to be one of limited and enumerated powers. It is exactly why the Founders expressly listed what powers the federal government possessed in Article I section 8, what powers the federal government did not have in Article I section 9, and what powers were denied to the States in Article I section 10. Further, as a condition to ratification in many States, the Founders included a Bill of Rights that further specifically limited the powers of the federal government to those which are enumerated, reserving all powers not granted to the federal government, nor prohibited by the Constitution to the States, to the States and the people.

    Which brings me to the warped Commerce Clause, which allows Congress to “regulate commerce among…the several States.” Everyone knows that establishing rules for trade is not the same thing as forcing people to engage in trade, but that is essentially what Congress just did by requiring as a condition of lawful citizenship the purchase of health care insurance. Many people retort that since Massachusetts did it, it must be okay for Congress to emulate Massachusetts, but that is wrong. As outlined above, the federal government has limited powers, whereas the states have much broader police powers with which to compel people to do things they do not want to do. Thus, as much as I do not like or agree with it, Massachusetts has a much better legal case for Chapter 58 than Congress does with Obamacare.

    Sadly, the thuggery demonstrated by FDR in his court packing plan of the 1930s scared the Supreme Court into not upholding the Commerce Clause as it was intended to fucntion, and instead changed its meaning to allow Congress to do whatever it pleased. The real losers are Americans in this bill, not because many aspects of the bill are good (ie, ban on preexisting conditions, universal coverage, etc), but because government now claims the power, and we have let them have the power, to dictate to us any terms of action they wish, and we can do nothing to check that power save a Supreme Court ruling; but since the Court obliterated just about all that was left of Commerce Clause limitations in Gonzales v. Raich in 2005 (see Thomas, J., dissenting), I am not holding my breath that the Court will do the right thing and uphold freedom and limited government.

    Many people say such a concern is silly or an overreaction. I think that because so many people are reacting by saying this is “socialism” it makes my views look silly because, instead of recognizing the principled (and correct) argument I am making, they just see another crazy right-winger who hates the idea of poor people being empowered (which obviously is not true). Rather, my argument is simply that the ends do not justify the means, and our default position should always be to Liberty. There are many other ways Congress could have provided care to everyone via the tax and spending powers of the government, and policy arguments as to cost aside, no one could credibly claim a constitutional crisis had they done so.

    Instead, they orchestrated a vast power grab never before recognized as a constitutional power. What’s worse, most of us not only willingly let them, but we cheered wildly as they did so.

    Talk about shameful.

    • Mike Flynn March 26, 2010 at 5:28 pm #

      Look captain law school, calm down.

      Where does one find the “vast power grab” in this bill? There are only two potential sources of such a comment in my mind.

      1.) The new federal agency – the National Prevention Health Promotion and Public Health Council, which has the goal of developing national preventative health campaigns and coordinating the prevention and wellness initiatives at the Federal level. – Clearly straight from the mind of Lenin
      2.) The mandates placed upon the Insurance Agency.

      The second I will grant you is a valid, in so far as any federal mandate on private industry is by nature an intrusion on the commerce clause. Especially, given that the health insurance industry isn’t quite the villain that Dem’s would like them to be. The industry profit margin was only something like 3% last year. That being said economically health care is absolutely too expensive in this country, as previously established in my post. It’s just to costly to our economy.

      From the numbers that I’ve seen, and I welcome more data on the subject, this bill will save us money in the long run. It’s not remotely enough, but it is the first step. I would like to see Republican’s step up on issues like tort reform.

      But your argument is really about the construction of our government, and how this legislation may violate principals of the founding fathers, but that is not an argument on health care or the costs associated with health care policy in this country.

      This bill isn’t enough to tackle any of the real problems, but it is a start. What it really isn’t is socialism or the largest burden placed upon our civil liberties, even in the past decade. I’d like to know where small c conservatives were during the Patriot Act debate…potentially the most egregious violation of our constitutional rights since the founders came up with the bill of rights.

      I throw it back to you, if you can get your nose out of John Adams ass for a second. Oh snap!

  3. Chris March 26, 2010 at 4:40 pm #

    This legislation is beyond onerous Michael and every bit as harmful as people are saying.

    You said it best when you stated that this bill expands coverage, it certainly does. But what it fails to do is address the issue of COST! Cost is what is making healthcare unattainable for many Americans. Jay made some very valid points above so I will stay away from his well worded argument.

    This bill increases taxes for many, including a $500 tax on providers whci will certainly be passed to consumers. There is a tax on medical devices that is being dubbed the wheel chair tax. Democrats were so excited to expand coverage they did nothing to deal with the real issue of cost. People would buy something if it was affordable right?

    You tout the elimination of preexisting conditions as a cheering point but do relize this adds risk and in turn drives costs even higher.

    Let us examine the Massachusetts experiment. In 2006 the landmark MA legislation expanded coverage to nearly 98% covered in the Commonwealth. Due note that before the bill passed 93% of residents in MA had coverage. So to boost coverage by a mere 5% it cost MA billions of dollars. MA needed the federal government to bail it out with between $300-$400 million dollars. So who bails the feds out when we cant pay for this thing? Our overlords to the east in China don’t seem to be in the mood to extend our debt any further…

    If Democrats were serious about the true issue of making healthcare affordable they would have enacted simple but effective reforms to increase competition and use the market to drive costs down. One simple solution is to allow across state line buying. How about some effective Tort Reform? This stuff is nowhere to be found in Obamacare.

    Let us also view this from an employer standpoint. In the middle of a recession with high unemployment rates what does this do to encourage job growth? Does the threat of huge penalties and fines do anything to hire new workers? I think not. Plus, think of how convoluted the process is in MA. The little error can hold up your state taxes until reviewed. Lets examine the enforcement on this new law, how many more IRS agents need to be hired to make sure people are in compliance? How much more will that bloat the IRS budget?

    Many Americans are going to find fault with this bill very shortly when they see their premiums rise. In MA expanded coverage was supposed to drive down costs but the opposite happened. Many people have seen DOUBLE DIGIT increases in their plans and it is certain that the same scenario will play out on the federal level. Add this to all the new hidden taxes and your are further driving middle class Americans into the poor houses.

    So don’t be so light about the impact this bill will have on the American people’s wallets and the overall US economy. This will do nothing to make healthcare affordable, it will only make it mandatory…

  4. Chris March 26, 2010 at 4:42 pm #

    PS: Is that Webster with the VP?

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