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Posted at 11:38 AM ET, 01/ 7/2011

Democrats need a new argument to save ObamaCare

By Jennifer Rubin

In an extraordinary poll out today -- isn't timing everything in life? -- Gallup finds that a plurality (46 percent) of those surveyed favor repeal of ObamaCare. A GOP staffer e-mails: "Imagine if they polled repeal AND replace! It seems awfully quaint now that Democrats said support would improve over time." Indeed.

Meanwhile, the debate over whether repealing ObamaCare will cost money is being waged on two levels.

The first is a technical argument about CBO and accounting gimmicks. You either think the "doc fix" costs count (hiking spending and making the disparity between revenue and spending greater) or you don't. You either think we can double count savings (cutting Medicare to pay for this new entitlement and also using the dollars to shore up the Medicare trust fund) or you don't. But that's the way a college freshman, anxious to show his math skills would size it up. In other words, it ignores real-world experience in favor of a dry academic exercise. The ObamaCare defenders believe -- or feign that they believe -- in the power of rationing boards and imagine that maybe, one day, Congress will actually stomach those cuts to bend the cost curve downward.

I guess you have to have gone around the block a few times in D.C. to appreciate how preposterous is the notion that a new entitlement program is going to save money. It's not ideology; it's common sense.

So the second level of the debate then concerns how Washington really works.David Brooks, a moderate sympathetic to Obama's agenda, explains:

The new system is based on a series of expert projections on how people will behave. In the first test case, these projections were absurdly off base. According to the Medicare actuary, 375,000 people should have already signed up for the new high-risk pools for the uninsured, but only 8,000 have. . . .

Companies and unions across America are running the numbers and discovering they would be better off if, after 2014, they induced poorer and sicker employees to move to public insurance exchanges, where subsidies are much higher.

The number of people in those exchanges could thus skyrocket, especially as startup companies undermine their competitors with uninsured employees and lower costs. The Congressional Budget Office projects that 19 million people will move to the exchanges at a cost of $450 billion between 2014 and 2019. But according to the economists Douglas Holtz-Eakin and James C. Capretta, costs could soar to $1.4 trillion if those who would be better off in the exchanges actually moved to them. The price of the health care law could double. C. Eugene Steuerle of the Urban Institute, who has been among those raising the alarms about this, calls the law's structure "unworkable and unfair."

Then, from Ruth Marcus (who tries ably to save the Democrats from their own ineffectual PR campaign) explains that CBO's $230B projected savings from ObamaCare over the next decade is less than certain:

Of all the cost estimates that the CBO produces, the most complex and least reliable involve health care. This is in no way a criticism of CBO. No matter how sophisticated the economic model, the multi-layered assumptions about the future cost of health spending make the $230 billion projection closer to an educated guess (albeit a guess made by very educated economists) than a take-it-to-the-bank certainty.

And even if the CBO forecasts were guaranteed to come true, there is the political calculus to consider. CBO made this point in its usual, restrained way Thursday, noting that "current law now includes a number of policies that might be difficult to sustain over a long period of time. If those policies or other key aspects of the original legislation would have been subsequently modified or implemented incompletely, then the budgetary effects of repealing [the health-care law]...could be quite different."

Translated into English: don't bet on that $230 billion. The health-care law will require billions in new spending. It relies on the expectation of billions in savings from slowing the growth of health-care costs and assorted cuts and taxes -- all guaranteed to produce howls of outrage, and a burst of lobbying, from the affected interests. Health-care reform, done right and with steadfastness that is not always forthcoming from the legislative branch, could be a huge contributor to reducing the deficit.

The American voters, most of whom have been around long enough and who have grown skeptical enough about politicians' math skills, understand this intuitively. They see the pile of debt, a huge new program and shout: "Stop!" In electoral terms, "stop" means 63 House and 6 Senate seats. That's why the Democrats would be wise to junk the "covering millions more saves money!" argument. It's not working, and by repeating it they simply convince voters that they are out to lunch.

By Jennifer Rubin  | January 7, 2011; 11:38 AM ET
Categories:  Obamacare  
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Comments

"Stop!" In electoral terms, "stop" means 63 House and 6 Senate seats.

NOPE,stop means Majority in the House,70 votes in the Senate,and the "Right" President. However,that's a two edged sword.

Posted by: rcaruth | January 7, 2011 12:03 PM | Report abuse

ObamaCare is a preposterous contraption, designed to game the CBO calculations. If Bush or Reagan had tried to the same accounting tricks the media would have jumped on it like Oprah on a doughnut. It's totally unworkable, will drive up private and public costs, empower bureaucrats, and reduce our liberty.

ObamaCare was passed over intense public opposition (see Massachusetts Senate race) and has only become more hated (see last November's elections). As insurance rates skyrocket and employers drop coverage, support for repeal will only increase. If the courts don't strike ObamaCare down, the next election will.

Posted by: eoniii | January 7, 2011 12:08 PM | Report abuse

the next election will.

See post#1,the courts are unlikely to annul OC,BTW,I agree with you on OCare,I support Universal Medicare.

Posted by: rcaruth | January 7, 2011 12:17 PM | Report abuse

Obamacare might be turned into a kind of Custer's last stand for American liberalism: compared to the much more straightfoward and popular entitlements enacted through the 20th century, Obamacare is complicated, unworkable, cynical and corrupt--it simply gives power to bureaucrats and allows the Administration to offer exemptions, which is to say, cut deals with political allies and thereby punish enemies; it blatantly lies about things like cost and your ability to keep your insurance, etc. It is thoroughly repulsive, and will become more so as time passes--the idea that people are so desperate to have their 26 year old "children" covered that they will line up to defend this is laughable. And yet, the left must go into the trenches to defend it--they must exhaust their already severely depleted ideological resources (i.e., the array of names they can call their objects of hatred) in a hopeless cause. It's like some strategically useless outpost that nevertheless can't be abandoned without a catstrophic decline in morale. What else might start unraveling as a result? If the Republicans are smart (a big if, I know), they will go after the public sector unions next--take them out, roll back the judiciary a bit, and with the welfare state increasingly discredited, the left might be dealt a blow from which they never recover. Once they lose the ability to distribute goodies to their clients, what do they have left?

Posted by: adam62 | January 7, 2011 12:18 PM | Report abuse

Great post, adam 62. I think Obama finally realizes how weak his position is strategically, which is why he's bringing in Daley and sidelining hack loyalists Gibbs and Jarrett. He's trying to mend his fences with the Wall Street crony capitalists who backed Clinton so enthusiastically (and profited so richly).

If they're smart (big assumption), the Republicans can destroy Obama with his hated ObamaCare.

Posted by: eoniii | January 7, 2011 12:42 PM | Report abuse

You know, Ms. Rubin never seems willing to go more than one or two steps into a debate over actual details. Once one of her points has been rebutted (such as the zombie lie about adding the extraneous "doc fix" to the cost of health reform, she drops her argument as retreats into complaints about "dry academic exercises." Or she immediately shifts into an entirely different points, such as claiming that future Congresses will surely reverse the cost savings from treatment efficiencies. (Of course, if that is true then nothing Congress can do, including the Republican cost-cutting proposals, will solve the health care crisis!)
The Republican argument about the "doc fix" is an accounting argument. It is either valid or it isn't. The equally spurious "uncounted discretionary spending argument" is either valid or it isn't. So too with the bogus "double counting" theory. All these were debunked not only by people like Ezra Klein, but by Doug Elmendorf himself. But as soon as the details go against her, Ms. Rubin adopts that world-weary "math is hard" pose that seems to be so common among young conservatives.

Posted by: hsny | January 7, 2011 12:42 PM | Report abuse

hsny, if you're going to make an argument from authority, Ezra Klein is a poor choice of authorities. That the same uneducated little guy who said the U.S. constitution is unclear because it's 100 years old.

"My friends on the right don’t like to hear this, but the Constitution is not a clear document. Written 100 years ago, when America had thirteen states and very different problems, it rarely speaks directly to the questions we ask it."

Posted by: eoniii | January 7, 2011 12:56 PM | Report abuse

Come up with something better Republicans.

Posted by: danw1 | January 7, 2011 1:11 PM | Report abuse

"Come up with something better Republicans."

Fortunately, they may not need soemthing better: after all, they have the public's ever intensifying hatred of Obamacare (and the Democrat's base increasingly desperate and dutiful defense of same) and the Democrats as opponents--that may be enough.

Posted by: adam62 | January 7, 2011 1:28 PM | Report abuse

to "eoniii": I dealt with the specifics of Ms. Rubin's claims about the "doc fix" issue and other spurious attacks on the CBO cost estimates in a response to her post the other day in which she made those attacks. As for Mr. Klein, I'll put aside for the moment the tone of your comments on "an uneducated little guy". You misquote Klein, who did not say that the Constitution was "written 100 years ago, when America had thirteen states." Rather, he said that it was "written more than 200 years ago, when America had 13 states and very different problems." As for significant portions of the Constitution being unclear, Mr. Klein is clearly correct. If you disagree, perhaps you can show us the provision that specifically provides for the application of the Second Amendment, which is directed at the federal government, to actions by states and localities.

But put all this aside: is anyone going to defend Ms. Rubin's preposterous argument that a health care spending issue (the "doc fix") that mu

Posted by: hsny | January 7, 2011 2:11 PM | Report abuse

sorry for the cut-off. My question was whether anyone was going to defend Mr. Rubin's argument that a healthcare spending issue that predates the healthreform bill by more than a decade, and which must be paid for whether or not healthreform takes full effect, must be added to the estimated cost of health reform.

Posted by: hsny | January 7, 2011 2:14 PM | Report abuse

There is no reason to engage every single detail of the health care bill--to do so is to play according to the Left's game. I will gladly stipulate that you can game the numbers so as to make it look like money will be saved, but you will never be able to "prove" that the inputs you choose will match the actually inputs (how can you anticipate, for example, new, expensive treatments, for example? How can you account for new treatments that never get developed because of lawsuits and onerous regulations imposed upon pharmaceuticals?) All we need to know is that new bureaucracies and new entitlements are being established, and we know what that means. Don't get dragged down into specifics, which grants legitimacy to a criminal enteprise--just do everything you can to turn this into a quagmire for the left.

Posted by: adam62 | January 7, 2011 2:19 PM | Report abuse

hsny, here's a better authority than Ezra Klein -- the new Chairman of the House Budget Committee, Paul Ryan:


... Paul Ryan said this afternoon that contrary to claims that Obamacare will reduce the deficit, it will actually increase the deficit by roughly $700 billion.

Ryan said this afternoon at the National Press Club that the only reason a Congressional Budget Office letter claims the national health care law will reduce the deficit--i.e. bring in more revenue through tax hikes and Medicare cuts than it spends on Obamacare--is because "the books have been severely cooked"--not by the CBO but by the Democrats who wrote the bill.

"CBO has to score what you put in front of them," Ryan explained. "And if you put a bill in front of them that ignores the discretionary cost of the $115 billion you need to spend to run this new Obamacare program, that double counts the Medicare savings, that double counts the CLASS Act revenue, that double counts the Social Security revenue, that does not count the "Doc Fix"--you add all that stuff up, net it out, we're talking about a $701 billion hole--deficit."

"So if you actually do real accounting, get away the smoke-and-mirrors, get away the budget gimmicks, this thing is a huge deficit-increaser. And so we're not interested in enshrining, and endorsing, and accepting all the budget gimmicks the Democrats used to cram this thing through [Congress]," Ryan continued. "Mark my words: this thing will not reduce the deficit. I am very confident in saying that. They have a piece of paper from CBO that they contorted to suggest that it does. But that's not reality."


You probably wouldn't accept budgetary gimmicks from Republicans, so why do you accept them from Dems? All the savings the CBO counted were stipulated savings based on wild assumptions.

The CLASS Act, for example, is a vast new home nursing care entitlement that will become unaffordable once the huge Baby Boomer cohort needs it. In the meantime, the premiums the government charges will reduce the nominal deficit, which is computed on a cash basis and disregards the accumulation of unfunded liabilities. This is Madoff territory.

Posted by: eoniii | January 7, 2011 2:58 PM | Report abuse

to "adam62": You are illustrating the phenomenonm I describe: conservatives like Ms. Rubin make extremely serious and specific allegations - "CBO's cost savings are phony because they exclude the cost of the Medicare 'doc fix'!" But when the specific charge is rebutted, rather than either respond to the specific point or admit error, conservatives retreat to etherious statements about "gaming the numbers" or Ms. Rubin's complaints about "dry academic exercises." Your recommendation that conservatives not engage "every single detail" reminds me of Steven Colbert's complaint that facts have a well-known liberal bias.
In reality, the CBO is a non-partisan body that does not "game" its rather conservative-leaning econometric models. And, while you are correct that such projections are inherently uncertain, and that costs may vary, the variability goes both ways. We liberals, for example overestimated the cost of Bush's prescription drug benefit. (By the way, is that an entitlement to which you object?) For example, the new law slashes co-payments and deductibles for preventive care, yet the savings, both in dollar terms and in terms of human health benefits, are deliberately not counted in the CBO analyses.

So, is anyone willing to defend Ms. Rubin's charge that the health care law must take the cost of the "doc fix" into account? Anyone? Bueller? Anyone?

Posted by: hsny | January 7, 2011 3:02 PM | Report abuse

I object to Rubin's mode of argumentation, yes--why make allegations that are inherently uncertain. Well, I don't "object"--I just don't share her very insider-baseball approach. The CBO may be honest, but the variables are provided to them by the politicians--they don't perform independent surveys on the likely fiscal effects of the legislation. Those kinds of calculations are really only relevant when we agree in principle--they can't settle the disagreements in principle. Of course the partisans (I don't deny I am one) will use the numbers for their own purposes, but that's never the point. If you think the government has no business telling insurance companies who they must cover, doctors what they must charge, citizens which products they must purchase, patients which treatments they must have, etc.; if you object to a bill that imposes all kinds of requirements that the President or some bureuacrat down the road an issue exemptions for--then all the calculations don't matter (by the way, do the CBO numbers factor in all the exemptions Obama has been issuing? Or will issue?) The facts tend to have a liberal bias before the fact and a conservative bias after the fact--everything costs more than anticipated, but by then it's too late: a fact that liberals count on.

And, yes, I am against the prescription drug benefit. In the end "compassionate conservativism" had to be tried, so that we can see and remember what a disaster it was. We have run out of other people's money.

Posted by: adam62 | January 7, 2011 3:26 PM | Report abuse

to "eoniii": 1) Mr. Ryan's false allegations regarding the "doc fix" have already been rebutted, but I'll give the short version: the "doc fix" is a cost that has to be paid whether or not we continue with health reform, repeal it in its entirety, or enact some inchoate Republican alternative. So it is absurd to attack CBO for not adding that cost to the President's program. do you have anything to say in response?
2) As for the CLASS program, neither you nor Mr. Ryan deny that this government-back insurance program to help seniors avoid nursing homes through assisted-living arrangements would have cost savings not only for the entire decade covered by the CBO analysis, but for an additional decade after that. AS CBO noted, it is entirely possible that two decades from now, the program may run deficits amounting to as much as tens of billions of dollars. But if you are going to include such estimated costs twenty years in the future, you must also include the expected cost benefits from health reform, which CBO estimated to be almost a trillion dollars, but which are not part of the official scoring. So, either way you look at things, healthcare reform comes out ahead, as it was always intended to do.

Posted by: hsny | January 7, 2011 3:40 PM | Report abuse

ADAM/We have run out of other people's money

Under our current monetary system,exactly how do we run out of money? Do we run out of trees to be converted into paper?

Posted by: rcaruth | January 7, 2011 5:37 PM | Report abuse

"Under our current monetary system,exactly how do we run out of money? Do we run out of trees to be converted into paper?"

A good question. If we can know that the money we print, say, 10 or 15 years from now, will not, in its then present value, cover the commitments we are making now, then we can know we have run out of money. We can print money, but we can't control prices. I think we do know that our commitments have outrun any amount of money we might print but, admittedly, I don't know how we know that.

Posted by: adam62 | January 7, 2011 5:45 PM | Report abuse

adam62's "by the way, do the CBO numbers factor in all the exemptions Obama has been issuing? Or will issue?" point is VERY important and must be addressed by those defending the CBO projections! GIGO

Well, are they, yes or no?? (And don't give us the ol' WFB "I'm too bright to answer a yes-or-no question"!)

Or, if you prefer, why or why not? This speaks directly to your credibility, libs!

Posted by: aardunza | January 7, 2011 6:00 PM | Report abuse

Adam/ I think we do know that our commitments have outrun any amount of money we might print but, admittedly, I don't know how we know that.

We know that because we can't meet our current obligations without creating more money(debt) to cover those expenses. It's the bankruptcy death spiral. Anybody/entity can stay in business as long as he/she/it can continue to print/borrow money,but when a loaf of bread costs a trillion dollars,it becomes difficult to manage,(how do you make change?)LOL Adam,think for a minute about the consequences of admitting we are bankrupt(which is a fact). The minute the Republican Conservatives admit we are Bankrupt in every legal,economic sense of the word,I will become one of you all.

Posted by: rcaruth | January 7, 2011 6:14 PM | Report abuse

"by the way, do the CBO numbers factor in all the exemptions Obama has been issuing? Or will issue?"

the "waivers" are irrelevant to the CBO cost estimates because they have noting whatsoever to do with either federal revenues or expenditures. They largely pertain to "mini med" plans with extremely low coverage limits. The waivers - specifically contemplated by the legislation - are intended to ensure that low-wage workers don't lose their current admittedly inadequate coverage while the system of subsidized exchanges is being implemented.
So suggesting that these waivers have anything to do with the fact that CBO has estimated that the Republican repeal of healthreform will add billions of dollars to the deficit is a complete falsewhood.

By the way, I see that no one here is yet willing to defend poor Ms. Rubin's claims about the "doc fix." Going once ....

Posted by: hsny | January 7, 2011 6:29 PM | Report abuse

hsny, there are reasonable-sounding arguments either way on counting the doc fix. It does seem to be somewhat independent of ObamaCare, but in fact it was part of the original bill until the Dems split it into a separate bill to improve the CBO score for ObamaCare.

As to the CLASS Act, the demographics are certain -- the Baby Boomers will pay taxes into the nursing care program for more than a decade, showing a cash surplus, but then, just as with Social Security and Medicare, the cash flows will turn unsustainably negative. Just another big government Ponzi scheme to be paid for by rising generations.

Posted by: eoniii | January 7, 2011 6:30 PM | Report abuse

"Anybody/entity can stay in business as long as he/she/it can continue to print/borrow money,but when a loaf of bread costs a trillion dollars,it becomes difficult to manage,(how do you make change?)"

I think this is pretty much what I was saying, but since bread is nowhere near a trillion dollars yet and, for most people, life proceeds pretty much normally (no one's pushing wheelbarrows full of money to market), it seems to me that general knowledge (the "we," not just "me") of our bankruptcy is still pretty intuitive and unformed. But it may be enough to function as a constraint--and if it is, it is a constraint that will function upon the Republicans, and only the Republicans. And certainly claiming a "right" to universal health care won't help.

Posted by: adam62 | January 7, 2011 7:44 PM | Report abuse

From a common sense approach, one would assume that adding 30 million new people to the health care program would cost a lot of money. Personally, I believe Paul Ryan’s assessment. However, it does not make a lot of difference in whether or not the CBO estimate is correct. For the past two years the Democrats have ignored the Republicans in the House because they had a huge majority. The shoe is now on the other foot. The Republicans now have a huge majority in the House. I have been watching the House deliberations on C-Span for the last several days. The Republicans simply don’t care what the Democrats want. On each vote, the Republicans get 50-60 more votes than the Democrats. They do not have to play nice, nice with the Democrats. In essence, the Republicans can do just about anything they want in the House. If the Republicans decide that they want to defund Obamacare, they simply do not include funding for Obamacare in their Appropriations Bill. The Republicans in the Senate can filibuster the Appropriations bill just like they did to the Omnibus Spending Bill just before Christmas. Obama wants an Appropriations Bill passed and also the debt ceiling raised. In order to accomplish this he will be forced to negotiate with the Republicans in both the House and the Senate. Obama is in the process of rapidly moving to the center in his Clinton triangulation maneuver. Also, Obama is not known as a skilled negotiator. The outcome of the negotiations will be interesting. My money is on the Republicans as they are skillful negotiators and the vast majority of the American People do not want Obamacare implemented.

Posted by: kjellanderj | January 7, 2011 7:56 PM | Report abuse

"the "waivers" are irrelevant to the CBO cost estimates because they have noting whatsoever to do with either federal revenues or expenditures. They largely pertain to "mini med" plans with extremely low coverage limits. The waivers - specifically contemplated by the legislation - are intended to ensure that low-wage workers don't lose their current admittedly inadequate coverage while the system of subsidized exchanges is being implemented."

Maybe the waivers are irrelevant to the CBO cost estimate, but in that case the CBO cost estimate is irrelevant to the actual cost of the law. The employers in question would drop their health care coverage of their employees if they had to comply with the law. If they were to drop their coverage, all those employees would either be without coverage or the government would have to cover them. You see this as a short term situation, but you obviously don't know that. The law provides an incentive for employees to drop coverage, rather than comply with the amount of coverage demanded by the law. That won't change. Either Obama, or future Presidents, or bureaucrats to whom the task is delegated, will keep granting the waivers, or the government subsidies will be far greater than anticipated. (Of course, you can force employers to provide coverage and a certain amount of coverage--and employers can stop hiring. Has the CBO factored that in?) If they keep granting the waivers, then the law just sets up a political exchange, in which more and less connected and favored constituencie jockey for the privilege. Has the CBO factored that in?

Posted by: adam62 | January 7, 2011 8:00 PM | Report abuse

"I have been watching the House deliberations on C-Span for the last several days. The Republicans simply don’t care what the Democrats want."

This is very good news. Aside from negotiations, let's hope they bring in some Administration officials and look very closely at the waivers and everything else they can think of.

Posted by: adam62 | January 7, 2011 8:06 PM | Report abuse

I do not care who's math you use but you can not cover 30 million extra people and have the costs go down while providing preexisting conditions, subsidizing premiums, and everything else. So far none of what was promised has been true, premiums going up, cost curve going up, exemptions being granted so employees do not lose coverage, the numbers were typical smoke and mirrors.
As far as the Republicans not allowing debate or amendments on this particular bill is just a campaign promise.
Let them pass the bill in the House let it die in the Senate, and let the States continue to sue as unconstitutional.
This bill also passes massive new Medicare costs to each State and who do we think pays this?
Not to mention that it is a potential job killer.

Posted by: apexmerch | January 7, 2011 9:18 PM | Report abuse

We are all still waiting to see a Republican plan.

Posted by: danw1 | January 7, 2011 9:25 PM | Report abuse

Adam/general knowledge (the "we," not just "me") of our bankruptcy is still pretty intuitive and unformed.

Adam,the functional definition of Bankruptcy is when you have to borrow to pay the interest. Does the Federal Government have to borrow to pay the interest? We are using debt to pay 40% of our budget. What organization that outspends their revenue by 40% would be considered solvent.

The "Right" to Healthcare like all inalienable rights is above&beyond financial situations. I'm not talking about face lifts and tummy tucks,I'm referring to Stroke,Heart attacks,Cancer,and accidents,the real stuff.

Posted by: rcaruth | January 7, 2011 9:31 PM | Report abuse

"Adam,the functional definition of Bankruptcy is when you have to borrow to pay the interest. Does the Federal Government have to borrow to pay the interest? We are using debt to pay 40% of our budget. What organization that outspends their revenue by 40% would be considered solvent."

But with whom are you arguing with here? All I'm saying is that most Americans don't act as if they live in a bankrupt country, and yet that reality is starting to impose itself upon them. How long and how complete that process is--or, whether it is a process of conscious realization or imposed by total and undeniable catastrophe--is of no epistemological, but great political, importance.

"The "Right" to Healthcare like all inalienable rights is above&beyond financial situations. I'm not talking about face lifts and tummy tucks,I'm referring to Stroke,Heart attacks,Cancer,and accidents,the real stuff."

Seeking out health care is an inalienable right; receiving it is not, because those who might give it have inalienable rights of their own. The whole problem with health care as a right lies in the fact that the clean line you want to draw can't be drawn--health care does not fall into the two categories of emergency, life saving treatment on the one hand and frivolous cosmetic surgery on the other. How about yearly check-ups from age 50 on and all the (increasingly advanced and expensive) tests involved therein? For starters...

Posted by: adam62 | January 7, 2011 10:23 PM | Report abuse

"We are all still waiting to see a Republican plan."

Why? Plan for what? For organizing the entire health care system? For solving all of the problems in the present one? Such plans are for socialist and utopian politics. Republican politics (small "r" as well as capital) should involve a series of measures aimed at freeing up markets in insurance, lowering regulations that make care and medicines more expensive, and focusing government intervention on subsidizing only the most difficult cases--the poorest people and those with the most uninsurable conditions. Otherwise, we assume, first, that free people will, through voluntary associations and exchanges, create the conditions that lead to the continual improvement of health care and, second, that not everyone will get all the care they need when they need it. The rich will have access to the new and more expensive treatments and, like every other invention, they will spread (as happens more and more rapidly all the time) through the population. The plans of politicians simply ruin everything.

Posted by: adam62 | January 7, 2011 10:56 PM | Report abuse

The Democrats don't "need" an argument to "save" anything. Health care reform is not a bill but a law. Republicans *need* an argument that will help them surmount a Democratic-controlled Senate and a presidential veto. Good luck with all that.

Posted by: mypitts2 | January 8, 2011 1:53 AM | Report abuse

The folks who currently pay for health care insurance are predominantly happy with what is the finest health care system in the world. The only problem we have is Porky Pig Government preventing insurance companies from competing across state boarders and bloated paperwork.

Freeloaders who don't pay for the insurance want it for free and love ObamaCare - you pay a small fine for not having any and when you get sick you just sign up at the hospital and when you recover you dump it.

This is, of course, insane except in ObamaVille.......

Posted by: PerryM1 | January 8, 2011 2:07 AM | Report abuse


If you don't have health insurance and get sick, the tax payers have to pay for it anyway- so go get health insurance please- search online "Wise Health Insurance" and learn how you can get insurance at discount price.

Posted by: jeremytaylore | January 8, 2011 4:18 AM | Report abuse

Premiums are going through the roof, insurance companies are dropping coverages, and businesses are terrified about hiring new employees.

These are things that the voters actually see. Now come the congressional Democrats... with their 10% public approval ratings... defending their folly with wonkish accounting projections.

And some of them even profess to welcome the fight as "a new chance to sell the program to the public."

Wow.
.

Posted by: gitarre | January 8, 2011 5:20 AM | Report abuse

Representative King was on Greta on Fox. He explained the process in defunding Obamacare. All that has to be done is to insert a statement similar to the following in the Appropriations Bill. "No funding in this bill shall be used for funding items in the Patient Protection and Affordable Care Act". It is as simple as that. Their will be no fight in the House. The fight will be in the Senate over whether or not that sentence stays in the Appropriations Bill. If it stays in, Obama will be given the choice to approve or veto the entire appropriations bill. His veto could shut down the entire government.

Posted by: kjellanderj | January 8, 2011 7:14 AM | Report abuse

ADAM/But with whom are you arguing with here? All I'm saying is that most Americans don't act as if they live in a bankrupt country, and yet that reality is starting to impose itself upon them. How long and how complete that process is--or, whether it is a process of conscious realization or imposed by total and undeniable catastrophe--is of no epistemological, but great political,
importance.

You're describing mass denial. I'm sure that in 470AD,or even 477AD,most Romans didn't act like the game was over,but facts are ugly things. The scariest point about our national bankruptcy is how few understand the causes,and how politically unpopular the actual causes are.

ADAM/Seeking out health care is an inalienable right; receiving it is not, because those who might give it have inalienable rights of their own.

There are only three inalienable rights,in no way does recieving healthcare for serious illness/injury not fit in with those three.(See FDR's 2ND Bill of Rights)
In no way does the inalienable right for someone who is seriously ill/injured,who doesn't have the means,to be cared for at public expense(that excludes the requirement that a privately owned hospital has to bear that burden at its expense),interfere with any of your inalienable rights.

Posted by: rcaruth | January 8, 2011 10:23 AM | Report abuse

to "apexmerch": You write "I do not care who's math you use but you can not cover 30 million extra people and have the costs go down while providing preexisting conditions, subsidizing premiums, and everything else."

You join Ms. Rubin in the "math is hard" club. Read the actual CBO analysis of how the President's reforms work. More money goes into the system because "free riders" now have to purchase insurance, rather than waiting for the taxpayer to fund their care when their motorcycles crash and they land up in the emergency room. Medical loss ratio rules limit force health insurers to return the majority of their premium income to patients in the form of claim payments. Health insurance exchanges allow consumers to easily shop and compare plans (think expedia.com). And rigorous cost controls reduce the medical inflation that is bankrupting our current system.

Just ask yourselves: how is it that every other industrialized country manages to provide excellent medical care to 100% of their citizens, while spending a fraction of the per capita costs that we spend? They have all figured out that getting everyone under the health insurance umbrella is the key to controlling costs. That's what healthreform is all about.

Posted by: hsny | January 8, 2011 11:20 AM | Report abuse

hsny/Just ask yourselves: how is it that every other industrialized country manages to provide excellent medical care to 100% of their citizens, while spending a fraction of the per capita costs that we spend?

That is irrelevant to the "yourselves". Exceptionalism shields us from logic. The Social Darwinists will never concede anything to the Social Democrats.

Posted by: rcaruth | January 8, 2011 11:39 AM | Report abuse

"You're describing mass denial. I'm sure that in 470AD,or even 477AD,most Romans didn't act like the game was over,but facts are ugly things. The scariest point about our national bankruptcy is how few understand the causes,and how politically unpopular the actual causes are."

That may be true, but there's nothing to be done but patient education and persuasion.

"There are only three inalienable rights,in no way does recieving healthcare for serious illness/injury not fit in with those three.(See FDR's 2ND Bill of Rights)
In no way does the inalienable right for someone who is seriously ill/injured,who doesn't have the means,to be cared for at public expense(that excludes the requirement that a privately owned hospital has to bear that burden at its expense),interfere with any of your inalienable rights."

It would interfere very minimally with inalienable rights--except, perhaps, those of the doctor who presumably can be forced to care for someone. But I wouldn't object to laws requiring health providers to give emergency treatment, especially if private providers are to be reimbursed--we already have such laws, don't we? But formulating this as a "right" complicates things--lawsuits will come along stretching the definition of "emergency care," etc. So I would prefer to leave it as one of the few things we can achieve consensus on--a heart attack victim, or someone who has been in a car crash, etc., when taken to the hospital, should be cared for. But this is very ,arginal to the debates over national health care.

Posted by: adam62 | January 8, 2011 12:09 PM | Report abuse

"Just ask yourselves: how is it that every other industrialized country manages to provide excellent medical care to 100% of their citizens, while spending a fraction of the per capita costs that we spend? They have all figured out that getting everyone under the health insurance umbrella is the key to controlling costs. That's what healthreform is all about."

This argument really is irrelevant (even if true, which I doubt, but the arguments comparing national health care systems are as tedious as futile), even though liberals think it's their trump card. As rcaruth notes sardonically, Americans are different (even if for rcaruth it's a fantasy of difference)--our preference is to solve problems by expanding individual freedoms and letting people interact voluntarily on the marketplace. That's why the individual mandate, for liberals a question of basic fairness and mere bookkeeping, is such an outrage. I, for one, will not cede to the Social Democrats--especially the American kind, who are actually much worse than their European brethren.

Posted by: adam62 | January 8, 2011 12:17 PM | Report abuse

to Adam62: "That's why the individual mandate, for liberals a question of basic fairness and mere bookkeeping, is such an outrage."

As a "liberal," I would prefer not to have an individual mandate to purchase health insurance. Many of us would prefer to simply enroll everyone in Medicare, regardless of age. A small percentage would prefer to extend the superb VA health system to every American. The "individual mandate" is a conservative approach. It was advocated by Republicans like Oren Hatch and Charles Grassley as an alternative to the Clinton healthcare proposal. It was adopted in Massachusetts by Mitt Romney, the frontrunner for the 2012 GOP nomination.
Why you think mandatory health insurance (as opposed to mandatory auto insurance) is an assault on our precious liberties is beyond me. Neoclassical economists have a name for individuals who deliberately decide not to purchase health insurance, yet depend on their fellow taxpayers to pay the freight when they land in the emergency room, have a heart attack, get pulled out of a car wreck, etc. That word is "free rider." You believe the right to be an economic free rider is an inalienable right. I think that is nuts.

Posted by: hsny | January 8, 2011 1:20 PM | Report abuse

by the way, here is what one very well-informed commentator wrote about the individual mandate:

"By law, emergency care cannot be withheld. Why pay for something you can get free? Of course, while it may be free for them, everyone else ends up paying the bill, either in higher insurance premiums or taxes. Some of my libertarian friends balk at what looks like an individual mandate. But remember, someone has to pay for the health care that must, by law, be provided: Either the individual pays or the taxpayers pay. A free ride on government is not libertarian.

I think Mitt Romney was right on the money when he wrote those words in April 2006.

Posted by: hsny | January 8, 2011 1:26 PM | Report abuse

"Why you think mandatory health insurance (as opposed to mandatory auto insurance) is an assault on our precious liberties is beyond me"

And it will probably remain beyond you. The individual mandate is necessary not because of the occasional individual who freerides on the emergency system--if that were all, then just make treatment mandatory but allow the hospital to collect costs afterward, including the right to take out of wages, savings, etc. There would still be losses, but not nearly enough to require us to restructure the whole system around that. The individual mandate is necessary because the government wants to tell insurance companies whom they must cover, what they must cover for, and how much they must charge. Of course, once you have this massive infringement on economic freedom, the final step, forcing everyone to enter the bureaucratic socialist system, is inevitable. De-link insurance from employment (first of de-privilege that particular connection), allow insurance to be bought and sold across state lines, do away with mandates on insurance companies, and then let's see how that plays out. I think innovations in health care--new kinds of providers (not every ailment requires an MD), innovations in medicines and treatments, once pharmaceutical companies are less likely to be sued, etc.--will also play a role. If the government is deciding prices and investment, none of that will happen.

Posted by: adam62 | January 8, 2011 1:39 PM | Report abuse

ADAM/we already have such laws, don't we?

NOPE,not in my state anyway,the private hospital eats the cost for indigent care and passes the expense onto the "paying" customers. This is the famous "Cost shifting". But there's no guarantee that a hospital will ever recoup its outlay. This also leads to the process of "patient shifting",which is moving an indigent patient by ambulance until they find one that has a slot open. You'd be surprised at how many hospitals just can't accept another patient when that patient is indigent. I don't believe there's a lot of patient shifting when there's good insurance.

BTW,The interest on the Federal Debt is now approaching $800M which is approaching the amount spent on Defense. This is why the Fed can't raise interest rates to slow down the Federal Borrowing.If interest rates were raised just 2 points,the interest on the debt would become the #1 item in the Federal Budget. If the Fed raised the rates 4 points/that's to four%,the interest on the debt would exceed Defense+SS+Medicare.

Posted by: rcaruth | January 8, 2011 1:45 PM | Report abuse

Adam,BTW,I really enjoy conversing with you,even though our worldviews are diametrically different,and I like the way you use logic,you're a gentleman,as opposed to yahoos like Skip Sailing and Jennifer herself, Anyway,I'm going to throw a few quotes at you with the hope that they interest the economic side of your thinking.
"Federal Reserve Is 100% Cause Of Global Inflation
Free trade, the Fed printing money like there is no tomorrow and the Derivatives are all in the news as China gloats over the obvious fact that the RMB will replace the dollar in world trade in the not-too-distant future. The US continues to ape Japan by trying all of the stupidest ways of escaping a depression. It is all very depressing, watching our economists struggle with the fact that their beloved free trade/floating fiat currency model is collapsing. They won’t admit this is the case, even now."
"The reality here is, all our trade partners virtually without exception, run trade surpluses with the US. The more free trade=the greater our trade deficit. Once the US began to export jobs wholesale, the entire US economy began to collapse and continues to collapse. The more we import goods the more we export jobs and the more red ink we create. Now, instead of massive billions in red ink in trade deficit spending, we are still seeing a trillion+ in red ink but it has moved over to the most dangerous point: government spending.
It is painfully obvious that printing money to spend for goods and government services is going to bankrupt the nation. There is no avoiding this reality. Worse, whenever a political party is out of power, they suddenly realize this fact and talk about it until they win an election and run the government when they switch suddenly to overspending and printing money."
The reason for this insanity is simple: nearly all the money we print or create electronically instantly flows overseas! Even government spending moves overseas via the Pentagon and State Department not to mention, trade. So it looks as if we can run in the red, print money and not have inflation" LOL

Posted by: rcaruth | January 8, 2011 2:08 PM | Report abuse

Thanks, Rex--same here. On the question of emergency treatment, it's close enough to a "right" insofar as it corresponds to a universally acknowledged obligation on the part of health care providers to treat those in immediate need (it would be a shameful doctor who didn't step forward on a plane if a passenger took ill). But beyond that, it's different (a doctor's not obliged to take on new patients, just because there isn't another doctor available, or to work for free, etc.). And all the issues related to health care policy are beyond that.

Posted by: adam62 | January 8, 2011 4:49 PM | Report abuse

Adam/I'm not alone

http://sitfu.com/2011/01/ron-paul-u-s-government-must-admit-bankruptcy-and-stop-cheating-people-with-devalued-money/

Posted by: rcaruth | January 8, 2011 8:12 PM | Report abuse

What we SHOULD do never follows automatically from what IS. We may, indeed, be bankrupt--what to do then is still a question.

Posted by: adam62 | January 8, 2011 8:34 PM | Report abuse

"BTW,The interest on the Federal Debt is now approaching $800M which is approaching the amount spent on Defense..."

Make that M a (really big) B...Gotcha

As long as the T's don't become Q's...!

Posted by: aardunza | January 9, 2011 2:02 AM | Report abuse

Even liberal Evan Thomas of Newsweak has acknowledged that ObamaCare is failing:

“It ain’t because of Congress,” Thomas said. “The unemployment will go down a little bit but the game in Washington will still be this unreal game. Health care though – I got to say, is one place where I think where Republicans are right.”

Back in November 2009, Thomas admitted the health care reform bill had flaws, but still voiced his support for it. Now he has proclaimed it a failure.

“The health care bill is a disaster,” Thomas continued. “We’re sort of slowly learning – it’s not working. It’s interesting – they’re implementing it and it’s not working out at all as people anticipated. There’s all sorts of wildly wrong projections. As it’s being practiced – it’s failed.”

Read more: http://dailycaller.com/2011/01/08/newsweeks-evan-thomas-the-health-care-bill-is-a-disaster/#ixzz1AWRMMB7j

Posted by: eoniii | January 9, 2011 2:55 AM | Report abuse

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