Health care reform

 

My comment on what we should do about doctors and other health care professionals who are bullies, as described in an item in the WSJ Health Care Blog titled, “Reader Consult:  Does the Culture of Medicine Enable Bad Behavior?

I think we should bully them into behaving better.  Demand that they do better.  Demean them in public. Throw things at them — chairs, the law, etc.

 

 

I presume Krugman said “real solution” because “final solution” was already taken:

Some years down the pike, we’re going to get the real solution, which is going to be a combination of death panels and sales taxes. It’s going to be that we’re actually going to take Medicare under control, and we’re going to have to get some additional revenue, probably from a VAT. But it’s not going to happen now.

Newsbusters.org URL.

BTW, both Palin and Krugman have clarified their original remarks. Krugman is the one we don’t want to have anywhere near the levers of power.

BTW(2), this is an example of why we should not be seeking solutions to our problems. We should instead seek to ameliorate them. (I’m trying to break myself of any lingering tendency to ever speak of any reform as a “solution.”)

 

Someone commented on the WSJ editorial, “A Deficit of Nerve : Obama’s commission has ideas that Republicans can use,” saying that many of the proposed budget cuts will kill people. My response:

Not making those cuts will kill people, too. Millions of lives could be at stake.

If we now have the histronics out of the way, maybe we can get down to serious discussion.

I agree with the editorial writers that there is much in the draft outline to build on. They makes the point that Canada doesn’t have a home mortgage interest deduction, yet has a higher rate of home ownership than we have. If this deduction can’t be zeroed out, I don’t know why it shouldn’t be reduced to say, $100,000 instead of the $500,000 suggested in the commission’s draft.

I also wish the commission had tackled the issue of health care reform. But it seems there were some taboo topics. According to the editorial:

More egregiously, the chairmen tiptoe around ObamaCare, which has led some on the right and left to claim that the commission is essentially endorsing the largest new entitlement in 40 years. We’re told the chairmen mostly dodged the subject because Democrats on the commission made that a nonnegotiable demand. A truly bold report would consider Congressman Paul Ryan’s model to make Medicare a defined contribution program. Instead, the chairmen settle for the familiar likes of “payment reforms,” which never work because of Medicare’s flawed political price-control model.

On that subject I posted the following comment:

Back in April, when setting up this commission, President Obama said everything needs to be on the table. But now we learn that the Democrats on the commission wouldn’t allow any health care reforms to be put on the table. It was non-negotiable. If they couldn’t accept the job they were commissioned to do, shouldn’t they have declined to serve on the commission, or if it was too late for that, resigned?

On the subject of taxes, I’m surprised they want to make our tax system more regressive by increasing the social security tax, of all taxes.

But there is one other item that would do more to reduce the budget deficit than any of their other proposals. Term limits would bring under control the budget distortions brought about by the power of incumbency. These limits wouldn’t need to be severe term limits to be effective.

We need a slogan: No justice, no peace.

Oops. Wrong slogan. It should be: No term limits, no tax hikes.

I’d say that if we eliminate ag subsidies (aka the root of all evil), zero out funding for NPR, and get a constitutional amendment to institute term limits for Congress, then we can think about a tax increase to get us out of our hole. If members of Congress are term-limited, we will have a better basis for trusting that they might really use new revenues for deficit reduction. Otherewise, that part should be just as non-negotiable as the Democrats’ refusal to reform our health care system.

 

cut-costs

Chance coincidence or coordinated conspiracy? You decide.

Earlier tonight the WSJ had these two items, side by side:

1: “Cuba Layoffs Show Ideological Shift: Cuba will lay off more than half a million state workers and try to create hundreds of thousands of private-sector jobs, a dramatic attempt to shift its nearly bankrupt economy toward a more market-oriented system”

2. New Medicare Chief Pledges to Cut Costs

What are the odds that the two countries would announce the same reforms on the same day if they didn’t plan it that way?

Disclaimer: I haven’t read the articles that these items link to.

 

My comment in response to the WSJ article, “Sebelius Has a List : Political thuggery from HHS“:

Someone please explain me how Ms Sibelius’s attitude toward information she doesn’t like is different from that of someone who thinks the solution is to burn a pile of Korans. In both cases, people are trying to protect their version of the truth from competitors.

 

My comment on Katherine Hobson’s blog article at the WSJ titled, “Institute for Safe Medication Practices: Drug Shortages ‘Unprecedented’

Since the author had a chance to talk to this Michael Cohen, I wish she would have asked more questions about this “authority” that he thinks the FDA should have. Who would be compelled to do what? Who is supposed to be responsible to whom for a “plan?” After all, it’s not clear how a “plan” could help with any of the causes that the article lists. There are a whole lot of unanswered questions that need answers before we think about giving the FDA more power; otherwise it’s just another power grab.

 

how-to-tell-your-child

I think of President Obama every time I see this how-to guide for parents: “How to explain to your child that you’re going to sell him.”

According to the English-Russia web site where I first saw it, it’s one of a series of fake book covers designed to ward off kibbitzers. You put your real book inside it. People will leave you alone to read in peace.

Unfortunately, in the case of President Obama it’s no joke. Like when he put pressure on German Chancellor Angela Merkel to agree to the euro bailout for Greece. I don’t know why he wanted to put his fingerprint on that act of selling people down the river, unless it was his way of writing the contents for the above book.

Here’s a good article explaining who he was helping and who is being sold to pay for it: Greek Myths and the Euro Tragedy by John H. Cochrane in the May 18 WSJ.

And here is one about the health care plan that he said would allow us to keep our existing health plans: No, You Can’t Keep Your Health Plan (by Scott Gottleib in the same issue of the WSJ). It’s like he was explaining to us, “Certainly you can keep walking. We’re going to break your kneecaps, but nobody’s going to stop you from trying.”

 

There has been some controversy over the question of whether doctors should discuss the downside of the so-called health reform bill with their patients. The AMA says no; Dr. Hal Scherz says yes and complains that the AMA is trying to muzzle doctors. (WSJ column here.)

But for some reason Dr. Scherz didn’t use the term “holistic medicine” to describe what he’s doing. Here is one definition of the term:

Holistic medicine is a system of health care which fosters a cooperative relationship among all those involved, leading towards optimal attainment of the physical, mental emotional, social and spiritual aspects of health.

It emphasizes the need to look at the whole person, including analysis of physical, nutritional, environmental, emotional, social, spiritual and lifestyle values. It encompasses all stated modalities of diagnosis and treatment including drugs and surgery if no safe alternative exists. Holistic medicine focuses on education and responsibility for personal efforts to achieve balance and well being.

Sounds to me like that would include the political aspects of health care, too.

 

President Obama says he will veto any financial reform bill that doesn’t bring the derivatives market under control. If he really meant that, he would have vetoed the recent health bill.

Derivatives are a problem in that they obscure what it is a purchaser owns. It’s hard to know how to value them, which makes it difficult for buyer, seller, and regulator. They create opportunities for market distortions.

The same is true of the health care bill. Supposedly there is some pie in the sky that’s going to repay the investment of higher taxes that we’ll be making. But it’s all so vague — it’s hard to connect value and payments in any accountable way. The health care plan should have been subject to the same scrutiny and controls (and perhaps prohibitions) that are needed in the securities market.

 

Fred Barnes has written an aptly titled article for the April 5-12 issue of The Weekly Standard: “Economics for Dummies.” It’s about “Nancy Pelosi’s cockamamie ideas.” Nancy does have a lot of those, but the dummy in this case is Fred Barnes.

(BTW, this may be the first and last time I’m going to say anything about Nancy Pelosi that isn’t critical of her.)

The dummy part is where Barnes says this:

So far as I know, Pelosi is the first person in the universe to regard the lack of portability of health insurance as a deathblow to entrepreneurship. This idea is, to put it mildly, farfetched. Is there evidence that budding entrepreneurs have been deterred by the fear of losing health insurance for a spell? Don’t bet on it. Are future Michael Dells or Ted Turners or Pierre Omidyars suppressing their entrepreneurial juices because their doctor visits aren’t covered? Please.

Pelosi, as is the habit of Democrats, cited an uncheckable and probably imaginary case. “If they had a child with diabetes who was bipolar … they would be job-locked,” she insisted. Maybe so. But a job-locked entrepreneur? It’s surely overkill to revolutionize our entire health care system for the sake of that rare bird. Besides, there’s COBRA, the federal law that permits an employee who quits to stay insured for months.

Barnes is way out of touch. Pelosi is NOT the first person in the universe to regard the lack of portability of health insurance as a hindrance to entrepreneurship. (“Hindrance” is a fairer way of characterizing her words than “deathblow.”) I’m not the first, either. All Barnes would have to do is get out and talk to people who work for large organizations that provide health benefits. Talk to them about their plans and aspirations. He would find no end of people who stay where they are because of health insurance, instead of striking out for something new and different, sometimes to start their own business — just like Nancy Pelosi describes.

If there could be any saving grace to nationalized health insurance, it would be in making health insurance more portable. Unfortunately, all the negatives about the Democrats’ way of going about it are going to cancel out any vestige of the benefits of the portability that Pelosi talks about. But she is absolutely correct in linking “entrepreneurial power” with greater portability in health insurance. If Democrats had concentrated on that and had really meant it, they could have devised a national plan that would have harnessed the power of markets to give us portability and lower costs, too, instead of creating a bigger and more fearsome monster than the one we have now.

Well, Democrats aren’t going to do anything to harness the power of markets or anything that will give people more choices. Their game is power. They have a psychological and political need for dependency, which means they’re not really going to do anything to encourage entrepreneurship, any more than Stalin tried to encourage the kulaks. But we should give Nancy Pelosi credit for at least talking a better game than the Barnes-type Republicans.

Barnes asked, “Are future Michael Dells or Ted Turners or Pierre Omidyars suppressing their entrepreneurial juices because their doctor visits aren’t covered? Please.”

The answer is yes, some future entrepreneurs will suppress their entrepreneurial juices due to the fear of losing health insurance for a spell. Some people will not risk dropping their employer-paid insurance and then incurring family difficulties that will constitute pre-existing conditions if they try to get it back in a few years. And not all entrepreneurs are people with the resources of Michael Dell or Ted Turner, nor should they have to be. Nor should we think only of those high-profile people when we think of entrepreneurs. We should also think of Joe Plumber and other people who don’t travel in Barnes’ rarified atmosphere.

And what’s even more amazing (and stupid) is that Fred Barnes thinks the health care debate is about having doctor visits covered. If it was just a matter of doctor visits, health care would not be 17 percent of our economy and growing. It makes you wonder if Barnes was hiding under a rock the past few decades while these things have been discussed. I’ll put his remark in the same category as Hillary Clinton’s, “I can’t be responsible for every undercapitalized business.”

Barnes refers to COBRA. But COBRA lasts only a relatively short time. We should expect entrepreneurs to be able to think a little further down the road than that. They have to be long-term planners who think ahead to more than the next paycheck, or they’re not going to be entrepreneurs. COBRA is one of those Democrat-devised things that was intended to keep people in dependence on the good graces of the government, as a way to avoid putting market forces to work to create truly affordable, portable, and accessible health care. It’s kind of strange for Barnes to be praising one of the Democrats’ Rube Goldberg devices in defense of another.

If the reason that Republicans pushed their better ideas only half-heartedly is because they were thinking like Fred Barnes, we can put a large share of the blame for the monstrosity that was just passed on Republicans. Such a head-in-the-sand attitude is going to drive people to desperate solutions — even solutions that will make matters worse. Which is what got enacted just last month.

Barnes is a dummy.

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