All politicians craft their words carefully, and most fudge the facts occasionally, but the current occupant of the White House uses language in such an Orwellian fashion that it’s starting to become a little scary. Here are a couple of samples from Obama’s latest remarks on his health care plan:
I believe it’s time to give the American people more control over their own health insurance.
The reality is precisely the reverse. His plan would remove patient choice in every important insurance transaction, including whether to purchase coverage at all. His plan includes an individual mandate that, in effect, makes it federal crime not to buy health insurance.
It would also remove any real patient choice in type and extent of coverage. Because his plan imposes strict benefit mandates on insurance companies, patients will be forced to buy government-approved policies that include coverage that they neither want nor need.
It incorporates the best ideas from Democrats and Republicans.
Huh? For a year, this man has been telling the American people that the Republicans are “the party of no” and have offered zero reform ideas. Moreover, as this video demonstrates, he clearly wasn’t interested in what he heard from the GOP at last last week’s summit.Â
The most important ideas the Republicans have offered are (genuine) tort reform, giving patients the ability to buy coverage across state lines, the elimination of tax favoritism for certain types of health plans and an end to mandate madness.  Obama has ignored all of these.
The list of his Orwellian statements on “reform” (an Orwellian term itself, as he uses it) goes on and on. My only hope that Obama is merely a liar. If this man actually believes what he said today, he’s crazy. Maybe that’s why this video of today’s speech (via Hot Air) shows him with guys in white coats.
As expected, Obama also threatened to jam the bill down America’s throat using reconciliation (a.k.a. the nuclear option). IÂ cover that empty threat here.
Comments 13
‘The most important ideas the Republicans have offered are (genuine) tort reform, giving patients the ability to buy coverage across state lines, the elimination of tax favoritism for certain types of health plans…’
Why weren’t these done under GW Bush?
Posted 03 Mar 2010 at 4:07 pm ¶lol, that’s your best retort, marc??
But, to humor you (again): probably because it was such a minuscule issue in the grand scheme of things that, on the whole, nobody* cared.
A better question would be: why are we wasting so much oxygen on an issue that pales in importance next to the unemployment rate??
Oh, right: because the loons in the prez’s base need a ‘win’, even if it is (absolute best-case) a Pyhrric victory.
*Spare me the pedantry that some policy wonk or random congressman cared, OK?
Posted 03 Mar 2010 at 6:57 pm ¶Marc, if the dems ideas are so great why weren’t they done under Clinton?
Your question/point seems like a strawman to me.
Posted 03 Mar 2010 at 7:17 pm ¶You must have forgotten that Clinton did attempt major healthcare reform.
Healthcare underpins the economy in many ways so pretending it isn’t important is silly. Very few people think that it is not important to address issues such as access to healthcare and discrimination concerning pre-existing conditions.
The GOP had their chance to do something such as sell insurance across state lines - they didn’t so can hardly start asking the Dems to enact faulty policies like this.
Posted 04 Mar 2010 at 5:33 am ¶Marc
Posted 04 Mar 2010 at 8:21 am ¶The Dems have had control of Congress far more often than Reps.
plc
Marc
The Dems have had control of Congress far more often than Reps.
Yes, Bush expanded the deficit, but he was fighting a War to keep our shores free from more attacks.
Now we have a radical in the WH who has no respect for our nation’s past.
Posted 04 Mar 2010 at 8:28 am ¶plc
Marc,
I did not forget, I remember it well. Point is, they could have passed it, but they didn’t.
By your logic, since they had their chance with the Clintons (and again more recently, when they failed to pass a bill that both the Senate and the House could pass) and failed to do so, they can hardly ask the Republicans to pass faulty policies like this.
And since when did a different set of priorities obligate a party to fail to attempt to improve proposed legislation?
I guess they should keep their mouths shut, eh, Marc?
Posted 04 Mar 2010 at 8:47 am ¶Well Rich,
as it happens now they don’t need the Republicans to pass a bill that’s already passed, but goodness knows Obama is trying hard to involve them.
It is clear that the US will have some form of universal healthcare at some point, so it’s pretty useless either saying no or not even taking some of the offers from the other side. If the GOP had really wanted to stop or postpone this reform, it would have done its own reform earlier, such as this supposedly terrific race to the bottom of cross-state selling, but the money men have been far too busy filling their pockets.
Posted 04 Mar 2010 at 11:44 am ¶The “race-to-the-bottom” claim is a straw-man, as it assumes there would be no federal regulation of insurers, which is precisely what this legislation claims to be about. It is only a race-to-the-bottom if someone in one state has no assurance that the insurer in another state provides the level of coverage one would otherwise expect in his home state.
So allowing interstate competition does not cause a race-to-the-bottom, if there are concomitant federal regulations. (Is anyone suggesting allowing cross-state insurance, without associated regulation or oversight?) What it does is allow insurers to compete on price and quality. Many goods and services are sold across state lines, even without regulation, and we still don’t have monopolies in any of those industries with a large customer base.
I agree, there should be debate, discussion, and some plan. What is unreasonable is to expect some to compromise their values in order to “get something done.” They could do something. They could do something bipartisan. But they (the dems) cannot expect any group of people to compromise their values to do so. (Those values being liberty, smaller government, self-determination, the right to one’s property, and enjoying the fruits on one’s labor - all of which are compromised by the current Senate proposal).
Frankly, if they want to tax people to pay for universal healthcare, they should say so plainly, instead of this massive shell game of “mandates.” If it is not a tax, it is a taking.
Posted 04 Mar 2010 at 1:02 pm ¶That’s a thoughtful response Rich.
Regarding cross-state selling - I think this is just a distraction. It’s something that’s been touted for a long time I believe and I doubt the GOP would do it if they had a majority - and of course they didn’t when they had. As you concede, it wouldn’t work without ‘associated regulation or oversight’ and in California, a huge market in its own right, it’s clear that unmandated insurance is failing. Further, insurance is not the only major factor as of course provider costs in the US are far higher than in other countries.
‘But they (the dems) cannot expect any group of people to compromise their values to do so.’
Healthcare is the wrong sector to single out for special treatment on values when so many other vital services are paid for collectively. By all means make an economic and social argument - that the US would be a healthier, more productive, more equal and less crime ridden society with a deregulated free market in healthcare, but I doubt you can do that.
As this guy says:
‘The mandate is not, as I see it, an unjustified limit on freedom; we have to pay taxes and fulfill many other obligations to maintain a decent society, and sharing in the cost of health care should be one of them.’
He also argues though that people should have an opt out with conditions.
http://www.nytimes.com/2010/03/04/opinion/04starr.html
And you say: ‘Frankly, if they want to tax people to pay for universal healthcare, they should say so plainly, instead of this massive shell game of “mandates.â€? ‘
I agree - every other western country is clear on this. You must realise that what you have is a staged approach and the art of the achievable at present. You already pay tax for Medicare which drives a huge amount of healthcare - it’s hardly a great leap to go for a public option for all, which I’m sure will come in the next 10-15 years.
Posted 04 Mar 2010 at 5:35 pm ¶Marc,
My point about values is that I believe that reform can be achieved that does not require anyone to compromise values. Of course this would require “starting over,” something the Dems see as a problem. They claim that there is not enough time - that too many people would lose coverage in the meantime, etc., etc. If this is so, I have to wonder why the bill authored by the Dems does not have patient protections go into effect for 4 years.
And regardless of how some may view mandates, they are unconstitutional (in my view). It is still not clear to me how they are going to do this. Expect a Constitutional challenge in the near future if this passes.
“- that the US would be a healthier, more productive, more equal and less crime ridden society with a deregulated free market in healthcare, but I doubt you can do that. ”
Even though it may seem intuitive, it has not been proven either that we would have a healthier, more productive, more equal and less crime ridden society WITH “healthcare reform” (particularly in its current iteration) either. In Florida there is a high doctor per-capita ratio among Medicare beneficiaries, where they enjoy a higher visit rate and greater access with more encounters per patient than elsewhere, with no improvement (actually a slight decline) in outcomes. (Ref not at fingertips, I will dig it up if you like). If a public option is not far from medicare, medicare should provide some of the improvements you mention where it is more available, but it has not done so.
The US is a large country. Many (US) states are larger than some other countries. We have a fertile ground for experimentation - something our country’s founders appreciated. We should be engaging in experimentation - the markets are large enough - just as we would before accepting, wholesale, some new medical intervention - healthcare reform deserves a phase III study.
Posted 04 Mar 2010 at 8:26 pm ¶Rich, again I appreciate your response.
I think though that again you are missing the point. You want to start again: but your side actually wants to do nothing. All this talk now of ‘free market’ reform is hot air. No one, even Catron as we know, is going to scrap Medicare except some completely wild extremists who will never be in power (hopefully). It makes no sense to have a wild west of insecurity for the under 65s and a safe haven for older people. And you can’t extrapolate Medicare to the whole population in terms of what it might mean say in worker mobility, productivity, wellbeing etc as Medicare is not for the working population. What we do know with solid evidence from other countries is that those with less relative inequality are healthier societies in many respects, and universal healthcare is a key underpinning reason.
Doing nothing cannot be an option for the Dems - they have an elected president after all - and the US healthcare system is a mess, with brutal consequences for far too many. The experimentation you have has already gone way too far in the wrong direction.
But let’s take your values. You want to make an exception for healthcare from other pooled resources that I’m sure you agree make up a decent society. I have to ask - why? Why does healthcare matter so much to you that you are content not even to take a moral position that a decent society looks after its citizens? Is it an academic point of freedom - when your own freedom is hardly threatened and in fact could be enhanced by the security of others? It is just money - a relatively modest tax? Will the republic collapse and the founders rise from their graves?
The acid test is this. Obama mentioned a woman in Ohio who’s had to abandon her insurance because of a massive rate hike and as a cancer survivor she’s presumably uninsurable, and he also spoke of a woman and her family in Wisconsin who are being bankrupted by medical bills. This story of a woman with kidney cancer that she can’t afford to have operated on is just dreadful:
http://kristyraerichardson.blogspot.com/p/in-beginning.html
(How do you fancy living with unresected operable cancer?)
I’d like you to role play: imagine one of these people is your neighbour. They may clean your house or hotel room, wait on your table, do your bookkeeping or whatever. Look them in the eye and tell them why the Dem’s reform is not in their interest. And then tell them what is.
Posted 05 Mar 2010 at 2:43 pm ¶Marc,
First, you conflate what I want with what my “side” wants. Second, while you may not believe that Medicare can be extrapolated to the working population, that is precisely what was done in Canada, and is in fact what many single-payer proponents advocate (though it is not the current proposal). In the US, the experimentation has hardly begun, except perhaps in Massachusetts and Maine.
“You want to make an exception for healthcare from other pooled resources that I’m sure you agree make up a decent society. I have to ask - why? Why does healthcare matter so much to you that you are content not even to take a moral position that a decent society looks after its citizens?�
I am not opposed to reforms in health care, or even universal coverage in some form. I am opposed to what has been proposed and is currently under consideration, because it does not address the valid concerns that you raise. Not in any way. I am prepared to sacrifice to have something better, but I am not prepared to sacrifice to have nothing better. So no, I do not want to make an exception for healthcare. If we are going to “look after our citizens� then the reforms we enact should do so. But the current proposals do not.
When I am forced to sacrifice - in higher taxes, in less freedoms, in less access to my own health care - and nothing improves, then the only natural outcome is to be forced to sacrifice more in the future to attempt to again reach those same goals.
The plans call for mandated coverage, and minimum levels of coverage. In my state, premiums skyrocketed when government mandated minimum levels of coverage, forcing people out of the market. That’s right - people who could afford coverage in the past could no longer afford it because of mandated coverage at the behest of some special interest group (e.g. government mandates that infertility treatments be covered). Subscribers cannot opt out. The current proposals make no effort to limit the exposure of such (non-life saving) mandates. In fact, without allowing cross-state purchasing, the Senate plan embraces them.
Our federal government is already coercing physicians to engage in certain behaviors by applying financial disincentives to those who fail to play along. See PQRI, and the coming mandated pay reductions to physicians who fail to engage in quality measures - to be determined by unelected government officials at their whim (outlined in last year’s stimulus package and reinforced in the Senate bill). How many patients with coverage, but who will harm the physician’s quality measure, are going to get adequate care? With a glut of patients and a shortage of physicians, those chronically ill patients who are likely to harm an individual physician’s quality measures may find that they have access problems, regardless of their “insurance” coverage.
Further, the current plans’ projections fail to take into account the mass exodus from employer provided plans and the resulting increase in public expense as employers face a penalty for not providing insurance that is substantially LESS than the premiums they currently pay. Obama says “you will be able to keep your insurance plan if you like it” but he makes no allowance that most people, receiving coverage from their employer, are not in a position to make that decision.
Furthermore, the plan will increase Medicaid roles, substantially, as one of the measures to cover the uninsured. While nationally, 28% of physicians will not see Medicaid patients due to dismally low fees, in some areas, such as where I have my practice, the percentage is much, MUCH higher. Medicaid payments would have to be tripled in my neighborhood before I would even consider taking a new Medicaid patient. This is not considered in the current plan. How are we going to realize savings when the Medicaid roles increase, and those people are still going to the ER for routine care? (See Massachusetts, where universal coverage did not decrease ER utilization, and studies elsewhere that show that ER was over utilized not by uninsured, but by the insured.) How are people with coverage that pays physicians less than their costs going to help people? Where are they going to get care? What has been accomplished other than politicians claiming that they got these people “covered,� and that unions, to whom our President owes a debt, get a bail out from their unsustainable benefits package as they dump their members onto the public healthcare roles to save their pensions. (Not to mention skyrocketing state taxes to cover the Medicaid program).
As for your role playing, I will bite. The woman with kidney cancer will not survive long enough for the Dem’s measures to go into effect in 2014. The family being bankrupted by medical bills will still go bankrupt for the same reason. The uninsurable cancer survivor will remain uninsurable for 4 years as well. How have they been helped?
The logical counter argument is that you have to start somewhere. I agree. Start with something that does not suffer the problems I have mentioned. Creative ideas abound, but no one is listening, because there is not a political advantage to be gained. Personally, I have some ideas on how to do it, but few are really interested in what an Internist from New Jersey has to say.
I favor a government (preferably at the state level) “re-insurance� type program, wherein the government provides a true safety net by limiting individual or family financial exposure on both an episodic and temporal basis. The family or individual then purchases, either on their own, via an employer, or in cases of low income with government assistance, an insurance plan that provides coverage up to the re-insurance limits. Insurers could compete on price and the services they provide for chronic and low-grade acute medical problems (and non-life threatening conditions as described above), with lower premiums because they would be shielded from catastrophic level expenses, which would otherwise be distributed across a large pool of, say, all of the state’s residents. Concomitantly, physicians (particularly primary care) could negotiate rates directly with patients, and the balance billing prohibition could be removed from Medicare for non-catastrophic services (e.g. routine outpatient care), allowing physicians to compete on price and quality, which would have the effect of lowering costs. Such a plan could be funded by pooling current payroll taxes, Medicaid subsidies, and Medicare taxes, and would likely require a nominal increase in taxes, likely a payroll tax. Pre-existing condition rules would largely be moot under such a program. This sort of hybrid program allows for free-market forces to improve quality and reduce cost at the routine, outpatient and chronic care level, while protecting families from financial ruin and skyrocketing premiums.
Posted 05 Mar 2010 at 11:55 pm ¶Post a Comment