Obamacare becomes law on 3/22/10
OK. I let this settle for a couple of days as I usually do. One of the problems with Internet news groups is too many people popping off instantly in reaction to another post. A little reflection is better.
I think the law is unconstitutional. That is not to predict the U.S. Supreme Court will agree with me. I have no idea about that.
It violates the Tenth Amendment:
The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.
The public seems to think the federal government outranks the state governments and the people. No. The opposite is true.
The Dems claim they can pass Obamacare under the “Commerce Clause.” But that says nothing about individual Americans. It states, in Article I, Section 8 that Congress shall have power “To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes.” Its purpose is to prevent states from charging import duties on stuff coming in from other states or countries. It’s a stretch to extend it to forcing citizens to buy a private product or service. But the Supreme Court is famous for stretching the commerce clause in the past.
Ironically, I think the federal government may have the right to establish a single-payer health insurance system, which is somewhat similar to social security, a mandatory pension plan for all workers in the U.S. I actually think social security is unconstitutional, but that question has already gone through the Supreme Court and they upheld it.
There are also provisions that seem to me to violate the Fourteenth Amendment “equal protection” clause. You have to treat everyone the same. NE, FL, and LA do not get a better deal than the other 47 states.
ObamaCare may be a tax on the states that is not permitted by the Constitution. The original Constitution allowed only a head tax. Income taxes were declared unconstitutional as a result. The Sixteenth Amendment allowed Congress to tax“ incomes.” But Southern states have paid lesser Medicaid benefits than Northern states. ObamaCare forces Southern states to pay more for medicaid. As such, it is neither a head tax nor an income tax.
There was much talk in the media about the Dems violating House and Senate rules. That did not happen. The law that was signed was passed by 60 Senators on Christmas eve. The House passed that bill according to their normal majority rule. Deeming was not used. I do not know what they are going to do to “fix” the Senate version to make it more like the House wants. Normally, they go to conference then the resulting compromise has to pass both houses which subjects it to the Senate 60-vote cloture rule.
I surmise they are going to use reconciliation to pass the compromise version to avoid the need for the 60 Senate votes they no longer have. That arguably violates the rules pertaining to reconciliation, but the Vice President can overrule the Senate Parliamentarian and he will. The Constitution says the House and Senate can pass their own rules. The Vice President’s power to overrule the parliamentarian is one of those rules. No unconstitutionality.
All that all of this means is the Dems are darned lucky Harry Reid met one of their arbitrary deadlines on Christmas eve.
Were the bribes to get those 60 votes sleazy? Absolutely. The whole Congress is sleazy. You get in there by winning a best- liar contest back in your district or state.The president is sleazy. He won the best-liar-in-the-country contest.
Hey, the Dems squeaked it through. If the Supreme Court does not overturn it, those who do not like it need to elect a new Congress and President to repeal it. It’s as simple as that. Read the Constitution.
‘Doing nothing was not an option’
Obama kept saying that the Republicans wanted to do nothing. He lied. The Republicans CAN do nothing because they are in the minority and do not control the White House.
Obama also said that health care as now operated in the U.S. is unsustainable.
That is correct. The costs are way too high compared to other countries and the rate of increase has been way too high.
Then Obama said the fact that current costs are unsustainable means we have to do “something.”
“Something?” What does that mean?
To Obama, it seems to mean “anything” as in “Anything is better than nothing.”
That is not correct. The action we need to take is to change the way medical care is purchased and paid for in ways that reduce the costs to more appropriate levels without causing new problems.
It is not clear what that would mean. I would expect we would need to study health care systems around the world and either copy the best one or a least use ideas from the best. I have read that Germany and Singapore have universal health care systems that work pretty well. Germany’s was started by Otto von Bismarck in the late 1800s and has survived two world wars, Weimar Republic hyperinflation, and more than a century. It works through private insurance companies. Basically, Germany helps its citizens buy private insurance. Germany and Singapore also have very successful economies. The rest of Europe is a mess being bankrupted by their versions of ObamaCare.
The premier of Newfoundland, Canada recently came to Florida for medical care rather than use his country’s universal system. I am told the affluent in Canada do that to avoid Soviet-style customer service and lowest-common-denominator, we’re-all-equal treatment of people who are used to going first class. Apparently, one of the unwritten ways Canada pays for its health care is to charge the rich for it, then drive them to pay again for better service in the U.S. like what’s done to those who send their kids to private schools in the U.S. (By the way, did you know Newfoundland used to be its own country. It could not pay its bills so the U.K. annexed it into Canada.That was called gunboat diplomacy. Apparently, they still cannot pay the bill for quality health care service.)
Was Obama’s version of “doing something” better than doing “nothing?
Are you kidding? The “problem” was high costs. What does ObamaCare do to lower costs? Absolutely nothing. Part of it spends billions on attacking waste, fraud, and abuse. They should have attacked waste fraud and abuse in 1965 when Medicare started. The anti-fraud billions raise costs. Whether the money will produce a a net benefit when you achieve savings and subtract the cost of the achieving them remains to be seen. Actually, I do not need to wait. There is not a snowball’s chance in La Jolla that waste, fraud, and abuse will be eliminated or even reduced. It is endemic to all government activity. Indeed, I am certain that the bureaucracy created to stop waste, fraud, and abuse will itself have the usual amount of waste, fraud, and abuse, thereby making the waste, fraud, and abuse worse.
ObamaCare is to fixing the high-cost problem of U.S. health care what shooting gasoline from a fire hose is to putting out a fire.
Is ObamaCare socialism? Yeah, of course. So are Medicare, Social Security, and Medicaid. Socialism is not a pass-fail question. It is a matter of degree. Pure socialism is government spending is 100% of GDP. Pure capitalism is 0%. Our spending in 1903 was about 17% of GDP and is now about 45%.
Here is a Web site that says the U.S. spends 19.9% of GDP, 144th out of 160. This is 2006 data. Other major countries on that table come out like this:
Japan 103rd 30.9%
Switzerland 76th 37.8%
Germany 41st 48.8%
U.K. 37th 50%
France 7th 61.1%
Obama denies it now, but in the past he said he was a single payer guy. That means total government takeover of health care. All doctors, pharmaceutical companies, hospitals, and medical equipment manufacturers are paid by a single payer: the federal government. That’s the Soviet, Cuban model.
Here is a YouTube of Obama saying this. I saw him confronted with it by a media interviewer. His response: He claimed he could not hear what he was saying on the video they played for him.
That’s lame and he knows darned well what he said. Transcripts of it are all over and Obama and his advisers have discussed it behind closed doors. “I can’t hear it” is the best they could come up with? “I changed my mind” might, I repeat, might be believable. “I can’t hear it,” is not believable.
In the video, he says, “we may not get there immediately.” ObamaCare 2010 is not getting there immediately. But make no mistake, every single hard- core proponent of ObamaCare regards it as merely the camel nose inside the tent. They are not stopping with ObamaCare. They will push for moving to single payer or closer to it as soon as they think they can get away with it. And they will not stop pushing for single payer until they get it. Shame on the American people who believe the Dems have abandoned their dreams of single payer. 2010 ObamaCare is to the left what Czechoslovakia was to Hitler. The British agreed to let Germany have Czechoslovakia to get an agreement that they would seek no more territory. It was called appeasement. The Peace in Our Time Munich Agreement was signed by the British and Germans on 89/30/38. Germany invaded Poland starting World War II in Europe on 9/1/39. Americans who oppose single payer but who are OK with 2010 ObamaCare are clones of British prime minister Neville Chamberlain who sold out the Czechs for a worthless agreement that Germany would seek no greater territory. The left will pursue single payer until they get it and they will use ObamaCare to get American addicted to government health care so they can later get single payer.
The next step will be leftists using ObamaCare rules and law to drive all health-insurance companies out of business. Then they will say, “See!? We told you those people were no good. We’ll take care of you now. And be sure to vote Democratic in the next election—if you know what’s good for you.”
Effects of government intervention
Socialism doesn’t work. Government intervention makes things worse. Here is what I expect will happen as a result of ObamaCare:
• The best and brightest Americans will stop going to medical school.
• Medical students interns and residents will abandon medical school and medical careers.
• Current American doctors will quit the profession or retire early.
• More hospitals and doctors will refuse to take Medicare patients. The Mayo Clinic refused to take them before ObamaCare.
• Your heath insurance plan, and doctor, whom Obama assured you that you would be able to keep, will shut down and no longer be an option.
• The addition of 32 million new insureds and the reduction in the number of doctors will result in a severe doctor shortage that will be partially taken care of by importing Third World doctors who cannot speak or understand English well enough to adequately understand your symptoms, adequately explain your situation and therapies to you, or establish any sort of cultural or personal rapport with you.
• The same will be true of nurses.
• The U.S., which is the last country to aggressively seek new medicines and medical devices, will stop doing that because of lack of profit incentive. The number of new patents for new medicine and equipment will flat line worldwide. Tenured University personnel will putter around continuing efforts to develop new therapies, but without the profit motive, they will do so only at glacial speed. Recently, the rest of the world has gotten away with not doing medical research cause they could count on us to do it for the whole world. When, we, too, allow a government takeover of all health care, neither we nor the rest of the world will be able to benefit from technological progress.
• All prescription medicine will become generic in about 17 years (patent term)
• Hospitals will deteriorate and age more than in the past. As in rent control, the building owners will have no incentive to rehab or replace them.
• Waiting lines will get unbelievably long. Waits for appointments will get longer.
• Many therapies and diagnostic tests will be rationed because the equipment or medicine is expensive.
• All medical personnel from doctors to nurses to orderlies to janitors to administrators will unionize and seek and get generous benefits like retirement when they are in their 40s, suspiciously high rates of disability, cost-of-living adjustments to pensions, high pensions.
• the best people and managers will leave health insurance companies to be replaced by gum-chewing, union, it’s-not-my-job, bureaucrat drones
Author of Is the Welfare State Justified?
On 3/28/10, I heard a brief interview with Professor Daniel Shapiro of WVU. He wrote the book Is the Welfare State Justified?
Basically he said that those who favor government health care and all that are even wrong when judged on their own priorities. Liberals say their priorities are right and those of the right wrong. Shapiro says, OK, let’s use your priorities. He then shows that the priorities of the liberals—like social justice, fairness, and egalitarianism—are better served by letting the market run health care. His evidence is to show how actual market and government health care systems around the world work. For example, in government-run health care systems, the poor end up at the back of long lines and waiting lists for health care. The rich pull strings, use connections, or spend money to get better health care and better service. Plus, the government-run system costs more so there is less health care for everyone, especially the poor, than in a market system.
Shapiro agrees with me that the proper health care delivery system is the 1970s and before approach. You pay out of your own pocket for routine and semi-routine and moderate cost care—like car insurance. And, as in car insurance, you have major medical insurance that only covers catastrophically high-cost care.
Essentially, that is what we will have, either because we are smart enough to recognize it, or because we act like idiots and bankrupt ourselves in which case we will be forced into the pay-your-own-way plus major medical system because we cannot get anyone to lend us the deficit spending necessary to offer Santa Claus level universal health care with no deductible.
Both Republicans and Democrats agree that pre-existing conditions have to be covered by health insurers. Good for them, but they’re nuts.
By definition, insurance cannot cover pre-existing conditions. Insurance covers risks. There is no risk in a pre-existing condition.
The answer to pre-existing conditions is pre-existing insurance. My sons were covered from birth. That ought to be the case with everyone.
What about people who for one reason or another did not do that or had gaps in coverage which caused them to be disqualified when they attempted to get new insurance?
1. Pay out of your own net worth for the needed health care. Your pre-existing condition is certainly not any one else’s fault.
2. Seek charity from relatives, friends, organized charities.
3. When you run out of money or private charity, go to Medicaid.
A bigger picture solution is to end government and employer involvement in health insurance. This was sort of done with pensions. It used to be that those who lost their job lost equity they had built up in company pensions. The pension was switched to the person, not the company, with 5401(k)s, IRAs, SEPs, and so on. Good law.
The same should be done with health insurance. You buy it from an insurance agent like car insurance or fire insurance, not through your employer. The stupidity of employers providing health care started during World War II as a way to get around another stupidity called wage and price controls. It was a way to give raises. Employers have better things to do than provide health care or insurance, like employ people. The requirement that they provide health insurance deters starting new businesses and expanding them. Everyone should buy their own health care and health insurance the way they buy food, clothing, housing, and so on. That would fix the high cost and rapid price increases too. Only bureaucrats tolerate high, rapidly rising costs. Consumers would shop around and refuse overly expensive treatments.
Letting people with pre-existing conditions buy health insurance that covers that condition is like letting you buy life insurance on dead people or letting people at the race track bet on races after they are over. It’s stupid on its face. People with pre-existing conditions don’t need insurance. They need to pay for their care themselves or get charity.
Essentially, people with pre-existing conditions have long been covered for health care by Medicaid. The real problem is that middle class and affluent people want someone else to pay for their misfortune. They do not want to have to burn through their net worth until they qualify for Medicaid. I understand the economics of their motivation. What I do not understand is why they do not see the economics and fairness in mine. Sorry about your pre-existing condition, but no you may not bankrupt me, my children, or my country to pay for it. You pay for it until you are bankrupt. Then become a ward of the state.
With ObamaCare, the law will now “cover” them, but only briefly before trying to do that bankrupts the insurance companies and the country.
End lifetime policy limits
Another “we can all agree” provision is prohibiting insurance companies from putting a lifetime cap on health care coverage.
Why don’t we repeal the law of gravity while we are at it? That would eliminate injuries from falls.
We cannot force insurance companies to end limits on the amount of are they will provide. They are not bottomless pits of money. All insurance policies have limits.
Of course, ObamaCare went ahead and outlawed lifetime limits anyway. Enjoy it while it lasts. It will bankrupt the companies then the country.
Bankruptcy of the U.S. government
We have been told for decades that Social Security alone will bankrupt the country. It will. The first of the 78 million Baby Boomers still have not yet started collecting. They have to be 67 to get full benefits that are not reduced by their other income. Social Security went into the red—outlays exceeded inflows— in 2008 for the first time in history. The first Baby Boomers turn 67 on January 1, 2013. You have to be 65 to get Medicare. The first Baby Boomers turn 65 on 1/1/11. The 12/9/09 Daily Paul—Congressman Ron Paul’s web site—says,
The 2009 Social Security and Medicare Trustees Reports show the combined unfunded liability of these two programs has reached nearly $107 trillion in today’s dollars! That is about seven times the size of the U.S. economy and 10 times the size of the outstanding national debt.
Actually, the current national debt is http://defeatthedebt.com/debt-clock/?gclid=CJTN99-U06ACFRlRagodeCcRsw.
An Internet article said his about Medicaid unfunded liabilities:
In the next 50 years, Medicaid, the program for the poor — broadly, sometimes very broadly defined — could become a bigger threat than Medicare to the nation’s prosperity.
Even Barack Obama says current U.S. fiscal behavior (spending, taxing, and borrowing) is “unsustainable.” He’s right. Everyone says that. They are all right.
But no one, I repeat, no one, is doing the slightest thing about it. Obama says ObamaCare will reduce the deficit by $118 billion in the next ten years according to the Congressional Budget Office. If you believe that, you are too dumb to vote. Please stay away from the polls. Second, even if it were true, it is a drop in the bucket. The problem is over $100 trillion. $118 billion is one tenth of one percent of the $100 trillion problem.
Basically, the bond market and/or foreign exchange market will go on strike with regard to the dollar at some point. It’s called a run on the dollar. Anyone who owns dollars or dollar-denominated assets like U.S. government or corporate bonds worldwide will frantically try to sell them. That will drive up interest rates dramatically. It may be that no one will buy dollars or dollar bonds at all. In that case, the Congress and the President will not be able to deficit spend. They will have to raise taxes or cut programs drastically to pay the government’s bills. In fact, they will simply not have the money to pay pensions, bond interest and principal, government employee salaries, government bills for ammunition, fuel, electricity, and so on.
That was going to happen without ObamaCare. ObamaCare greatly accelerates it.
So in the end, the issue is not how Obama Care will hurt health care. The issue is when will ObamaCare and all the prior entitlement programs stretching back to 1933 cause the world financial markets to say “No more.” I saw a Harvard economist get asked when that will happen on Charlie Rose or some similar show in 2009. He thought a moment and said,
Five years—not ten.
In other words, he expects the U.S. to go bankrupt in 2015, 2019 at the latest. It’s really not possible to tell. It depends on events worldwide.
ObamaCare, therefore, is not something that you will experience in a hospital or doctor’s office. It is something you will experience on Fox Business TV, Wall Street, at your bank, your 401(k), your IRA, and, after the bankrupt federal government figures out how to pay the judges and bailiffs, in your recently re-opened local bankruptcy court.
Can the “greatest country in the world” actually go bankrupt?
YES WE CAN.