TCS Daily

Why Tragedy Will Be Result of Dems Rush to Victory on Health Reform

By Douglas Holtz-Eakin & Paul Howard - November 16, 2009 12:00 AM

Last Saturday, House Speaker Nancy Pelosi begged, cajoled, and threatened health care legislation to a successful vote in her chamber, albeit by a razor thin margin of 220-215. The administration and House leadership touted this as a landmark vote, which it is, but only if you ignore the fact that the bill achieves almost none of President Obama's promised health reform goals. In fact, it is very likely to explode the deficit, drive up health care costs, and inflict massive new taxes on middle-class Americans.

Watching events unfold in Washington at first hand, it's become clear that health reform has become the Democrats version of "Moby Dick," as party leaders embrace the premise that they must pass something this year and declare victory, no matter how flawed the final product is. Unfortunately, they may sink the economy along the way.

If clearer heads prevailed, Congress would scrap these partisan bills and start over:

Both the House and Senate bills will cost well over $1 trillion over the next ten years. The CBO scores the Senate bill at $829 billion and the House bill at $1.055 trillion, but only because of the most transparent budget gimmicks. The Senate Budget Committee puts the fully-implemented price tag at roughly $2.5 trillion for the first decade - demolishing the president's promise that reforms would not cost more than $900 billion.

The cost curve for spending gets bent...up. The CBO says spending in both bills rises at 8 percent annually as far as the eye can see and CMS actuary Richard Foster says that national health spending gets worse, not better. So much for the president's repeated assurances that reform would slow the rate of health care inflation.

New entitlements plus cost growth equals taxes, and debt, debt, debt. The CBO only scores the bills as reducing the deficit because Democrats pretend that Medicare docs will get slashed by over 20 percent in two years. Reality says Congress will borrow about $240 billion for the "doc fix". Democrats pretend they will cut over $400 billion out of Medicare through more vigorous price controls - cuts that will never live to see the light of day. Get ready for a bubble in health entitlement debt.

What isn't borrowed in these plans is inflicted on drug companies, diagnostic companies, private health insurance companies, "Cadillac" health plans, and individuals and businesses that don't buy government mandated coverage. These taxes and fees, roughly 90 percent of which fall on families making under $200,000 a year, must grow even faster (10 percent annually) to keep up with the new spending spree.

Private insurance: expensive or off-limits. Taxes, fees and ill-conceived insurance reforms raise the specter of double-digit premium inflation for the majority of Americans with insurance. Millions will find their policies don't pass muster with the bill's insurance czar, driving them to more costly policies. The rest? Fifteen million will be thrust into Medicaid as eligibility rises to 150 percent of poverty.

It's not too late for moderates and conservatives in Congress to force Nancy Pelosi and Harry Reid to chart a safer, bipartisan course. Here are five fundamental, commonsense reforms that will cost less, improve health care quality, and expand coverage:

  1. End the tax exclusion for health care and replace it with a standardized tax credit or tax deduction. Economists from (Obama adviser) Jason Furman to Martin Feldstein know that the tax exemption for employer-provided insurance is regressive (the rich benefit more), arbitrary (why tie insurance to employment?), and drives up health care inflation. End it - the largest tax break in the code - and use the proceeds to expand private insurance.
  2. Expand existing state high-risk pools to address pre-existing conditions. Today, 35 states have high risk pools that they use to subsidize coverage for Americans who might go without coverage because they have pre-existing health conditions that make coverage very expensive or unavailable in the individual insurance market. Federal dollars should go to states that embrace model high risk pools offering affordable premiums and disease management plans that help keep beneficiaries in better health.
  3. Create real interstate insurance competition through a transparent national market. The president and Congress talk a lot about competition. But forcing consumers to choose among three or four expensive government designed plans - bronze, silver, gold or platinum, stacking the deck in favor of public plans, and hamstringing private insurance isn't real competition. Could we limit consumers to four choices of cars, computers, or colleges and call it competition? Congress should allow interstate sale of insurance, but mandate transparency and standardized coverage descriptions so that consumers always know what they are buying and can easily compare different coverage options.
  4. End waste fraud, and abuse in the Medicare and Medicaid program. Experts estimate that Medicare alone may lose up to $60 billion (about 10 percent of total spending) in fraud annually, but the government spends almost nothing on tracking and uncovering fraudulent schemes in federal health programs. Congress should switch to the best practices models use to detect fraud in the credit card industry by relying on real time algorithms to detect fraud at the point of service and stop it in its tracks.
  5. Enact real tort reform that will end lawsuit abuse and reduce defensive medicine. Former DNC chairman Howard Dean admitted his party's allegiance to the plaintiff's bar precludes backing tort reform. So the president has acknowledged that lawsuits "may" drive up health care costs - but hasn't offered any serious solutions. Bipartisan malpractice reforms do exist - from expert health courts to a "safe harbor" for doctors who embrace best practices - that could reduce lawsuit abuse. The CBO estimates that tort reform could save $54 billion over ten years.

Republicans and Democrats agree that health care reform is a critical issue for the nation's future. But the Democrats have developed deeply flawed, partisan reforms that expand coverage without fixing any of the systems' underlying problems. Unless they chart a new, bipartisan course soon their rush to declare victory will result in a national tragedy.

This article originally appeared on Fox Forum.

Douglas Holtz-Eakin is a former director of the Congressional Budget Office and a fellow at the Manhattan Institute. Paul Howard is the director of the Center for Medical Progress at the Manhattan Institute.


This guy was McCain's economic 'advisor' as well...
...notice how that doesn't show up in his bonafides?

I WANT the Dems to pass this crap. That way, the Reps can run on a platform of just one issue: repealing it.

Well, two issues after some do gooder judge lets the 911 dude to be tried in NYC walk on some technicality.

Reps repealing it
I appreciate the sentiment but I don't think that would happen. Remember that both parties love big government, and thus are very reluctant to repeal anything that gives them more power.
We note that in the Bush time liberals were went ballistic about how the Patriot Act, and Homeland Security, as just two examples, were fascist. But now that their messiah Obama has got in, nobody says a word about those two agencies, muchless depate about repealing them.
Governments main interest is power.

'Liberals' usurp power and 'conservatives' hold it.
The cycle will continue until we vote out all incumbents all the time.

Off topic, or may be not
White House On “Stimulus” Errors: “Who Knows, Man, Who Really Knows” via

Careful, what right to health care?
Do you see a medical task force or do visit a doctor?
In a free market system, the doctor should do what you want him to do it does not violate his ethics.

Careful Marjon, what do you mean "the doctor SHOULD do what you want him to do"
The doctor may do what you want him to do, if he likes what you have got to offer.

Are you saying people SHOULD do things others want them to do?

So, are you OK with an adult consulting a doctor - and the doctor obliging - for suicide?

Joanie was expressing her frustration at a social condition about to be exacerbated by GOVAGs
There is no need to be so nitpicking Marjon.

Selective reading, again.
There was something about ethics you forgot to mention.

Again, what 'right' to health care?
You didn't answer either.

I don't understand
how does Marjon saying 'that women shouldn't have the right to make decisions regarding their healthcare' translate into supporting National Healthcare?

One does not mean the other and vice versa.

That's nothing...
..I'm waiting for them to get real power so they can tell women how many children to have/not have and who gets to fertilizes them. Or better yet, conscripted surrogate motherhood so the children aren't even yours even by half, period.

Whatever you read in "The Handmaid's Tale" is what they'll pull. The attack on the religious right in that novel was only thing wrong with it. It is the Left that will pull that off.

What ethics?

You mean people have no Right to take care of their health?

You don't pay attention either.
You said some government agency was attacking womens' right to health care.
How could that be unless it was the government controling health care?
As I said, so far, we all have the liberty to contract for services from any doctor we choose. If the doctor refuses your wishes, you can find another doctor.
Assuming what you want won't violate a physician's ethics, you should find what you need, until the government socializes health care by declaring it a 'right'.

I did not say that.
" 'that women shouldn't have the right to make decisions regarding their healthcare'"

I said no one has a right to health care.

It only matters if doctors follow the 'guidelines'.
What doctors are following such guidelines?

Also, what doctor or government panel will stop you from examining yourself?

I think the timing of these announcements are perfect if one is opposed to socialized health care. It is energizing a large segment of the population which is what Reid and Pelosi don't need.

You claimed some 'right' to health care.
You have the right to force me to pay for your health care?
You said nothing about a 'right' to see the doctor of your choosing and the 'right' to make your own health care decisions.

I'm OK with that
It's already the case in some countries that assisted suicide is legal. I guess Holland and many a couple of others in euroland, and I guess Canada is considering it too.
If you believe in freedom, then your body belongs to you, not to the government, thus you should be able to dispose of it if you like, or abuse it with drugs or junk food, etc.
It's an authoritarian concept that your body belongs to the government.

So am I

Your body belongs to you.
I agree.

Then you must do the deed if you want to commit suicide.

You have no right to expect or encourage anyone to commit violence.

"It's a hell of a thing, killing a man. Take away all he's got and all he's ever gonna have. "
Clint Eastwood from the Unforgiven.

Should we have professional suicide assistants? Why not spectacular 'suicides'? The person who wants to die could hire a film crew and hire someone to kill him is some spectacular way and capture it all on film.

People who work in slaughter houses killing cattle or hogs must be rotated or else they suffer emotional problems.

Under what principle you object consenting adults helping each other?

What free market?
The market is not free now as insurance companies are restricted and regulated by each state they operate in.
In a really free market such produces will be available.
Ever hear of a company called Life Line? The travel the county selling ultrasound screening tests.
If what you suggests happens, if demand is their, mammography centers will still provide services for patients and I suspect costs will drop if insurance won't cover it.

How do you know it is not murder?

no problem re assisted suicide
There are various ways to do it. One is to sign off on a disclaimer with the doctor, like an affidavit.

Another is that there be 'euthanasia centers' as part of a hospitals services, also with sign-off facilities.

There are various scenarios too whereby the individual can't do it himself and thus needs assistance, like some guy who is bed ridden, can't move, all wired up to life support, etc. People like that need assistance.

your body and you
It doesn't follow that if you accept that your body belongs to you, then you must do all services to it yourself. Nobody would expect you to do the following to yourself; cut your own hair, massage, pedicure, set broken arm, vasectomy. Indeed, most people even come into the world with assistance, not even the mother does that herself usually these days.

Regarding your statement that it is a 'right' also doesn't follow.
If you are contracting with another person, voluntarily to do to you what would normally be called violence against you, then it wouldn't be violence against you; consenting adults.

We also know that some kinky people actually pay people to tie them up and beat them; MS play. This is another example of voluntarianism.

I've even hear that some people have paid girls to let them spank them, and this should also be OK since it's voluntary. Indeed, I've even heard that some guys out there would let some say, school girls spank them and wouldn't even ask for payment!!!! How sick is that, right guys?

Death is final.
I certainly don't want to be around people who are paid to kill people as a business.

From a basic homo-sapien survival point of view, individuals who can genetically develop the capability to kill people without feeling should not be encouraged to pass on such traits. Better to discourage such behavior in the first place.

You, whose ultimate goal is "anarchy", talking about being certain if a death is a murder Marjon?
Since "anarchy" means there can be NO pre-selected group of people assigned the task of passing verdict on violence in society, how can you talk of knowing if a particular death is self-inflicted, natural or murder?

On the other hand, since I know that an institution tasked with passing verdict on violence in society is a must IF you want a society that's for the most parts peaceful for most of the time, those kinds of death will also be handled and determined to be either murder or assisted suicide, IF somebody complains.

Now Marjon talks about survival of "basic homo-sapiens" and NOT of individual men
How is it different from all those people (the “socialists”, the “environmentalists” et al) you lambast Marjon?

They also talk about “discouraging behaviors they don’t approve of, in the first place”, for the survival of basic homo-sapiens.

"Don't bother getting up Colonel and unhooking yourself from life-support, I am here from the government to assist you with that."

Still can't understand voluntary associations?

What voluntary associations Marjon? How does “anarchy” handle dead bodies on university campuses?

How does a bankruput government handle 50 dead bodies?
"Detroit today has an unemployment rate of 28 per cent, higher even than the worst years of the Great Depression.

The murder rate is soaring. The school system is in receivership. The city treasury is $300 million (£182m) short of the funds needed to provide the most basic services such as rubbish collection. In its postwar heyday, when Detroit helped the US to dominate the world’s car market, it had 1.85 million people. Today, just over 900,000 remain. It was once America’s fourth-largest city. Today, it ranks eleventh, and will continue to fall."

that is 'nothing' compared to what else is coming down the pike, yes
And that is ABSOLUTELY nothing as far as the Messiahcrats who have taken over are concerned.

I'm waiting for the Congressional Black Caucus to 'mandate' that white women surrogate-birth black babies so there will be population parity of the two races, for example.

Exreme thinking? I hope that is is.

But YOU promote "anarchy” as THE alternative to status quo; so, the onus is on YOU to prove that
“anarchy”, where there can be NO pre-selected group of people assigned the task of passing (and ENFORCING) verdict on violence in society, is better.

Governments are failing all over. YOU justify your murderous state.
I HAVE proven the effectiveness of free market solutions to government.

"Patient trapped in a 23-year 'coma' was conscious all along"
"A man thought by doctors to be in a vegetative state for 23 years was actually conscious the whole time, it was revealed last night.

Student Rom Houben was misdiagnosed after a car crash left him totally paralysed.

He had no way of letting experts, family or friends know he could hear every word they said.

"Supporters of euthanasia and assisted suicide argue that people who have lain in persistent vegetative states for years should be given the opportunity to have crucial medical support withdrawn because of the 'indignity' of their condition.

But there have been several cases in which people judged to be in vegetative states or deep comas have recovered.

Twenty years ago, Carrie Coons, an 86-year-old from New York, regained consciousness after a year, took small amounts of food by mouth and engaged in conversation.

Only days before her recovery, a judge had granted her family's request for the removal of the feeding tube which had been keeping her alive.

In the UK in 1993, doctors switched off the life support system keeping alive Tony Bland, a 22-year- old who had been in a coma for three years following the Hillsborough disaster.

Read more:

Read more:

Kill em all and let God sort them out?

Blacks make up only 13% of the population
and all those family planning clinics founded by Margaret Sanger were really for population control of the 'undesirables' in society.

So yes, they want to reduce the population. But not for all groups. They will want to increase the population of Dem supporting groups at the expense of those that increasingly don't.

So no. It is not farfetched.

What proof? You handed over a murder case to "God" to sort out. Show me how I support State murder
Merely asserting won’t make it so.

I'm a man. I don't care, really.

But I sure do appreciate all those women who do care. For only they can raise the kind of hell needed as a result of this to do anything about it.

I have my own hands full screaming about getting robbed in the wallet like I'm some sort of cash cow for these liberal bastards.

Basically, to each is her/his won passion is best to get energized over enough to do something about it.

"What also ticks me off are the ones who don't vote and then complain about how things are turning out."

Why? Just ignore them. They don't count anyway. Besides, I actually want less people to vote, not more. 'Less' as in: Those chumps who don't even bother learning what is going on or anything about history or economics yet somehow think that their opinion is worth jack anyway. Hell those idiots are more of threat to the Republic than all the Messiah Kool-Aide drinkin' commies put together, if you ask me.

As for those who voted for the Messiah but now regret it: I have little respect for them. They were fools and they are costing the rest of us dearly. But moving forward, I am glad that many of them plan on rectifying their errors.

re; dead bodies on campus
This topic has been dealt with exhaustively some months ago. I answered your questions regarding this and many other matters, but you never reply to questions put to you.

re: anarchy & death
Wrong again. Under anarchy there is indeed a pre-selected group with the task of passing verdict. Remember, I gave you the scenario where the house invaders are raping and murdering your daughter? Only you would have trouble knowing that YOU are assinged the task of passing a verdict on the perp.
The problem is not with anarchy(absence of repressive government), but rather with you.

to NearNod on anarchy
I've thought of another solution for your problem with anarchy. Let's say such a state existed, but you didn't like it. In such a system you would still be free to pay somebody else to tell you what to do, and punish you if you don't comply.

to NearNoad on health rights
Since people own their own bodies they do have the right to take care of their health. On the other hand, they also have the right to abuse it.

Here are some examples of how people already do that; body mutilations like piercings, tatoos, etc: taking unhealthy drugs: having diets they know are harmful: remaining in situations that are stressful thus unhealthy: submitting to sadistic groups like governments and religious ones: submitting to peer pressure although harmful.

You never did Colonel; Like Marjon, you just ASSERTED. Explain the HOW and WHY of it

Irrelevant drivel to EVADE the issue by harping on cut & dry examples; talk at the Principles level

Friendly warning; brace for a caustic reply from Marjon for grouping Governments & Religion together

NN, you don't answer the questions
Some time ago you presented a case of there being some murders on a campus, but you had trouble trying to figure out who was guilty, what to do about it, etc. Some of us exhaustively answered those queries plus gave more examples to illustrate both the principles involved and specific examples of the. But you never answer; that's your reputation around here.

Now, have you ever figured out what to do to the perp who is raping your women? Or are you still have trouble with that one too?

caustic reply
I don't think so, he probably knows that they're usually joined at the hip.

I differentiate faith and religion.
Some can't.
Today, in the USA, religion and faith are voluntary. I define religion as an organization of those who have the same faith for the purposes of reinforcing such faith. Like all human organizations, many fail by enjoying the power and prestige such an association may bring.
Faith is personal and can not be forced.
A difference between a religion and government in the USA is religion cannot put you in jail.
A Catholic bishop may chastise 'Patches' Kennedy for supporting abortion and can even kick him out of the club, that's their right. But that is all a religion can do.

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