What a Difference a Year Makes

One year ago today President Obama, flush with the success of his Presidential campaign and basking in widespread public admiration, stated the following in his inauguration speech:

. . . We will not apologize for our way of life, nor will we waver in its defense, and for those who seek to advance their aims by inducing terror and slaughtering innocents, we say to you now that our spirit is stronger and cannot be broken; you cannot outlast us, and we will defeat you.

. . . [T]hose values upon which our success depends - hard work and honesty, courage and fair play, tolerance and curiosity, loyalty and patriotism - these things are old. These things are true. They have been the quiet force of progress throughout our history. What is demanded then is a return to these truths.

I was impressed with his speech, and said so in these pages:

President Obama deserves our honest support and the benefit of the doubt, at least for now. Let us pray that what he spoke today were not empty words, but wisdom springing from true historical insight and real conviction. Let us hope that in pursuing "change we can believe in," his administration will respect individual freedom, the Constitution, bedrock social institutions, and our free enterprise system. If our new President strays in the future from the lofty vision embodied in his inaugural speech, by trying to exchange our liberties for economic security or our institutions for a "values-free" society pleasing to his far-left supporters, let us be there to remind him of what he said today.

A few people in Massachusetts must have read my post, or my mind, because they delivered a very forceful reminder yesterday in electing Republican Scott Brown to the United States Senate, filling the seat left vacant by the death of Democratic Sen. Edward Kennedy. That awful sound you hear from the northeast is Sen. Kennedy's corpse spinning at warp speed in his grave.

It is truly a shame that President Obama has so quickly and dramatically squandered the promise inherent in the election of the first African-American President of the United States. I didn't vote for him because of his patent leftist views and associations, but I shared with many some confidence in his intelligence, presence, apparent thoughtfulness, and reputation for listening to all sides before acting. I thought he might actually help move the country away from partisan rancor and toward a greater civility; that he would act as a bridge between factions and viewpoints and seek the national reconciliation so many discerned in his election; and that he would steer a middle course in order to win the public's trust and the respect he would need to govern effectively.

Boy, was I wrong! And he didn't waste much time dispelling my fantasies. Right from the start of his administration, President Obama and his minions in Congress and the federal bureaucracy made generous use of the arrogant, intimidating, in-your-face tactics characteristic of the Chicago political machine from whence he came. In no respect was this more evident than in the area of "health care" or "health insurance" reform. Instead of commissioning a careful, bipartisan study and discussion of all the options available, the President had his henchmen- and -women in Congress slap together massive, impenetrably complex bills for introduction in the House and Senate--and then pressed for their quick passage without any meaningful analysis, debate, or a chance for lawmakers to even read what they were supposed to approve. When the American public objected to these tactics and confronted their representatives in town hall meetings, questioning the bills' content and cost, they were denounced as racists, Klansmen, Nazis, right-wing extremists, liars, and purveyors of "ignorance and hate." When commentators like Rush Limbaugh and Michael Savage gave voice to public concerns, they found their names on "enemies lists" and were threatened with muffling through a revival of the "Fairness" Doctrine. When no Republicans in Congress could be made to support the bills and even Democratic members held out against the administration's pressure, the President's gang resorted to bribing the holdouts, cutting deals with special interests, and secret negotiations from which the opposition, the press, and the public were excluded. So much for bipartisanship, civility, and transparency.

But that was just one facet of this off-the-rails administration one year in. Alongside the President's contempt for the will of the majority of the people is his determination to infinitely expand government influence and control over the economy and all aspects of American life. Whining that he inherited from the Bush administration a staggering national debt, budget deficits, and corporate bailouts in the hundreds of billions of dollars, his solution has been to inflate all of these far beyond the obscene levels they had already reached under his predecessor. He now dictates to the biggest corporations, and they all--having taken massive federal bribes--bow to him and his minions. His enourmous "stimulus" packageshave produced no discernible job growth, but have effectively turned the states into federal lickspittles. He has nominated or appointed to powerful government positions people who have expressed deep admiration for communist mass murderers, can't decide what gender they are, or recommend sexually perverted reading materials to children. His idea of protecting national security and enhancing our image abroad is to kowtow--literally--to foreign despots, apologize for our leadership in the world and the way of life our forefathers bought with their blood, and afford admitted terrorists the full panoply of legal rights guaranteed in our court system. He even has the bush-league (no pun intended) arrogance to go to Copenhagen and accept a "peace prize" for which he was nominated less than two weeks after taking office, and to earn which he has done nothing since.

One of President Obama's favorite expressions--repeated ad nauseum in almost every interview and speech he gives--is "make no mistake." He obviously made the mistake of reading the electorate's frustration with the preceding administration as some kind of dramatic leftward shift in American values. Massachusetts voters alerted him to that mistake yesterday. Having had their initial trust in him dashed so quickly and forcefully, I don't think the American people will again make the kind of mistake they did last November.

Dr. Obama's Miracle Cure

"Snake oil" has been defined as "a derogatory term for compounds offered as medicines which implies that they are fake, fraudulent, quackish, or ineffective. The expression is also applied metaphorically to any product with exaggerated marketing, but questionable or unverifiable quality or benefit." This is a concept to keep in mind when considering the current furor over "health care reform" now gripping the country.

I don't usually watch speeches by politicians--even Presidential ones--on TV. But I felt that the health care debate was grave enough a matter that I should watch President Obama's speech before Congress Wednesday night to find out just what he is trying to sell, and to see if he could somehow dispel the confusion and suspicion that surround the legislation now before our representatives. Click here to read the full text of his remarks.

As contemporary political speeches go, it was a pretty good one--direct, breezy, and kinda friendly-like (except toward insurance companies and critics of his ideas). We all know that Mr. Obama is a good speaker. His outline of the health care reform plan he proposes was presented with appealing, and probably deceptive, simplicity. As he sees it, nobody loses, everybody gains, and it won't cost anybody an extra cent. Given the breathtaking complexity of medical science and the health care business, and the fierce battles that have raged over the issue for so many months and years--does that smell just a little like snake oil to you?

For one thing, if this plan is so clear and self-evidently ideal for everyone, where was this speech when the health care debate started last spring? Why not lay out your plans at the outset and thereby avoid all that public confusion, anxiety, and anger? Why, instead, were 1000+ -page bills hurled onto the table with a dare that anyone try to read them, and a demand that they be passed in a matter of days, essentially without opposition? Why, having so put people on the defensive and insulted their intelligence and integrity, did Democrats find it necessary to castigate them as liars, racists, and Nazis when they expressed reservations or objections to what they believed, without the benefit of the President's guidance, this legislation provided? Was it just a try to get away with whatever they could and, if determined opposition developed, have a basis for demonizing it? Don't blame people if, after being treated this way, they are suspicious of the Administration's new-found candor.

Another thing that left me skeptical was the President's explanation of how his plan will be paid for--all $900 billion of it over 10 years. Is it really possible that "reducing . . . [fraud,] waste and inefficiency in Medicare and Medicaid will pay for most of this plan"? If all that fraud and waste were so easy to identify and eliminate, why hasn't it already been done? Can government agencies that have squandered that much money for so many years be trusted to suddenly become honest, efficient, and financially responsible, merely because this President wills it? Can the rest of this reform really be paid for by adding premiums paid by or for 30 million new insureds--less than 10 percent of the population--when insurance companies are also being forced to cover all of their preexisting conditions, all of their routine checkups and preventive care, and all of their annual, lifetime, and out-of-pocket expenses? And what's this about "charg[ing] insurance companies a fee for their most expensive policies"? Aren't those usually their highest-quality policies? That's probably one choice you won't have under the new plan.

Nor was I impressed by the President's reference to tort reform, such as limits on specious lawsuits and on jury awards for noneconomic damages. All the President promised to do was "move forward on a range of ideas" in this area. No specific ideas or proposals, and no promises--"We'll look into it." Given that organizations of plaintiffs' lawyers are always among the Democratic Party's most slavish and financially generous supporters, you can rest assured that meaningful tort reform won't be part of any health care bill that gets through Congress.

Remember that, as the President stressed, the financial viability of his plan depends on everyone being forced--under threat of fines--to participate in the health insurance system at their own cost (or at the taxpayers'). It matters not that an individual may have sufficient means to pay his or her own medical expenses if and when they arise. And for larger businesses, providing health insurance benefits to employees is no longer simply a supplemental form of compensation or a means to attract and retain the best talent available; it's now a moral and legal obligation to employees and to society in general.

What most affronted me about the President's speech was contemptuous way he characterized those (including me) who have raised serious and legitimate issues about what the current health care reform legislation does and doesn't provide for, and what its effects may be. His response to concerns about rationing care to senior citizens and coverage for illegal aliens and abortions consisted almost entirely of epithets: "misinformation", "bogus claims," "demagoguery and distortion", and "lies." Aside from vituperation, here is all he had to say about these things:

It is a lie, plain and simple [as to rationing of care]. . . .

The reforms I’m proposing would not apply to those who are here illegally. . . .

[U]nder our plan, no federal dollars will be used to fund abortions.

As to care rationing, the President gave no explanation as to how government-run or -certified boards and panels would be restrained from taking into account the age and "quality-of-life" prospects of senior citizens and critically ill patients in determining how to contain costs and allocate scarce resources--as Rahm Emmanuel's own physician brother has advocated.

The President's assurances that his health care plan will not cover illegal immigrants or abortion don't seem credible, either. An article today from the Associated Press observes that while the House version of the health care bill prohibits spending any federal money to help illegal immigrants get health care coverage, and health care legislation in the Senate is also being crafted to exclude illegal immigrants from coverage, illegal immigrants could use their own money to buy into a new government-run insurance plan if Congress creates one; worse, there is no provision in any of the bills for enforcement of the prohibition on federal health care subsidies for illegal immigrants, nor is there any requirement for people to prove that they are citizens or legal residents before getting health care benefits.

As to coverage of abortions, the nonpartisan FactCheck.org reports that while the bills now before Congress don’t require federal money to be used for supporting abortion coverage, the legislation would allow a new "public" insurance plan to cover abortions, despite language added to the House bill that technically forbids using public funds to pay for them; low- and moderate-income persons who would choose the "public plan" would qualify for federal subsidies to purchase it, and private plans that cover abortion also could be purchased with the help of federal subsidies.

Of course, one runs a risk in pointing these things out. As the President said, "If you misrepresent what's in this plan, we will call you out." As in, take you behind the woodshed? Whup you upside the head?

The bottom line: we must all be most vigilant about what issues from Congress in the way of "health care reform." Will it really do, or avoid, all the things the President promised? Will it carefully adhere to the guidelines that he set forth Wednesday night? Or was the President just talking through his hat like the snake oil salesmen of the 19th century, using his personal charm and glibness to sell us a magic elixir that contains (in its dense and endless verbiage) who knows what, and will affect the body politic in ways we can't foresee and wouldn't want? This is one instance in which we can't "try before we buy," so we'd better be absolutely sure that this cure is not going to be worse than the disease.

Baby Steps to Socialized Medicine?

The current buzz on health care/insurance reform, as reported by Bloomberg.com, is that the Obama administration may be stepping back from including a "public option"--that is, a government-run insurance program to compete with private companies--in reaction to widespread popular resistance to such an approach. According to the story, "the Senate Finance Committee is discussing cooperatives, or networks of health-insurance plans owned by their customers, that would get started with government funds as an alternative to the public plan." However, House Speaker Nancy Pelosi and a number of the more liberal Senators, Representatives and Democratic leaders (Maxine Waters, Jay Rockefeller, Howard Dean) still strongly favor government insurance, and have said that they won't support a reform package that doesn't include it. Nor has the President clearly endorsed any other approach.

Wavering on this issue among reform supporters shouldn't be cause for celebration by conservatives, at least yet. The "public option" is still backed by the Democrat party establishment, and it's doubtful they would seriously consider anything else unless and until their backs are pinned to the wall and the political futility of government-run health care is made plain to them beyond rational denial. At the same time, the somewhat more palatable alternative of federally subsidized cooperative networks may still, depending on how the system is set up, provide an infrastructure and incentives that could extend government influence into, and eventually control over, private insurance and health care (not to mention taxpayer-funded coverage of abortion). An Associated Press analysis based on interviews with several authorities indicates that it would be years before the federal government could relinquish control of start-up co-ops to their governing boards, while some critics charge that taxpayers and politicians might be too invested in co-ops to ever agree to eliminate the government's role in them. In the end, this approach could turn out to be a "foot in the door" for socialized medicine, a tactic its advocates have used for decades to advance their goals.

PLEASE listen to this 10-minute discussion by the late President Ronald Reagan, who provided a compelling description, all the way back in 1961--long before he became President--of how this indirect approach may eventually bring us to the point of no-choice, government-controlled health care (this is a longer version of a clip that appeared on my sister's blog a couple of weeks ago). Then think again about what level of federal involvement in providing and insuring health care, if any, that you'd be comfortable with.

More Bad Medicine

Guess my sister and I are on a roll regarding "health care reform" this week. Bring it on!

Today's installment is prompted by a story from the Associated Press describing how health insurance bills now before Congress would allow federally-subsidized coverage of abortion, even outside "public" plans:

For years, abortion rights supporters and abortion opponents have waged the equivalent of trench warfare over restrictions on federal funding. Abortion opponents have largely prevailed, instituting restrictions that bar federal funding for abortion, except in cases of rape and incest or if the mother's life would be endangered.

A law called the Hyde amendment applies the restrictions to Medicaid, forcing states that cover abortion for low-income women to do so with their own money. Separate laws apply the restrictions to the federal employee health plan and military and other programs.

But the health overhaul would create a stream of federal funding not covered by the restrictions.

The new federal funds would take the form of subsidies for low- and middle-income people buying coverage through the health insurance exchange. Subsidies would be available for people to buy the public plan or private coverage. Making things more complicated, the federal subsidies would be mixed in with contributions from individuals and employers. Eventually, most Americans could end up getting their coverage through the exchange.

The Democratic health care legislation as originally introduced in the House and Senate did not mention abortion. That rang alarm bells for abortion opponents.

Since abortion is a legal medical procedure, experts on both sides say not mentioning it would allow health care plans in the new insurance exchange to provide unrestricted coverage.

* * * *

In the Senate, the plan passed by the health committee is still largely silent on the abortion issue. Staff aides confirmed that the public plan -- and private insurance offered in the exchange -- would be allowed to cover abortion, without funding restrictions.

Under both the House and Senate approaches, the decision to offer abortion coverage in the public plan would be made by the health and human services secretary.

The story also notes that a compromise approved by a House committee last week would allow the public plan to cover abortion but without using federal funds, only dollars from beneficiary premiums, and that private plans in the new insurance exchange could opt to cover abortion, but no federal subsidies could be used to pay for the procedure. As pointed out by Douglas Johnson, legislative director for National Right to Life, "It's a sham. . . It's a bookkeeping scheme. The plan pays for abortion, and the government subsidizes the plan."

One comment to this story is especially apt:

One of my fears about this whole health care bill is that it would allow the administration to add new social spending under the guise of health care. Abortion, public funding of drug treatment etc could all be added by presidential fiat. I envision liberals will want to add all manner of social education programs and call it health care. With government mandates on what must be covered no one could escape paying for whatever the administration deems is necessary. Congress isn't going to run this, it will all be done by regulators. We could end up with enormous health care costs that don't end up benefiting the majority of people who lead responsible lives.

This is indeed "nightmare legislation." When abortion advocates can't accomplish taxpayer-funded infanticide directly, they go through the back door to enable it in the guise of sweeping "health care reform." As I noted in my an earlier post, perhaps the most insidious aspect of the various proposals now being considered by Congress is that they insinuate government influence, policy preferences, and ultimate direction into the means by which we care for our own and our families' health and lives. At what point will especially young, old, or ill mothers be forced into abortions because bureaucrats or "plan administrators" decide that giving birth to their babies is too expensive or too risky (in other words, a poor policy choice)? With the government holding the purse strings and having the power to determine coverages, directly or indirectly, it could happen. God forbid.

Health Cares

An insightful post on my sister's blog about the health care debate grabbed my attention today. We've been so inundated with rumors, rancor, news, and views on this issue lately that it's no wonder many want to take refuge in a quiet cave somewhere, and come out only when the brouhaha is over. I'm one of them. But we must force ourselves to pay attention to this and learn all we can about it, as "health insurance reform," "public health care," or whatever you want to call it may be the most revolutionary and personally invasive government program ever to issue from Washington.

I'm not thoroughly versed in all the details of all the bills now circulating on Capitol Hill, nor have I read even a few hundred of the thousands of pages they take up. That puts me on about the same level as most of our Senators and Congressmen--a sobering thought in itself, since they bear the heavy responsibility of determining, very soon, whether this monumental package will become national law, and in what form. They will be doing so under enormous pressure from the White House, lobbies, interest groups, and even the news media--who all want "something done NOW"--without benefit of detailed knowledge or careful study of the legislation's provisions, or of its probable and possible effects. The very size and density of the legislation, and the desperate haste with which the Obama Administration is demanding final action on it, raise suspicion that there is much in its provisions that they do not want you (or your representatives) to know or think about.

A recent Associated Press article explores some of the more questionable claims made by both sides about the new health care legislation. It's said that "the bill would require Medicare to pay for advance directive consultations with health care professionals [about end-of-life issues], but it would not require anyone to use the benefit. . . Patients and their families would consult with health professionals, not government agents . . ." The problem is that when the government foots the bill, it can call the shots even for private parties. How long will it be before officials require health care professionals to certify that they have discussed end-of-life issues with their elderly or seriously ill patients, or require patients to have such consultations as a condition of public payment, in order to serve what the officials deem to be the best policy? The article also explains that health care revisions would not necessarily lead to government-funded abortions, but also notes proposals that each region of the country have at least one plan that does, and that "a health care overhaul could create a government-run insurance program, or insurance "exchanges," that would not involve Medicaid [but] whose abortion guidelines are not yet clear." Again, regardless of whether public coverage of abortions is mandated at the outset, the proposed reforms put in place the means (government-operated plans and certification of private plans) through which government-dictated policies can be forced on the private sector, at any time officials deem it desirable.

Perhaps even more ominous, the article acknowledges that "Denying coverage for certain procedures might increase under proposals to have a government-appointed agency identify medicines and procedures best suited for various conditions. . . . Obama says the goal is to identify the most effective and efficient medical practices, and to steer patients and providers to them." It's unfortunate enough when a private insurer denies coverage of a vital medical procedure to individual patients. But we are now confronted with the specter of enabling government boards to deny such coverage to entire classes of sufferers, on grounds that the procedures are too expensive or that the need for them is unproven. Just consider what the London Telegraph reports is happening in Great Britain's nationalized health care system at this moment:

Patients forced to live in agony after NHS refuses to pay for painkilling injections
By Laura Donnelly, Health Correspondent
Published: 7:45AM BST 02 Aug 2009

The Government's drug rationing watchdog says "therapeutic" injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known. Instead the National Institute of Health and Clinical Excellence (NICE) is ordering doctors to offer patients remedies like acupuncture and osteopathy. Specialists fear tens of thousands of people, mainly the elderly and frail, will be left to suffer excruciating levels of pain or pay as much as £500 each for private treatment.

The NHS currently issues more than 60,000 treatments of steroid injections every year. NICE said in its guidance it wants to cut this to just 3,000 treatments a year, a move which would save the NHS £33 million. But the British Pain Society, which represents specialists in the field, has written to NICE calling for the guidelines to be withdrawn after its members warned that they would lead to many patients having to undergo unnecessary and high-risk spinal surgery.

* * * *

Iris Watkins, 80 from Appleton, in Cheshire said her life had been "transformed" by the use of therapeutic injections every two years. The pensioner began to suffer back pain in her 70s. Four years ago, despite physiotherapy treatment and the use of medication, she had reached a stage where she could barely walk. "It was horrendous, I was spending hours lying on the sofa, or in bed, I couldn't spend a whole evening out. I was referred to a specialist, who decided to give me a set of injections. The difference was tremendous"; within days, she was able to return to her old life, gardening, caring for her husband Herbert, and enjoying social occasions. "I just felt fabulous – almost immediately, there was not a twinge. I only had an injection every two years, but it really has transformed my life; if I couldn't have them I would be in despair".

Such a development is perfectly predictable and normal for a government agency managing a health care system--they simply aren't going to cover things that agency officials don't feel are "cost-effective," and they aren't going to allow choices that they don't believe, in the professional judgment, are the "best" ones. And don't expect this state of affairs to be foreclosed by the maintenance of a "public option" plan in competition with private plans. Government by its nature and very purpose is about control, not competition, and will exert itself politically or by certification or other private-plan approval mechanisms, if not directly. In any case, it's become quite clear that the intent of health care reform's most active supporters--including the President--is to supplant, not supplement, private health insurance.

I'm concerned enough about what shape health care reform might take upon its emergence from Congress. I'm even more anxious about what it could easily become after a few years, when our attention has turned to other crises. Once government insinuates itself so deeply into the most personal aspects of so many people's lives, the tentacles of coercion are likely to become irremovable and inescapable.