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Obamacare: The Only Exit Strategy

Health Care Obamacare 2009

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#1 Nittany Lioness

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Posted 09 September 2009 - 10:59 AM

This is from weeks ago so I think the Post has released it to view in full:


Obamacare: The Only Exit Strategy

Friday, August 28, 2009

Obamacare Version 1.0 is dead. The 1,000-page monstrosity that emerged in various editions from Congress was done in by widespread national revulsion not just at its expense and intrusiveness but also at the mendacity with which it is being sold. You don't need a PhD to see that the promise to expand coverage and reduce costs is a crude deception, or that cutting $500 billion from Medicare without affecting care is a fiction.

But there is an exit strategy. And a politically clever one, if the Democrats are smart enough to seize it.

(1) Forget the public option. Whatever the merits, and they are few, it is political poison. It dies by the Liasson Logic, the unassailable observation by NPR's Mara Liasson that there are no liberal Democrats who will lose their seats if the public option is left out, while there are many moderate Democrats who could lose their seats if the public option is included.

(2) Jettison any reference to end-of-life counseling. People see (correctly) such Medicare-paid advice as subtle encouragement to voluntarily refuse treatment. People don't want government involvement in a process they consider the private province of patient, family and doctor. The Senate is already dropping it. The House must follow.

(3) Soft-pedal the idea of government committees determining "best practices." President Obama's Federal Coordinating Council for Comparative Effectiveness Research was sold as simply government helping doctors choose the best treatments. But there are dozens of medical journal review articles that do just that. The real purpose of such councils is ultimately to establish official criteria for denying reimbursement to less favored (because presumably less effective) treatments -- precisely the triage done by the NICE committee in Britain, the Orwellian body that once blocked access to a certain expensive anti-blindness drug until you went blind in one eye. (NICE: the National Institute for Health and Clinical Excellence.)

(4) More generally, abandon the whole idea of Obamacare as cost-cutting. True, it was Obama's original rationale for creating a whole new entitlement at a time of a sinking economy and a bankrupt Treasury. But, as many universal-health-care liberals complain, selling pain is poor salesmanship.

(5) Promise nothing but pleasure -- for now. Make health insurance universal and permanently protected. Tear up the existing bills and write a clean one -- Obamacare 2.0 -- promulgating draconian health-insurance regulation that prohibits (a) denying coverage for preexisting conditions, (b) dropping coverage if the client gets sick and © capping insurance company reimbursement.

What's not to like? If you have insurance, you'll never lose it. Nor will your children ever be denied coverage for preexisting conditions.

The regulated insurance companies will get two things in return. Government will impose an individual mandate that will force the purchase of health insurance on the millions of healthy young people who today forgo it. And government will subsidize all the others who are too poor to buy health insurance. The result? Two enormous new revenue streams created by government for the insurance companies.

And here's what makes it so politically seductive: The end result is the liberal dream of universal and guaranteed coverage -- but without overt nationalization. It is all done through private insurance companies. Ostensibly private. They will, in reality, have been turned into government utilities. No longer able to control whom they can enroll, whom they can drop and how much they can limit their own liability, they will live off government largess -- subsidized premiums from the poor; forced premiums from the young and healthy.

It's the perfect finesse -- government health care by proxy. And because it's proxy, and because it will guarantee access to (supposedly) private health insurance -- something that enjoys considerable Republican support -- it will pass with wide bipartisan backing and give Obama a resounding political victory.

Isn't there a catch? Of course there is. This scheme is the ultimate bait-and-switch. The pleasure comes now, the pain later. Government-subsidized universal and virtually unlimited coverage will vastly compound already out-of-control government spending on health care. The financial and budgetary consequences will be catastrophic.

However, they will not appear immediately. And when they do, the only solution will be rationing. That's when the liberals will give the FCCCER regulatory power and give you end-of-life counseling.

But by then, resistance will be feeble. Why? Because at that point the only remaining option will be to give up the benefits we will have become accustomed to. Once granted, guaranteed universal health care is not relinquished. Look at Canada. Look at Britain. They got hooked; now they ration. So will we.
============================

And this is pretty funny:

No, I don't want to interview Obama - by Richard Cohen

Edited by Nittany Lioness, 09 September 2009 - 11:34 AM.

I'm cold Howard.jpg


#2 Balderdash

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Posted 09 September 2009 - 11:47 AM

From the article by and about RIchard Cohen in July:

Quote

In truth, I did not seek an exclusive interview with the president of the United States not only because I wanted to write something that would be noticed but also -- actually mainly -- because I feared that if I did get an exclusive interview I would be expected to ask him something about health care reform, about which I know next to nothing. What was worse, despite reading six newspapers a day, watching cable news shows, network news shows, the "NewsHour" and being online all the live-long day, I could not fathom what the president wants to do with health care. I suppose this is all my fault since, I learn from reading my e-mails, almost everything is.


First, I take any and everything said by Charles Krauthammer with a salt lick.  :p  I know you like the dude but he's far too partisan.  But the Cohen article is about as right as it can get.  I don't understand how we can be told that the public option is off the table when I don't even know when it was on there and how it got off.

Another Democrat leaning Independent that has to search for truth because it can't be found on Fox News OR MSNBC.



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#3 Drew

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Posted 09 September 2009 - 12:07 PM

As I read Krauthammer's solution, I thought "Is he nuts?" . . . and then I got to the "catch." He's spot-on. His solution would have vast appeal, but that's because everyone would be too short-sighted about it to see what would be coming down the road.

Though it would be helpful if we could get tort reform, wouldn't it? I wonder why no one in Congress will touch that one?  :sarcasm:
"Someone must have slandered Josef K., for one morning, without having done anything wrong, he was arrested."

#4 Nick

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Posted 09 September 2009 - 12:18 PM

View PostDrew, on Sep 9 2009, 01:07 PM, said:

Though it would be helpful if we could get tort reform, wouldn't it? I wonder why no one in Congress will touch that one?  :sarcasm:

Lawyers are the larval form of politicians.  Can't impact the livlihoods of their babies.

On the other hand, I've said before, "tort reform" makes me uneasy.  Malpractice does happen and true victims can be ruined for life, unable to work (if they survive), and put a major burden on their families.  This will all vary on a case by case basis, and I think determining if the doctor's really at fault and how much the victim deserves should remain the decision of a judge and jury of peers.  So I'm pretty "anti-cap" as a result.

Now, looking at the lawsuits themselves . . . how much of a drag on overall healthcare spending are we actually talking about here?  How many of these suits are legit vs. bogus and how can it be accurately determined which is which?

Finally, malpractice insurance is outrageous . . . but do malpractice insurance premiums accurately reflect the costs of litigation spread out over a pool of doctors?  Or is the real drag being caused by insurance company gouging?

And what sort of tort reform do you have in mind, specifically?

#5 Drew

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Posted 09 September 2009 - 12:38 PM

View PostNick, on Sep 9 2009, 12:18 PM, said:

View PostDrew, on Sep 9 2009, 01:07 PM, said:

Though it would be helpful if we could get tort reform, wouldn't it? I wonder why no one in Congress will touch that one?  :sarcasm:

Lawyers are the larval form of politicians.  Can't impact the livlihoods of their babies.

On the other hand, I've said before, "tort reform" makes me uneasy.  Malpractice does happen and true victims can be ruined for life, unable to work (if they survive), and put a major burden on their families.  This will all vary on a case by case basis, and I think determining if the doctor's really at fault and how much the victim deserves should remain the decision of a judge and jury of peers.  So I'm pretty "anti-cap" as a result.

Now, looking at the lawsuits themselves . . . how much of a drag on overall healthcare spending are we actually talking about here?  How many of these suits are legit vs. bogus and how can it be accurately determined which is which?

Finally, malpractice insurance is outrageous . . . but do malpractice insurance premiums accurately reflect the costs of litigation spread out over a pool of doctors?  Or is the real drag being caused by insurance company gouging?

And what sort of tort reform do you have in mind, specifically?

Well part of the problem, as mentioned elsewhere, is that thanks to our overly litigious society, doctors prescribe far more tests than are actually necessary just to cover their asses. So every time I hear complaints about doctors wanting unneeded tests, I chalk this up to scummy lawyers like John Edwards who single-handedly made North Carolina the most dangerous state in the union for OB/GYNs to practice in.
"Someone must have slandered Josef K., for one morning, without having done anything wrong, he was arrested."



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