Health Care "Reform"

Please forgive me for a serious column, only two weeks after another one. Also forgive me for not even bothering to link sports to it. This is too important an issue for literary gymnastics.

Where to begin? Let's begin with this: I am completely opposed to the health care "reform" bill that was enacted (not passed, mind you, as I'll discuss later) by Congress and the President this week. But it's not enough to say it sucks, or that I hate it, or blah blah blah. There are plenty of pundits supporting or deriding the bill who haven't done a sufficient job of elucidating their thoughts. They haven't explained WHY they hold their position.

This came up in a discussion with my mother this week. She had read some particulars in the paper and wondered why everyone she knew was so opposed to the new bill. After all, besides forcing people to buy insurance, what was so objectionable about it? That led to me basically trying to break down objections and explain their source for the next 20 minutes. Hopefully, writing them down will give more clarity to them. So with that in mind, here is why I am completely opposed to this bill, and why I hope you will join me in "throwing the bums out" this November (as much as we can here in Kansas, which generally has more traditional representatives anyway).

There are three primary reasons I oppose the plan. The first is that I oppose the ideology of the plan. Some of what this bill purports to do is simply against the nature of the United States and freedom in general. But before being written off as an "ideologue" that refuses to accept reality, note that there are two other primary reasons to my opposition. The second is practicality. This bill is an unwieldy monster, over 2000 pages of legalese to challenge even the most adroit reader. The third primary reason is the bill's lack of integrity. The story of this bill's enactment is a sordid tale of secret deals, thinly-veiled ulterior motives, and finally a legislative sleight-of-hand that violates the Constitution itself, the very law members of Congress are sworn to uphold. Let's look at each of these primary reasons in turn, answering the comments of a fictional "advocate" of the bill.

Advocate: "Don't you want to help people? What about those poor people who can't afford health insurance? Shouldn't we all pay our fair share to help them?"

Of course we ought to help people, but it must be VOLUNTARY!!!! That is the very nature of freedom. That is the very nature of liberty. If I CHOOSE to do something, then I am exercising freedom. If I am FORCED to do something (and let's please not go down the rat-hole of philosophical discussions concerning whether anyone can really be forced to do anything) by the government, my freedom is being squelched. This bill forces me to purchase something. If I don't, I will be fined for a roughly equal amount. That goes for every man, woman, and child in the country. According to this bill, simply to live requires you to purchase health insurance.

Advocate: "How is this any different from rules that force people to own auto insurance, or even pay taxes, which we've been doing for years?"

First, you don't have to purchase auto insurance. You purchase auto insurance in order to drive a car, but you can choose not to own a car and you won't have to purchase insurance. So there is a choice involved, unlike with this health bill. As for taxes, again there is a choice involved. Taxes are based on income, property, and transactions. If I choose to live off the land, own nothing of significant value, and obtain no discernible income.... I am not liable to pay any taxes. That may be a terrible life, but at least there is the choice. That is different than this health bill, where no matter what choices I make, I will be held liable to purchase insurance.

Also note that there is no provision in the Constitution of the United States that gives the federal government the power to enact this demand. The government may levy taxes and regulate interstate commerce, but nowhere does the Constitution grant a power to force an individual purchase.

Advocate: "You're splitting philosophical hairs. Legal counsel will argue you under the table on the Constitution, and the courts will deny all these states-rights objections being raised around the country. You gotta have a better reason than that to oppose such a wonderfully beneficial piece of legislation."

OK, the second main objection is that this bill simply isn't practical. It forces insurance companies, the same ones from which it forces us to obtain policies, to expand benefits while not denying anyone coverage (the "no pre-existing conditions" stuff). Now just how will the those insurance companies, who already have an average profit margin of a mere 2% (For every dollar you give them, 98 cents goes to pay medical bills and their own employees), respond? They will raise their rates to compensate. So prices will go up. Also, ask any doctor why medical costs are so high and one of the first things mentioned will undoubtedly be the cost of insurance... THEIR OWN. Doctors have to spend a TON of money on medical malpractice insurance, just in case something goes wrong and a patient sues. With that in mind, take a look at this little excerpt from the actual bill:

(A) REQUIREMENT- Beginning not later than January 1, 2011, a health insurance issuer offering group or individual health insurance coverage (including a grandfathered health plan) shall, with respect to each plan year, provide an annual rebate to each enrollee under such coverage, on a pro rata basis, if the ratio of the amount of premium revenue expended by the issuer on costs described in paragraphs (1) and (2) of subsection (a) to the total amount of premium revenue (excluding Federal and State taxes and licensing or regulatory fees and after accounting for payments or receipts for risk adjustment, risk corridors, and reinsurance under sections 1341, 1342, and 1343 of the Patient Protection and Affordable Care Act) for the plan year (except as provided in subparagraph (B)(ii)), is less than-

(i) with respect to a health insurance issuer offering coverage in the large group market, 85 percent, or such higher percentage as a State may by regulation determine;

(ii) with respect to a health insurance issuer offering coverage in the small group market or in the individual market, 80 percent, or such higher percentage as a State may by regulation determine, except that the Secretary may adjust such percentage with respect to a State if the Secretary determines that the application of such 80 percent may destabilize the individual market in such State.

Huh? I'll admit that I'm not the greatest reader in the world. I'll also admit that there are probably some accountant lawyers out there who actually understand this. But remember that this bill is over TWO THOUSAND PAGES of this same legalese. It's a labyrinthine mess. Did we really need over 2000 pages of incomprehensible junk just to help people pay for health insurance? No, but can you now imagine your local ambulance chaser getting hold of this? Do you think that perhaps lawsuits might be springing up left and right? Don't you think it's probable that malpractice and other medical lawsuits are far more likely under such a bill than they already were? Medical costs will skyrocket. Insurance costs will skyrocket. And because we'll be FORCED to join, our bills will skyrocket.

Advocate: "This bill isn't THAT complicated... and besides it will save money in the long run! President Obama and even the Congressional Budget Office said so!"

Uh-huh. Right. Do you really think that playing a spreadsheet shell game with Medicare funding will miraculously provide money for all the provisions in this bill? This bill is such a money-saver that it required a rider piece of legislation that performs a sweeping government takeover of the student loan business (a terribly under-reported issue that gets short shrift simply because it pales in comparison to the health bill itself) to balance plan incomes. This bill is such a money-saver that it required scads of new taxes (the tanning tax, the capital gains tax increase, the medicare tax, etc.). This bill is such a money-saver that it calls for the addition of some thousands of new IRS agents (all federal jobs with big paychecks and benefits) specifically just to track everyone's payments and insurance companies' compliance.

Advocate: "Well, the rich need to pay their fair share! We need higher taxes!"

Without getting deep into this argument, just note that this comes at a time when money around the country is in short supply. The national debt is already so high that it is threatening the stability of our entire economic system, and we're now piling onto it with this bill. Forget fair for a moment. Is it realistic to think that we can throw a bunch of additional taxes on any group in this economic climate without bad consequences? Is it realistic to think that you can levy a bunch of taxes on behavior and get a very specific amount of income? What if the behavior changes? It comes to this: the CBO is largely a calculator. If I ask it what 2+2 is, it will return 4. But if the 2 and the 2 that I gave are crazy to begin with, then their answer doesn't do us much good. That's what's happened with this bill. And remember that government programs invariably end up costing many times more than original estimates. There is simply no way that this bill is going to save money. It will cost money, and it will hurt the economy.

Advocate: "Sour grapes. Just because YOU can't read it, and YOU are afraid that the estimates will be wrong doesn't make it so. If you take the bill at face value and give a little benefit of the doubt, it could be great!!"

I'd like to take this bill at face value. If I honestly thought that it was enacted with altruistic motives, I might give it the benefit of the doubt. But the way this bill was written and enacted completely destroyed those possibilities. Consider: Just to get a bill written involved back-door deals of a disgusting nature. Did you hear about the "Cornhusker Kickback?" To win Ben Nelson's (Senator from Nebraska) vote, the bill was re-written so that the state of Nebraska would not be liable for certain Medicaid payments, to the tune of $100 million. Other deals were soon struck for other states, such as Louisiana and Florida.

Advocate: "AH-HA!!! GOTCHA!! These kickbacks were taken out of the final bill! Your argument is toast!!!"

But you see, those kickbacks weren't ever really taken out of the bill. There was no "final" bill. Due to congressional procedures, the only way to avoid a Republican filibuster (which was made possible by the stunning election of Scott Brown in Massachusetts) in the Senate was to enact a process called "reconciliation." I won't pretend to describe the whole chain of events for you, as it's been much better described here: http://news.yahoo.com/s/weeklystandard/20100323/cm_weeklystandard/theprocessisthesubstance . The upshot is that the House never actually voted for a final health care bill. They instead voted on a series of modifications, of which the removal of the "kickbacks" was one. But because the modifications said that the original Senate bill was "deemed to have passed," passing the modifications was equivalent to passing the whole bill. It's a ridiculous legerdemain that violates the principle of the Constitution which (in Article 1 section 7) specifies that bills must pass both the House and the Senate before being presented to the President for approval. Now for all the "I"s to be dotted and the "T"s to be crossed, the Senate must approve the House's modifications, putting members in the untenable position of voting to either accept the changes or "vote for the kickbacks." Republicans who opposed the bill from the beginning are now being accused of supporting the corrupt kickbacks ( http://www.huffingtonpost.com/bill-scher/now-that-health-care-is-l_b_509935.html ). You see, the senate can stop the modifications, but the underlying bill (the original senate version with all the kickbacks) IS LAW thanks to the House having "deemed it to pass." Those kickbacks are still in there. If the senate blocks the modifications, the original Senate version (with all the kickbacks) will be law, despite never actually having been voted upon by the House. In other words, we could have a health care reform bill that was never actually voted upon in the House of Representatives.

Advocate: "Hey, it's an ugly process, everyone admits that, but at least the reform is good, and people will be helped!"

But the devil is always in the details. At what cost will this "reform" take place? Should I trust this bill and the people who enacted it? They've performed legal back-flips to push through a ridiculously over-sized, legalistic monster of a bill that oversteps the bounds of power that the Constitution provides. They claim they just want "reform" but have repeatedly stated in the past a preference for an entirely government-run health care system. I'm sorry, but as I wrote two weeks ago, the ends do not justify the means. Even if this bill was beneficial, the method by which it was enacted is shameful. Even worse is that this was done by the same people who chided President Bush as being too "secretive" and promised an "open" government where everything would be on C-SPAN. Oops, I guess.

Advocate: "So you would rather let people die?!"

People will die. You can't stop it. I can't stop it. Doctors and nurses can't stop it. Only God can stop it, and Barack Obama and Nancy Pelosi combined are still nowhere near God. This health care bill will not prevent people from dying. What it WILL do is destroy the core of our freedoms, sink the nation even further into debt, and further corrupt our already corrupt government institutions. Someone, somewhere, will probably benefit as a result of this health care bill. But that doesn't justify the slow ruination of every American's life. If we are to improve health care in the United States, this bill isn't a good way to do it. In fact, it will make things worse. Reform is only good if it improves something. Otherwise, it's change for the sake of Barack Obama's change.

I am steadfastly opposed to this "reform" package. It is wrong on a philosophical level in that it violates our freedoms and the spirit of the Constitution. It is wrong on a practical level because it will raise costs, increase litigation, and sink our nation further into debt. It is wrong on an ethical level because it was slipped through Congress via a series of procedural sleight-of-hands, back-room deals, and broken promises.

Hey! I CAN link this post to sports. Health care reform bill? Strike three.... you're out!

SAH