Hobby Lobby

If you have not heard the SC just ruled that some companies may be required to provide only 16 of 20 kinds of  birth control in their employee health care.  Obama care cannot be required to provide the other 4 on the grounds that they are too close to happening after conception and therefore contrary to some peoples religious beliefs.  This means that if you want one of the other 4 kinds then you would have to get it from charitable group or pay for it your self.  I think that this is a close call and a hard case.  However, as usual, the rhetoric goes way beyond the reality.

I also heard Rachel Maddow describe this in a way very similar to the following.

"The Supreme Court basically ruled that bosses can tell women what they can and cannot do with their bodies.  They can control our reproductive health care.  This has nothing to do with religious freedom."
Donna Brazille, ABC news, Sunday morning show

The hostess did not caution her that she was over the top.  Someone needs to.

It is time that we start to call this kind distortion what it is.

What she said is not true.

SHE IS LYING.

The Affordable Care Act

I urge you to watch the news and recall the quote from Nancy Pelosi:

"We'll have to pass the bill, in order to find out what is in it."

Disease

The AMA has classified obesity as a disease.  With the move from private insurance to universal government sponsored health care in the US it seems inevitable to me that the definition of disease will devolve to include anything that remotely resembles a health issues.  Which, being covered by the ACA, is then (by definition) a public issue.

I predict that under the guise of protecting us (the citizen flock) a crisis mentality will be generated in Washington that will insists on government sponsored research to identify the health benefits or effects of almost everything.

Currently the NIH spends over 1B annually to study the cause and health effects of obesity.  I am pretty sure weight gain is caused by putting too much food in your face.  I suspect the obesity studies are merely the tip of the silliness health studies to come that will protect us from “disease”.  

Campaign 2012 Obama Domestically

A continuing description of the candidates in several aspects of the job.  I am putting this up, not for your benefit, but for mine. I am soliciting your comments in the hopes of improving my own perspective.

See also Campaign 2012 Obama Foreign Policy for thoughts on that.

In domestic policy the thing that I wanted from Obama was NHI (= national health insurance.)  I would have preferred that it be a single payer thing and that the financing be honest.  See YA NHI1 and YA NHI2 

Of course we did not get NHI, but we got ACA which I consider to be a giant step in that direction.  We also did not get a fiscally sound system.  The second shortcoming of ACA is part of the more general fiscal problem.

With respect to the giant step.  I believe that we have not had NHI because of our system of employer provided health insurance.  People are afraid of what they do not know and so they cling to what they have.  The ACA offers employers a very good deal if they decide to not offer health insurance to their employees: a $2,000 “fine” instead of a $5,000 to $15,000 health care plan.  Hmmm - I wonder which they will choose.  Within a few years there will be far less employer provided health insurance.  Shortly after that we will have national health insurance.

I give a lot of credibility to the argument that we were in a very deep hole when Obama came in.  We are coming back.  They tell me that when the recession comes from a failure in the financial industry, then the comeback is slower. 

I understand that Obama could not get any more stimulus than he did, but it should have been spent on infrastructure rather than tax cuts (Republicans) and bailing out state governments (Democrats).  [Just on that thought, I too am a national debt worrier.  Perhaps even a "Krugman denier".  But there are limits.  Scheduled, short term debt is different.  More and more people are pointing out the lunacy of our not taking advantage of the following:  we have high unemployment, major infrastructure needs, and money that the Fed. Govt. can borrow for 10 years at less than 2%.  When the gods make you an offer that you can’t refuse, don’t refuse it!  We could borrow and spend a trillion dollars, earmark Obama’s tax on the rich (or something else) to pay it back over ten years. You can do that for a total interest cost of 11% of the loan.]

I blame the Republicans for the profligacy of continuing the “Bush tax cuts”, the Democrats for the subprime mortgage fiasco which the government financed and which has not yet been unwound, and both of them for constructing a financial system which includes entities which were too big to fail.   They have not fixed any of these things.  (Capitalism without failure is an oxymoron.  If a company is too big to fail it is too big to exist.  Break it up.)

The GM-Chrysler thing is something that I cannot judge – whether Romney’s direct bankruptcy and then refinancing was essentially the same as Obama’s except that the unions got a special deal from Obama which was funded by the government. (We still own a lot of GM.)

Obama’s attitude toward business worries me.  Like so many liberals he gives the impression that, if he had his druthers, he would really like to have his capitalism without so damn many capitalists in it.  The context from which his little “you didn’t build it” line came is more troubling to me than the line itself. “You say you worked hard.  There are a lot of hard workers out there.”  Seriously, what exactly is the conclusion that we are going for here?  (If you are going to answer this, go a little deeper than – “there is luck involved”.  Who among us does not know that there is luck in life?)  Seriously, if you were going to talk to people about what goes into starting a business, wouldn’t you at least mention risk?  And it is not just business.  A lot of successful people had to take risks to be where they are.  For example, if you are a doctor then you have all of the costs of the ten years of schooling beyond HS and the cost to live during those ten years.  But, perhaps the biggest thing is that you go for those 10 years without earnings, without building up any savings, without building up any equity in a home.  And nobody guarantees that you will actually become a doctor.

The main negative for Obama in this area is the fiscal problem.  I believe this is a very serious problem.  Not just the “fiscal cliff” that you hear about on TV from those who don’t know the difference between the debt and the deficit.  I mean the long term short fall.   I am not convinced that he takes it seriously. 

We the people have been borrowing and spending all of this money, not just in the recession, we have been doing this for years.  Who is doing it:  the “great middle class.”  That is the POWER in this country.  Who will speak truth to POWER? The politicians have been pandering to that POWER.  Listen to how often all of them talk about how they are going to protect the great middle class.  It is a constant pandering which is hard for us to hear because they are pandering to US. 

The left wants a larger government.  An honest liberal will tell me (or at least give me a signal) that to achieve his vision (with fiscal responsibility) we will need serious tax increases on the middle class (as well as the rich).  I have not heard that from Obama.  In fact what I have been hearing from Obama is a litany of promises to maintain all of the goodies that the various groups get from the government.

The right wants a smaller government. An honest conservative will tell me (or at least give me a signal) that to achieve his vision (with fiscal responsibility) we will need to cut some programs that are dear to my middle class heart and pocketbook.  I have heard that from Romney’s first choice: Paul Ryan.

grade B (revised from a C 10-9-12)

Tax medicare as income

To the receiver of Medicare it is insurance (very good insurance I might add).  That insurance has a value which can be calculated in a simple way (or complicated if one wanted to).  The government gives me that insurance like it gives me SS.  In the case of SS the govt computes how much I paid for it and  calculates the rest as income.  We should do the same for Medicare.  (I would do the same for any insurance paid for by an employer.  But that is another question.)

It is simple "fairness".  If you work you pay taxes on the income.  If you win the lottery you pay taxes on the winnings.  If the government gives you healthcare insurance, then you should pay taxes on it.

Notice that it is elegantly simple and also progressive.  This income would be taxed at the taxpayer's highest marginal rate.  Someone with enough income to pay at a higher rate would pay more.  I would pay (considerably) more.  However,  the poor (including a lot of our mothers) could add the value of their healthcare onto their income and still not be owing any income tax.

The proceeds should be placed in the Medicare Trust Fund.  It would go a long way to solving medicare's  long term problems and be quite progressive without the onerous label of "means testing" medicare.

If you have not heard about this proposal, that is because it would hit the biggest sacred cow in the American tax universe:  THE MIDDLE CLASS.

The reason both sides offer pixie dust solutions is that they want the public to believe that they are the ones who can solve the money problem WITHOUT hitting the middle class.  I do not believe it.

Of course the rich should pay more per person than anyone else,  they do so now, and they would pay even more with this proposal.  But you can't get it all from them.  The tax  loopholes uh "opportunities" that are owned by the middle class are huge:  untaxed healthcare, mortgage interest deductions, child deductions, and charitable contributions.  These are called tax expenditures and they are defended vigorously by all of the middle class's agents in Washington i.e. the politicians.

Of course, this is not a complete solution to the fiscal problem.  But it would be a significant step.
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on Bruce's April 2 Post

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1. Yes I am serious about how silly I think it is.
2. I think we all are to some degree going to have a problem being objective.
3. The PCIP issue is one of the main reasons that I support NHI and one of the main justifications for requiring that everybody participate. (Preferably by taxation by just expanding Medicare. Of course we would need a lot more taxation.)
Obviously the PCIP individual wants health care and my sympathy for them is dependent on how they got there. If they had insurance and lost it because of a life change, then I’m sympathetic. But if they just didn’t want it and didn’t buy it until they got the illness, then it seems unrealistic to me to tell an insurance company (whose business it is to manage risk) that they should have to pay someone’s bills after the fact.
Consider an analogous case of someone who gets a fatal illness and has only 2 months to live. Should an insurance company be required to sell them life insurance?
4. Why does this move me to support NHI? Well, medical technology being what it is, the possibility of predicting what expensive illnesses you will have is growing rapidly and undermining the whole concept of “risk management” insurance. In a few years you will be able to check the dna markers and know what diseases you are likely to get and with what probability. In deference to your rights of privacy the govt will not let anyone require you to tell them what those things are. Now when you set down with the insurance agent you have a lot more information than he does. The ins. Com. will have to assume the worst and charge accordingly. That is not an arrangement that will produce good contracts.
5. I agree that the Rs are not looking very good either, but Ryan’s budget does show the Rs accepting heat (for proposed reduction of services) to further their goal of restraining the growth of government and dealing with the fiscal situation. The Ds on the other hand offer everything to everybody and are not willing to take the heat (increased taxation) to further their goal of increasing government services.
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Are you Serious?

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The title was the answer that Nancy Pelosi gave when someone asked her which of the delegated powers of Congress was the one on which Obamacare was based. She apparently couldn't believe that Congress was required to be concerned about their authority granted by the Constitution.

You can see a conservative view of what it means at:Constitutional Contempt and a liberal view atA Moment of Silence for Obamacare.

Just on the side: "Does the Federal Government have a right under the Constitution to pass a law that will bankrupt the country?"
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The healthcare mandate silliness.

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This is a working example of how dishonest our nation has become.

The central question is: "Can the Federal Government force a person to buy a particular product? In this case health insurance."

We already know the answer to a similar question: "Can the Federal Government force a person to pay taxes to the Federal Govt in order for the govt to provide a particular product? In that case Medicare." The answer is yes.

So what is the problem? Why didn't they just call it a tax?

Because the entitlement programs (that were advertised by their advocates as costing much less than they do) are sliding our country into bankruptcy and the people have started to figure that out. (The response of many of them, not too clever in my mind, is to put an absolute veto on taxes.) So to get the bill passed its advocates were obligated to make all sorts of magical claims. Thirty million newly covered (no extra cost!), 500 billion taken from medicare (no loss of coverage!), finally that small extra cost would be covered by the health car tax uh mandate. Because of Obama's campaign promise and all the politicians fear of the electorate, they couldn't raise taxes!

So they just walked us into Wonderland and here we are.

Disclaimer: This is written by someone who supports national health insurance and is disgusted with our politicians.
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Birth Control Mandate 2 - Cynical(?)

In the comments on Birth Control Mandate 1 I suggested that Obama did this "as a base rousing action. A chance to change the topic of conversation from money to culture wars issues."

Bruce suggested that this was cynical. I think that raises a good pair of questions:

A. Is it cynical to think that Obama did this thing as a political ploy? Consider Clinton's Sister Souljah moment in 1992 which was a similar gambit. No, I don't think that it is cynical that I believe that politicians try to manipulate our emotions in order to get our votes. I think that it just means that I watch these guys.

B. Would it be cynical of Obama if he did this thing as a political gambit*? Well by doing this he has firmed up an important part of his base and thrown a monkey wrench into the Republican nomination race. Notice how much the Rs have dwelt on it and that Santorum, the quintessential R social issues guy, is now at the front of the pack. This is a great issue for Santorum in the primaries, but a disaster for the Rs in the general.

With a bit of luck Obama may have induced the Republicans to nominate Santorum!!

I don't think it is cynical of Obama, I think it is clever.

* The word "gambit" is particularly appropriate here because, in chess, a gambit is the giving up of something - usually a pawn - in the expectation of getting a lot more back later. In the political case you take some temporary heat for some bigger gain later.
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National Health Care 3

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Most of the time the advocates of national health care have taken an all or nothing approach. Medicare being the huge counter example. Have you ever wondered what would have happened if they had taken a gradual approach at other times?

After Medicare was done in the sixties what if the supporters of national health care had simply extended it to children under 18? There were several times in the seventies and nineties when the Democrats controlled the President, Senate and HR. Kids are not too expensive and an equal opportunity argument could have been made.

Maybe next you could include all of those who had ever been in the military service for the country for 5 years. Then their families.

Now imagine the consequences. After they passed 18 all of those people would be accustomed to having had health care all of their life.

Surely they would be more inclined to support a full scale "medicare for all."

Clinton on Health Care

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“I think the Democrats are going to have to be willing to give up, maybe, some short-term political gain by whipping up fears on some of these things — if it’s a reasonable Social Security proposal, a reasonable Medicare proposal. We’ve got to deal with these things. You cannot have health care devour the economy.”
Bill Clinton

Dr. Death

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They tell me Jack Kevorkian died.

Did he have any help?

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the individual mandate

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The argument about Obamacare seems to center on the "individual mandate".

I mentioned to a friend that they say it is unconstitutional for the federal government to require an individual to buy health care insurance.

My friend responded: "OK. Now tell me again what Medicare is?"

He's still waitin' for an answer.
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Romney and the individual mandate

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The individual mandate (IM) is the requirement that the individual purchase health care insurance or pay a fine.
Here are the facts as I understand them:
1. Romney's healthcare law in Massachusetts included an individual mandate.
2. Obama's healthcare law contains an individual mandate.
3. There has been a major legal attack on Obama's healthcare law which argues that the individual mandate is unconstitutional.
4. Many people see this as a major problem for Romney.

The argument is that any Rep. candidate must oppose the IM.
Romney cannot oppose the IM because his program contained one.
Therefore Romney has a big problem.

I don't see it.

As everybody (except Nancy Pelosi) knows the Federal Government is limited to its enumerated powers. The states have the power to do anything that is not prohibited to them. That is, the states' powers are open ended.

The IM lawsuit says that the enumerated powers of the Feds as specified in the constitution do not include the power to require an IM.
But the lawsuit does not say that STATES do not have that power.

It seems to me that Romney can simply argue that he believes that this is a legitimate state power but not a federal one.
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Healthcare 2 - another view

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Vince offered a different point of view on national health care the other day. Since the original post was so long ago June 11, 2010, I thought that I would just put Vince's comment up here as a new post.

There is a central point that is generally ignored by those who favor National Heath Care. Here, a maxim from the philosophy of Libertarianism is needed.

There can never be a right to health care. Any so-called right whose implementation is dependent on the seizure of money or property from one man to another can never be right. It is nothing less that inflicting slavery and tyranny upon one man from another.

To put it simply, if you come to my house carrying near lifeless, sick child in your arms, I will do my best to give what I can and seek to raise the rest from the voluntary charity of others.

But if you come with the determination to take by force, if necessary, what is needed to save that child, you are no better than a common thief and robber and should be treated accordingly.

Despite the slow poison of government interference, (i.e. Medicare and Medicaid), what is left of the free market in medicine in this country has produced the highest quality medical care in all human memory.

Problems of access can only be solved by the slow elimination of all price distortions of government granted health care and a return to the original principles of the free market.

If you scoff at what you might say as simplistic solutions, go to the Cato Institute. There you will find detail plans, showing what a true free market in medical care would look like.

Vince, March 16, 2011

Say it ain't so...

So, I'm actually somewhat out of the loop on what's going on in the US right now.

I just found out that there are some members of congress who voted against the so-called ObamaCare and yet signed up for the new tax-payer subsidized congressional and government plans.

I further heard that the reason this is OK (even if slightly hypocritical) is because “Unfortunately, being here in Washington is very expensive." (Rep. Renee Ellmers, N.C. (R)) Apparently way too expensive for her $174,000 annual congressional salary.

But I don't blame her for anything. I don't agree with affirmative action, but I'm a beneficiary of it. And I will continue to be as long as I can. Hypocrite? Sure. But it'd be just plain stupid to do otherwise. So, if I have a choce between being stupid, and being a hypocrite, well I think there is not really a choice to be made. So, I think members of congress are perfecetly right in accepting the healthcare they attempted to eschew from general voting populace. It's a dam good deal and they'd be stupid not to take it.

Clearly the problem lies elsewhere. I don't know where exactly, but it's probably somewhere in the neigborhood of whatever the hell made her think it was a good idea to take a job that doesn't pay enough to live "comfortably" in the city where the job is located.

I'd be willing to bet that the worst student in the worst inner city middle school in the worst inner city in the nation would be able to tell you it's a bad idea to take a job that doesn't pay you enough money to live where you need to live in taking the job. Hell, ask your own kids. "Kids, is it a good idea to take a job that doens't pay you enough money to live in the city where you'll have to live if you take the job?" I'll wait..................

Please tell me I'm missing part of the story...Surely the leaders of our country cannot be so dense as to not know that you don't take jobs that don't pay you enough money to live in the city where you'll have to live if you take the job...And if they are that dense, then I think our nation's elite private schools (that many members of congress attended) have much bigger problems than our underfunded public school kids who are merely getting there asses kicked in math by the Japanese.

So please readers, where have I, or it, gone wrong??

S. Holbrook

P.S.
Here's an idea...stop paying members of congress so much money to not sit in those supremely comfortable looking tax-payer bought chairs I see on C-SPAN and I'd be willing to bet that the prices of goods and (ahem) "services" would decrease dramatically.

Just a thought...

one sixth of the economy

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I'll bet that you have heard that "Obamacare is a government takeover of one sixth of the economy!" This is because health care is about one sixth of the economy. I find it curious how infrequently anyone points out that, what with medicare, medicaid, and military healthcare the government has already taken over half of health care. O K, so that's half of that one sixth of the economy which is .... Oh, now I see now why it doesn't get mentioned much. Wait a minute, I know a math guy. Alright, half of one sixth is one twelth of the economy which was already taken over by the government before Obama arrived on the scene.

But that means that the new program can be taking over at most the remaining half, which is also one twelth of the economy!

Obamacare is a government takeover of one twelth of the economny!

Doesn't sound like nearly as big a deal that way, does it?

I guess they don't teach that kind of high powered math in Journalism School.
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death panels?

Why do death panels continue to capture peoples imagination?
Perhaps it is because the 2010 Healthcare Bill originally contained something about end of life planning which was later taken out.
Perhaps it is because the Nobel Laureate and liberal economic spokesman Paul Krugman used the term in late 2010.

I think that it resonates with people because they understand, intuitively, that any health care system must include a method for deciding which things the system will cover and which things it will not. That is simple reality.

My favorite example would be one of those procedures that is very expensive and has a very low rate of success.
I saw a television show the other day about a woman whose son was ill with a rare and expensive disease. She explained how happy she was that the lifetime limit on his insurance was $6,000,000. But then she discovered that the first treatment would be $250,000 and she calculated that the coverage would run out when he was about 5 years old. What then?
Of course there is always the issue of elective surgery.

With our present system it is the much demonized insurance companies who make these decisions. You could say that they operate, or that they are, the “death panels.”
Except in the case of medicare, in which case it is the government which is making the decisions about what will be covered and what will not and how much it will pay for various services.

Someone will have to make these decisions. Someone will operate these “death panels”. Why not simply acknowledge reality here? Then give a bit of thought to the political-perception question. Begin by recalling a lesson from the past. Remember how much better it sounds to say that you are pro-choice rather than pro-abortion? Perhaps we could start calling them by some less ominous, and more accurate, name. How about, Coverage Boards.

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Wingnuts

From a recent survey:
Almost 1 in 4 Republicans suspects Barack Obama is the Antichrist, one of the most astounding findings from a stunning new online poll from Harris Interactive. Majorities of Republicans also believe that Obama is a socialist (67 percent) and that he wants to take away Americans’ guns (61 percent), is a Muslim (57 percent), has done "many" things that are not constitutional (55 percent), and wants to turn the country over to a one-world government (51 percent). In fairness to the GOP, the poll indicates that the country generally seems to have become a bit unhinged. Overall, 40 percent of Americans think Obama’s a socialist, 32 percent think he’s a Muslim, and 1 in 4 thinks "he is a domestic enemy that the U.S. Constitution speaks of." As noted small businessman and family values maven Norman Bates once said, "We all go a little mad sometimes." But it’s clear that the right wing is the anchor pulling the country toward loonyville in this data set.

This is very interesting. Someone on the right needs to do a study of some analogous foolishness on the left.
For some possible questions consider what % of democrats would agree with:
1. House Majority Whip James E. Clyburn 's statement that "every American will benefit from this healthcare bill."
2. The healthcare bill will cost less than $1 trillion.
3. Taking $500 Billion out of medicare will strengthen medicare.
4. No one with an income of under $250,000 will have any kind of tax increase during Obama's administration.
5. I don't care about any of that, I have faith in Obama.

PS That thought came from a single payer advocate who voted for Obama.
Remember there are wingnuts on both sides, and apparently none of them can do arithmetic.

National Health Care 1

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I have reluctantly come to support it. By NHC I mean some variation of a single payer plan with the federal government picking up the bill. A simple description of that is: Medicare for all.
The principle motivator for me was that technology has presented or is presenting us with a major problem with respect to the viability of health insurance itself. We are becoming more and more able to predict which diseases that someone is likely to get. What do we do with that information? Privacy concerns will prevent individuals from being required to reveal that information. Therefore, in the face of that deficit of information, the insurance company would have to charge a rate based on the worst case scenario. That will make insurance even more expensive than it already is.
Of course, this would require an increase in taxation. If the choice is between doing it and not paying for it or not doing it, then I choose not doing it.
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