Sunday, November 29, 2009

An Obamacare Final Exam

Posted by: Hugh Hewitt at 11:06 AM

Hank Adler is my co-author on The Fair Tax Fantasy, and he raises some very basic questions as the big denate on Obamacre opens this week:

Finals are approaching in most universities and high schools throughout the country. With a 2000 page Senate Healthcare proposal, it is unlikely that anyone could pass an examination on the specifics of the legislation. However, we should expect that the members of the United States Senate should be able to pass an examination regarding the general aspects of the current Senate proposal. Below is a series of essay questions, each of which should be answerable on two pages of a blue book, which should be presented to each member of the Untied States Senate:



Questions related to the overall economics of the Senate proposal:

1. Including the proposed tax increases, the current proposal is promised to be revenue neutral over the first decade. Are there any recently passed Senate bills or future Senate proposals which will positively or negatively impact the revenue neutrality of the current bill? If so, how do/will such bills impact the revenue neutrality of the proposal? (Please include a discussion of any current proposals to permanently improve doctor's compensation under Medicare.) As perhaps the strongest argument supporting the current proposal is its revenue neutrality, is it appropriate for each Senator to commit to vote against any future proposals which would increase healthcare costs?

2. The current bill is not revenue neutral after year ten, what revenue increases or expenditure reductions would you propose and/or expect beginning in year eleven to pay for the healthcare proposal?

3. Over $400 billion dollars of new taxes will be collected during the first four years of the Healthcare proposal without a significant expenditure of funds. What are the underlying economic theories supporting the raising of taxes in the midst of the most severe recession in over fifty years? (Please include a discussion that contrasts the current proposal with President Hoover's increase of taxes during the early years of the Depression.)

4. Assuming that a public option is included in the final proposal, please identify the timing and impact of employment in the private sector versus the public sector for the healthcare system. Please identify concerns and solutions with respect to geographic dislocations and system creation issues.

5. Given that several states, including California, are currently virtually bankrupt resulting from systemic budgetary issues, please explain the significant expansion of state funded Medicaid requirements in terms of the financial viability of such states.

Questions regarding the health delivery impact of the Senate proposal:

1. The Senate proposal anticipates increases in preventative care and increased access to the healthcare system outside of free clinics and hospital emergency rooms. Please explain how citizens without sufficient funds to pay the required co-pay included in virtually all insurance policies will be accessing the healthcare system under the current proposal.

2. Please explain why the exact coverage to be required and the amount of co-pays is not specified in the legislation and why that lack of specificity does not cause you to be concerned as to the cost estimates and ultimate access to the healthcare system.

3. Please explain the impacts of the current proposal on charitable contributions to hospitals and clinics in the United States and indicate whether these organizations will be viable with any decrease in contributions anticipated. What do you see as the continuing role, if any, of charitable organizations or free clinics in general after implementation of the current proposal?

General Questions:

1. Please explain why the current proposal is preferred over either of the following other options:



A "Marshall" type plan to train doctors and nurses wherein the government would provide loans to all individuals being trained which would therefore result in minimal costs over the ensuing decades or



The creation of government operated free clinics throughout the country providing preventive care etc., therefore avoiding all of the accompanying complications of the insurance driven strategy encased in the current healthcare proposal.



2. The President has indicated on several occasions that the current proposal is nearly identical to state requirements for auto insurance. However, in many or most states, there is a state requirement to carry insurance for uninsured drivers, which indicates that a significant percentage of the public is not carrying legally mandated auto insurance. What is the underlying data indicating that (1) with penalties for individuals not carrying insurance being drastically lower than the cost of insurance, (2) the requirement for co-pays that many poorer Americans simply will not be able to pay, and (3) the continuing requirement for hospitals to treat individuals in emergency rooms regardless of whether they have insurance, Americans will decide to purchase the insurance being offered? What data supports a result that more Americans will be covered following passage of the proposal? (In your answer, please include a discussion of the ability to get coverage regardless of current health as an incentive to individuals deciding to pay the penalty rather than carry health insurance.)

3. What is the underlying data that demonstrates that Americans who are currently uninsured because they have not completed sufficient paperwork to be insured under current governmental supported plans will complete the new forms under the proposal?

4. Please define the term "insurance" in the context of the Senate healthcare proposal. In your definition, please differentiate between automobile and homeowners' insurance where if one is fortunate, he or she may never make a claim and the insurance expected in the Senate proposal.

Bowing, Dithering and Trashing America
by Victor Davis Hanson
NRO’s The Corner

When Reality Catches up to Rhetoric

The growing problem for the Obama administration is that the public has finally caught on that the president's tough rhetoric and soaring oratory don't match reality.

"Considering all options" and "wanting more information" essentially mean dithering and voting present on Afghanistan, even after announcing the adoption of a new bold strategy.

"Saving jobs" means conjecturing about the effects of massive borrowing and enhancing your figures through the creation of fictitious congressional districts and bogus employment reporting.

"Punishing KSM" means giving the liberal community a world platform for legal gymnastics designed to repudiate the past administration and demonstrate that community's "tolerance" — without much worry about justice for KSM or the adverse effects of giving such a monster a public megaphone.

The healthcare mess grows worse: The Chinese have caught on that Obama wants to borrow more billions for us, who are cash poor, to create entitlements that they, who are cash rich, would not create for their own people. The new government suggestion that women not begin receiving routine mammograms until age 50 comes at a bad time, given that critics of Obamacare have been arguing that it will lead to rationing of service.

Guantanamo is about to go the way of tribunals, renditions, intercepts, Predators, and wiretaps — damned in rhetoric, but kept intact in reality.

"Transparency" did not quite happen either: The Obama administration has offered more photo-ops and fewer press conferences (cf. Anita Dunn on that tact), and Washington has as many lobbyists as ever. Meanwhile, the administration has not fulfilled its promise to post pending legislation on the Internet; it has politicized the NEA; and it has declared war on Fox News, the Chamber of Commerce, and the town-hall protesters. The president has even employed the sexual slur "tea-bagger" against his opposition.

Obama's "reset button" foreign policy in just ten months has made the Middle East worse and has delighted European leftists as much as it has terrified Europe's centrist leaders. In Latin America, the U.S. has gone from being an advocate of consensual government, human rights, and market capitalism to being an appeaser of Chávez, Zelaya, Ortega, the Castros, et al., inasmuch as these communist hardliners are now seen as problematic advocates for indigenous peoples and economic justice.

We are left with two conclusions. 1) A very inexperienced president has discovered that all the easy, Manichean campaign rhetoric of 2008 does not translate well into actual governance. 2) Obama is in a race to push a rather radical, polarizing agenda down the throat of a center-right country before the country wakes up and his approval ratings hit 40 percent.

We may see one of two things happen: Either the country will move more to the left in four years than it has in the last 50; or Obama will take down with him both the Democratic Congress and the very notion of responsible liberal governance, thereby achieving a Jimmy Carter–type legacy.

The next year will be one of the most interesting in memory.

Get Used to an Exceptional President and an Unexceptional Country

That's the current Obama-administration message.

I suppose that in World War II or Korea, the U.S. could have captured non-uniformed infiltrators, shipped them to a POW camp, dithered over how to handle them, and then sent them back to the U.S. for civilian trials, as if they were U.S. citizens, with full legal rights, facing criminal charges of the sort brought against Americans.

But with the upcoming terrorist trials in New York, we have crossed the Rubicon, and lots of eerie questions will arise. Can those attacked or wounded by Predator drones sue in U.S. courts for America's judge/jury/executioner treatment of them? The next time we catch a terrorist blowing up a building in Kabul, should we read him his Miranda rights, videotape his testimony, offer him a lawyer, and send him to the U.S.? Or should we wink and nod and turn him over to the Afghans, with the understanding that our post-modern justice system is so absurd that we would rather informally rely on others' pre-modern way of doing business? (Is that why Obama kept renditions — because the more we become utopian and loudly perfectionist, the more we will need others to do our dirty work?)

Why the assumption that KSM and others will be found guilty? What if one or two sympathetic souls on the jury nullify (as in the O.J. Simpson case) the evidence? If KSM et al. are found innocent, will we connive to keep them in custody anyway? Can KSM give the jury the names of those who hurt him in Guantanamo? Did Mohamed Atta go a little too far in acting out his mere "suggestion" to take down U.S. high-rises? Did KSM face life-changing bias and hurtful discrimination while a student in North Carolina?

Once you turn war into a legal tussle, every military act attracts dozens of second-guessers — as if in the cold sobriety of peace, safety, and security, those with law degrees can post facto pick apart the acts of younger fighters amid the chaos, mayhem, and danger of war.

There is a larger issue here: Obama's image is at odds with America's self-interest. The civilian trials, loud promises to close Guantanamo, and trashing (if only rhetorically) of Bush's anti-terrorism protocols apparently reflect well on Obama overseas, but they don't enhance our security.

We saw all that with his reset-button/apology tour, and the old tropes that he was only a lad when America acted badly. More recently, his not showing up at Berlin hurts us; using a video link instead to talk about his own landmark presidency merely enhances Obama. Ditto his "first Pacific president" remark. Even the trivial incidents of bowing to Saudi royals and the Japanese emperor in a way other heads of state do not reflect Obama's image of himself as the first post-national global citizen, rather than the commander in chief of the U.S.

After another year of all this apologizing, revisionism, ahistoricism, and separation of Obama the Nobel Prize winner from Obama the U.S. president, no one will quite remember that it was the Chinese and Russians who butchered millions of their own and threatened the free world during the Cold War, or that from the Middle East we got international terrorism, crippling oil boycotts, and energy cartels, or that Reagan helped crash the Soviet Union, or that the Japanese started WWII at Pearl Harbor.

Yet, given our growing mega-deficits, sliding dollar, mounting debt, spiking unemployment, burgeoning trade deficits, and government takeovers, bowing to foreign dignitaries will soon be seen, not as a sign of Obama's transnationalism, but as an obsequious and accurate reflection of our genuine inferiority.

©2009 Victor Davis Hanson

Kill the Bills. Do Health Reform Right

by Charles Krauthammer, Washington Post

WASHINGTON -- The United States has the best health care in the world -- but because of its inefficiencies, also the most expensive. The fundamental problem with the 2,074-page Senate health-care bill (as with its 2,014-page House counterpart) is that it wildly compounds the complexity by adding hundreds of new provisions, regulations, mandates, committees and other arbitrary bureaucratic inventions.

Worse, they are packed into a monstrous package without any regard to each other. The only thing linking these changes -- such as the 118 new boards, commissions and programs -- is political expediency. Each must be able to garner just enough votes to pass. There is not even a pretense of a unifying vision or conceptual harmony.

The result is an overregulated, overbureaucratized system of surpassing arbitrariness and inefficiency. Throw a dart at the Senate tome:

-- You'll find mandates with financial penalties -- the amounts picked out of a hat.

-- You'll find insurance companies (who live and die by their actuarial skills) told exactly what weight to give risk factors, such as age. Currently insurance premiums for 20-somethings are about one-sixth the premiums for 60-somethings. The House bill dictates the young shall now pay at minimum one-half; the Senate bill, one-third -- numbers picked out of a hat.

-- You'll find sliding scales for health-insurance subsidies -- percentages picked out of a hat -- that will radically raise marginal income tax rates for middle- class recipients, among other crazy unintended consequences.

The bill is irredeemable. It should not only be defeated. It should be immolated, its ashes scattered over the Senate swimming pool.

Then do health care the right way -- one reform at a time, each simple and simplifying, aimed at reducing complexity, arbitrariness and inefficiency.

First, tort reform. This is money -- the low-end estimate is about half a trillion per decade -- wasted in two ways. Part is simply hemorrhaged into the legal system to benefit a few jackpot lawsuit winners and an army of extravagantly rich malpractice lawyers such as John Edwards.

The rest is wasted within the medical system in the millions of unnecessary tests, procedures and referrals undertaken solely to fend off lawsuits -- resources wasted on patients who don't need them and which could be redirected to the uninsured who really do.

In the 4,000-plus pages of the two bills, there is no tort reform. Indeed, the House bill actually penalizes states that dare "limit attorneys' fees or impose caps on damages." Why? Because, as Howard Dean has openly admitted, Democrats don't want "to take on the trial lawyers." What he didn't say -- he didn't need to -- is that they give millions to the Democrats for precisely this kind of protection.

Second, even more simple and simplifying, abolish the prohibition against buying health insurance across state lines.

Some states have very few health insurers. Rates are high. So why not allow interstate competition? After all, you can buy oranges across state lines. If you couldn’t, oranges would be extremely expensive in Wisconsin, especially in winter.

And the answer to the resulting high Wisconsin orange prices wouldn’t be the establishment of a public option -- a federally run orange-growing company in Wisconsin -- to introduce "competition." It would be to allow Wisconsin residents to buy Florida oranges.

But neither bill lifts the prohibition on interstate competition for health insurance. Because this would obviate the need -- the excuse -- for the public option, which the left wing of the Democratic Party sees (correctly) as the royal road to fully socialized medicine.

Third, tax employer-provided health insurance. This is an accrued inefficiency of 65 years, an accident of World War II wage controls. It creates a $250 billion annual loss of federal revenues -- the largest tax break for individuals in the entire federal budget.

This reform is the most difficult to enact, for two reasons. The unions oppose it. And the Obama campaign savaged the idea when John McCain proposed it during last year's election.

Insuring the uninsured is a moral imperative. The problem is that the Democrats have chosen the worst possible method -- a $1 trillion new entitlement of stupefying arbitrariness and inefficiency.

The better choice is targeted measures that attack the inefficiencies of the current system one by one -- tort reform, interstate purchasing and taxing employee benefits. It would take 20 pages to write such a bill, not 2,000 -- and provide the funds to cover the uninsured without wrecking both U.S. health care and the U.S. Treasury.

Obamanomics 101

No cheers for capitalism.

by Fred Barnes

Back in February, President Obama met with a group of CEOs in the White House, seeking their support for his economic stimulus package. One of his chief targets was Jim Owens, the head of Caterpillar in Peoria, Illinois. The day after the session in Washington, the president flew to Peoria to speak at the Caterpillar factory and took Owens and newly elected Republican representative Aaron Schock, the youngest member of Congress at 28, with him.

Aboard Air Force One, Obama chatted amiably with Owens and Schock. Owens showed Obama two pages of a PowerPoint presentation. The first gave the details of China's stimulus, devoted mostly to infrastructure. The second was Obama's stimulus (drafted by congressional Democrats), with far less money going to building and repairing roads, bridges, and other projects. That was the problem, Owens told Obama: too little for infrastructure and thus too little to engage companies like Caterpillar, which had just furloughed 20,000 workers.

When Obama delivered his speech in Peoria, he either hadn't understood what Owens told him or simply refused to accept it. The stimulus package, he said, would be "a major step forward on our path to economic recovery. And I'm not the only one who thinks so." Owens, the president said, had told him that "if Congress passes our plan, this company will be able to rehire some of the folks who were just laid off."

This was not only untrue, but proved to be embarrassing for Obama. After the speech, Owens talked to reporters at the foot of the podium. No, he wouldn't be bringing back any workers. (Later, Caterpillar announced that 2,500 of the layoffs would be permanent.) Owens and Schock flew back to Washington on Air Force One. This time, Obama ignored them. There was a chill. Press Secretary Robert Gibbs and adviser David Axelrod walked past Owens and Schock repeatedly to speak to the press pool in the rear of the plane. They didn't stop to chat either.

I bring up Obama's Peoria adventure because it bears on the Jobs Summit for which he has summoned business leaders to the White House on December 3. In February, the president and Owens were not on the same wavelength. That's likely to be the case with Obama and the business community at the summit as well--unless Obama has changed his economic tune significantly. There's no reason to believe he has. Nor have congressional Democrats.

Obama has his own theory of our current economic situation. His "first job," he told Chuck Todd of NBC News, was to stave off another "Great Depression," save government jobs (police, firefighters, teachers), and "make sure certain sectors of the economy were supported," such as "construction and infrastructure." "We've gotten that job done," he said.

"Our next job is to make sure we can accelerate the job growth," he said. "   So what we're seeing now is businesses are starting to invest again, they are starting to be profitable again, but they haven't started hiring again."

What's the matter with these business guys? The suggestion here is they ought to be hiring. But they're "sitting on the sidelines," the president told Major Garrett of Fox News. He regards them as not-very-conscientious objectors, avoiding the struggle to revive the economy and put people back to work. They're not doing their part, their duty.

Stronger words from Obama may follow. During the Depression, President Roosevelt demonized business and the wealthy ("economic royalists") and raised their taxes. When they declined to invest and stir economic growth, he accused them of staging a "capital strike." The Obama equivalent, if it comes to that, would be a "hiring strike."

We haven't gotten there yet. But Obama has made clear in his 10-month presidency that he has minimal respect for business or the profit motive. Ambitious, talented young people should work for nonprofits. Last summer, he criticized doctors who gouged by insisting on expensive tonsillectomies to cure simple sore throats. They reflected a "business mentality," he said.

And what the president doesn't understand--or, to be more charitable, refuses to acknowledge--about free markets, the economy, and competition could fill a book, or at least an Obama speech. The economic growth he sees was produced, in part, by cash-for-clunkers and the first-time homebuyers tax credit. It foreshadowed an unusually weak recovery. And the profits came largely from cost-cutting, not a flood of new revenue.

Obama told Garrett that spending cuts or tax increases would jeopardize the recovery. But what do businesses, small and large, see staring them in the face? Tax increases--President Obama's tax increases. He backs an increase in tax rates on income, dividends, and capital gains that will go into effect in 2011. Obama-care, should it pass, is loaded with tax hikes. House Speaker Nancy Pelosi wants a Value Added Tax.

The president is looking at "tax provisions" to spur hiring, but he's done that before. Last winter, he spoke fondly of a two-year tax credit to boost small business hiring, but congressional Democrats declined to put it in the stimulus. Instead, they produced a measure that bailed out profligate state and local governments and rewarded liberal interest groups.

That stimulus has failed to stimulate, and the administration's claims of jobs it has supposedly created or saved have been discredited and become a national scandal. Obama's excuse: Calculating a jobs number is an "inexact science."

Small, targeted tax cuts like the one aimed at small business won't do much for hiring. "This is an anti-risk-taking climate," says Republican representative Paul Ryan. "You have to give them [businesses and investors] incentives to lower the price of risk." Ryan recommends cutting the business income tax to 25 percent from 35 percent, eliminating the tax on capital gains for two years, and providing a 100 percent tax writeoff for equipment, plant construction, and other expenses the first year. Hiring would follow.

Presidents from Calvin Coolidge to John Kennedy to Ronald Reagan to George Bush understood that strong incentives are necessary to trigger rapid growth and hiring. Strong incentives, plus more investment in infrastructure, would no doubt have won the endorsement of Jim Owens of Caterpillar. He didn't get them from Obama, and my guess is he never will.

Fred Barnes is executive editor of THE WEEKLY STANDARD.

An important word from Mike Walker, Col., USMC (retired)

All,

By now you have heard of the trial of Khalid Sheikh Mohammed that is to begin in New York. Some may think this is simply a trial of a terrorist tied to 9/11.

No thought could be more wrongheaded. This fight is as important as the decision to invade Afghanistan in 2001 or Iraq in 2003 or the Iraq War surge of 2007 or the current strategic review of the campaign in Afghanistan in 2009.

In fact, one could argue that the decision already made to enter this battle was more important than the decision to invade Iraq in 2003. This is a strategic battle in which the lives of thousands, tens of thousands, of innocent civilians hangs in the balance.

It is not simply a court case dealing with terrorists. It is a nation, my Country, which has crossed the Rubicon. There is now no looking back.

What is at stake is the viability of the rule of law as it has been understood for centuries in western civilization. What is at stake is a contest between two radically divergent visions of the future for humanity.

On our side are the proponents who argue that a legal system can be founded on the principal that free and reasonable citizens can create a just and progressive society. On the other side are the nihilists who believe that the seeds of destruction of that free and reasonable society lie in exploiting and perverting its judicial system.

Again, on the one side you have a society that strives to remain within the parameters of civilized behavior, all the while failing imperfectly as any human endeavor will. On the other side you have an organization that systematically attacks every tenet of the free and rational society concept. It is an enemy the embraces and revels in the violation of every concept of civil liberties as we in America know them and stridently seeks to use those selfsame values to destroy us.

As our side enters the slippery slope of demanding perfection in the most imperfect of all undertakings, war, we have an enemy who is equally determined to make gains by violating every rule and law of civilized behavior in making war.

The goal of the enemy is clear, if they so totally destroy the rules of warfare then they hope to escape entirely the consequences of their perfidious deeds. The path is clear, if the enemy violates each and every law then the enemy creates a state of chaos where the disciplined mind will, for sake of sanity, ignore their countless sins.

In its stead and in frustration born of chaos, the bewildered rationalists will seize on and lash out at the more manageable sins of those who share, rather than reject, their free and reasonable society worldview. They would rather retreat to the safety of their comfort zone by trying one of the their own then stand in the violent chaos created by the enemy and confront the enemy's wrongs.

The lesson is clear, if you try to embrace a civilized behavior in making war then you will eventually err as all humans do. At that point, having failed to be perfect, you will be criminalized and suffer the consequences.

If, on the other hand, you behave as the enemy and liberate yourself of the norms of civilized behavior in making war by deliberately killing innocents such as strapping bomb vests on the mentally disabled and sending them into a crowed market to explode (al Qaeda really did this) and are willing to lie about all your evil deeds and kill and intimidate any witnesses then, if captured, your freedom may well be assured. That is an abomination.

What must be powerfully empowering to the enemy is to witness the energies of our more civilized souls to divert their failure in reining in the enemy's terror by targeting, out of ineptitude, those who strive yet fail to obey the civilized laws of warfare.

The ramifications of the outcome of this trial are simple. In no small part, this trial will decide whose strategy is more powerful. It will partially decide if the future of civilization rests in the hands of those who adhere to a principle of removing all restraints in fighting a war or with those who imperfectly try to limit the pain and suffering to the combatants, to those who actively engage in the battle like Khalid Sheikh Mohammed.

For those who prefer the former, then set Khalid Sheikh Mohammed free. For those who believe in the later then give this man the punishment he deserves.

In no small degree, the fate of progressive civilization for at least a billion of human beings, fortunately overwhelmingly not Americans, hangs in the balance.

Semper Fi,

Mike

OBAMA'S DECLINE

November 1, 2009 Posted by John Hinderaker, Powerline

Rasmussen Reports charts the decline in President Obama's approval index--the difference between those likely voters who strongly approve and who strongly disapprove of his performance--from his inauguration to the present, on a monthly basis. What is striking is how stable the electorate's views of Obama have been. There isn't a lot of volatility or noise; the approval index has declined in steps as basic facts about the Obama administration have become evident:

Michael Barone, responding to a liberal's question, tries to explain where all the Obamamaniacs have gone. In a summer and early fall that were dominated by popular expressions of opposition to the Democrats' legislative agenda, why couldn't Obama mobilize the supporters who were so visible last year?

As the above chart suggests, some of them may find their enthusiasm waning. Michael adds:

Where have all those Obamenthusiasts who were so visible in 2008 been hiding this year? ...

Many Obamenthusiasts were thrilled by the idea of putting Obama in and getting George W. Bush out. They achieved their goal a year ago. What more is left? Did these people really expend all this energy to reduce the percentage of people without health insurance? "We are the change we are seeking," Obama said during the campaign. Well, the Obamenthusiasts got that change. Now they can go back to gardening or Sudoku.

I suspect that most gardeners are Republicans, but otherwise I think Michael is right. That's one of the problems with the politics of self-validation: when the election and ensuing self-congratulation are over, there isn't necessarily a lot of energy left for the nuts and bolts of public policy.