No Runny Eggs

Yes, I missed the morning flight through piss-poor planning and preparation, which always results in piss-poor performance. However, that means I get to read Ed Morrissey’s latest column for American Issues Project, a historical look at why health care is not a “right”:

Rights cannot be confiscatory in a society that respects the individual right to property. That’s why none of the enumerated rights in the Constitution involve confiscation. Americans have the right to free speech, but they do not have the right to demand publication in a newspaper, nor do they have the right to demand that other people listen when they speak. The right to free expression of religion does not involve occupying someone else’s church and using it to your own ends. You have the right to keep and bear arms, but you do not have the right to demand free or publicly financed weaponry. All of those examples involve confiscating someone else’s property or services, whether done through the government or by force individually.

That brings us to the notion of the “right” to health care. As human beings, we want to see people succeed to the point where they can feed, clothe, and care for themselves independently, as that establishes true personal freedom. However, none of us have the right to confiscate the services of a doctor or nurse without their consent, and without their ability to set a price for their time and expertise. We don’t have the right to walk into a grocery story to demand apples when we’re hungry, either, although we should have access to the market without bias when we can properly compensate its owner for the goods.

I can’t put it any better.

After getting an earful of challenges on everything from health care to whether he was actually abiding by his oath to uphold the Constitution, Senator Arlen Specter had this insight:

“They (objectors at the town hall) may not be representative of America, but they are significant, and their views have to be taken into account.”

Respectfully Senator Specter, you need to get out of the echo chamber of Washington!

The latest Rasmussen poll shows that 53% of Americans are against the plan being offered by the Democrats while only 42% support the plan.  In addition, Rasmussen shows that 57% are opposed to a single payer plan with only 32% supporting one.

Senator Specter, not only are the concerns you are hearing “representative” of America, they represent the majority opinion of America.  In fact, according to Rasmussen and other polling agencies, the harder the Democrats push and the longer the public is told that they aren’t smart enough to know what’s best for them, the lower the support for any health care reform legislation goes.

In fact Senator Specter, it is you who is not representative of your constituents or Americans in general.  That said, there is something you have in common with the health care legislation.  The more voters hear about you or health care reform, the more they think you are a rock, as in “sinking like a……“

As more people read and analyze the health care reform act, more and more potential issues are being raised.  Funding for abortions, procedures approved based on the patient’s economic value and elimination of private health insurance are just a few of the issues raised.  Any one of these by themselves should be enough to cause people to say “whoa!”  In total they should be enough to have thinking folks recognize that this bill’s approach to health care reform should be thrown out completely.  As important as any of these, and many others that I haven’t listed are, there is one issue that has received very little attention but if understood completely, should bring this house of cards called reform, crashing down.

Three years ago Massachusetts implemented its version of health care reform.  The program in Massachusetts is the closest real life experiment of what is being proposed as the national version of health care reform.  The plan requires nearly everyone to have health insurance.  There are subsidies for those who can’t afford the insurance, penalties for companies that don’t provide insurance and the plan provides insurance to illegal aliens, all similar to the proposed national plan.

Massachusetts is a blessed state when it comes to health care professionals.  In a recent survey by the Kaiser Family Foundation, Massachusetts has the highest rate of non federal physicians per thousand of population.  In fact, at 5.3 physicians per 1,000 population, Massachusetts’ rate is 60% higher than the national average of 3.3 physicians per 1,000 population. 

One would think that with such a high physician to population rate, access to health care would be easy in Massachusetts.  One would think that with a rate significantly higher than the rest of the nation you should be able to pick up the phone and get a medical appointment with little if any delay.  You might think that but if you do, you would be wrong.

A recent survey by Merritt, Hawkins & Associates looked at the average length of time it takes to get an appointment with various physicians.  The study looked at waiting times for several specialties as well as family practice.  It looked at 15 major cities including Boston.  The study found that of the cities survey, Boston had the longest wait times for getting appointments with physicians.  Not only that, but Boston’s average wait time of 49.6 days was more than twice as long as the national average of 20.5 days.  If that doesn’t concern you, the average wait time for a family practice appointment for a routine physical was found to be 63 days in Boston.  If you’re still not concerned, the study found that with the exception of cardiology, the waiting times for all specialties that were surveyed in both 2004 and 2009 had increased, in some cases substantially.

What’s the point?  Massachusetts has always had a high ratio of physicians to patients.  Relative to national statistics, Massachusetts traditionally had a small number of uninsured individuals.  Prior to the implementation of their health care plan, Massachusetts was estimated to have 10% or fewer of its population uninsured compared to 15% – 16% nationally.  If Massachusetts with relatively fewer new insureds and significantly high physician to patient ratios can’t manage to manage access times after the implementation of unrestricted health care, what does that portend for health care consumers if a national plan is implemented?

According to Kaiser Family Foundation there are 46 million people without insurance.  You can see the breakdown by state here.  Let’s assume that we now insure every person in the country with a national plan.  Let’s assume that to maintain existing wait times we will need to maintain the average ratio of physicians to population.  As a proxy, let’s assume that for each 1,000 additional insured we will need to increase physicians by the current rate per 1,000 (this is actually a bit low if you work through the math because the divider should actually be the insured people versus total population but we’ll allow for a bit of breakage.)  If we extrapolate that number, how many additional physicians will we need?  The following chart shows by state, how many additional physicians we will need to maintain access times:

To maintain the same level of physicians to insured, the country would need to have nearly 144K additional physicians on the day that the health reform act became operational. 144K is an increase of 15% in total physicians. According to the Department of Health and human services, at the projected level of medical school graduations the country won’t increase the number of physicians by 144K until well after 2020. Even if we increase medical school graduation rates by 20% we won’t achieve the 144K increase until after 2020.

More frightening than the total increase in physicians required is the instantaneous shortfall that several states will have if the national health plan is implemented. Take note of Texas which will need a 24% increase in physicians to stay even, New Mexico will need 22%, Mississippi and Florida will need 20% and Arizona will need a 19% increase.

In free market economics the result of dramatically increasing the demand of a product needs to be met with an equivalent increase in production or an increase in prices that will remove some demand for the product. In the case of national health care, demand will increase, prices will not be allowed to increase so how will this work? If production can’t be increased or prices adjusted, the only other way to balance the equation is to regulate the demand, this is called rationing.

Folks, the math on the number of physicians doesn’t work. There is no way to dramatically increase the number of insured into the system, restrict or reduce pricing and not have rationing. Well, there may be one way to do it. Grab your magic wand, waive it and say “Poof, you’re a physician!”

During the Bush leadership of the Iraq war there was a constant debate about whether someone could disagree with the war but still support the troops.  Invariably, those who thought they were able to separate these issues, when challenged, would fall back on some version of wrapping themselves in the flag and claiming that they were being called Un-American for protesting. 

Of course we all remember how the Democrat’s responded to any notion that the Iraq protesters were Un-American.  Perhaps the most publicized response was from Hillary Clinton herself, who told us that in fact is was patriotic to protest and American President.

In today’s USAToday oped, Nancy Pelosi and Steny Hoyer call those who are protesting the health reform bill “Un-American!”

In their oped, the two Democrat herders (they aren’t leaders by any sense of the definition) go on to say:

However, it is now evident that an ugly campaign is underway not merely to misrepresent the health insurance reform legislation, but to disrupt public meetings and prevent members of Congress and constituents from conducting a civil dialogue.

Interesting, it looks more to me like members of Congress who are not knowledgeable or are knowingly lying about the bill and members of Congress who are not willing to hear a dissenting voice from their constituents.

Next, Pelosi and Hoyer pick up the new meme of the left:

These disruptions are occurring because opponents are afraid not just of differing views — but of the facts themselves. Drowning out opposing views is simply un-American. Drowning out the facts is how we failed at this task for decades.

They then attempt to set the record straight on the “facts:”

The first fact is that health insurance reform will mean more patient choice. It will allow every American who likes his or her current plan to keep it. And it will free doctors and patients to make the health decisions that make the most sense, not the most profits for insurance companies.

Well, no it won’t.  As has been documented by numerous sources, your ability to “keep your plan” will end at the time that you change your job, lose your job or if any change occurs to your existing plan. 

Reform will mean stability and peace of mind for the middle class. Never again will medical bills drive Americans into bankruptcy; (it will just drive the entire country into bankruptcy) never again will Americans be in danger of losing coverage if they lose their jobs or if they become sick (at least until you get to a point where your future value to society isn’t greater than the cost of your treatment); never again will insurance companies be allowed to deny patients coverage because of pre-existing conditions (Yes, the all knowing government will now take that role.  Just try to appeal one of their decisions.).

Italics mine

Further:

Our plan’s cost-lowering measures include a public health insurance option to bring competitive pressure to bear on rapidly consolidating private insurers.

Um, nope.  The CBO says it won’t lower costs.  The state plan in Massachusetts, which is the most comparable existing government run plan to the one being proposed, has in fact increased costs at a rate higher than the national average.

Aside from their “let them eat cake” attitude, it’s hard to understand how Pelosi and Stoyer think their oped helps their cause.  With Obama’s poll numbers continuing to slide, Congress’ numbers hitting new lows, Pelosi polled as having the highest unfavorable rating of any Congressional leader and Rasmussen showing that a plurality of Americans support the protester’s efforts, the trend is clearly not their friend. 

Calling common, everyday people “Un-American” seems to be a hail Mary pass in an attempt to stop the public relations slide.  Given the credibility, or rather the lack of credibility that Pelosi and Hoyer have, I doubt it will help.  In fact, I suspect it may have the opposite effect as common sense Americans will view it in the words of the Bard:

The lady doth protest too much!

Oh, one more thing, you may want to consider reporting the oped piece to flag@whitehouse.gov as fishy, misinformation about the health reform act.  We want to make sure and keep the President informed!

Another town hall, another Democrat melt down. Watch as Georgia Congressman David Scott goes on a rant because one of his constituents happened to ask him a question about health care:

Apparently, only people who agree with Congressman Scott can be counted as his constituents!

In this extended version you can see Congressman Scott lean to his aide to ask whether the plan asked about is the one being considered by Congress…he’s told yes. Apparently Congressman Scott hasn’t read the legislation either.

Now we have another congressman whining about actually having to read bills before voting on them. First it was Representative John “You gotta be kidding” Conyers, and now it’s New Hampshire Democrat Paul Hodes telling the editorial board of the Nashua Telegraph to get real:

Democratic Rep. Paul Hodes (NH-02) believes reading every bill in Congress “would slow down the business of Congress to a crawl and it would be hard to get done what needs to be done.”

Members of Congress who don’t read the bills they are voting on “is not necessarily the major problem with the way Congress functions,” he said.

Hodes, who is the sole Democratic candidate in the race to replace the retiring New Hampshire Sen. Judd Gregg, made the remarks during a recent editorial board meeting with the Nashua Telegraph.

“Hodes said it’s not realistic to expect members of Congress to read every bill word-for-word, as Congress took more than 2,000 votes in the session that ended in December,” the paper reports.

This year, Hodes voted in support of President Barack Obama’s stimulus package and for so-called cap-and-trade legislation. Both measures were finalized late in the legislative process and rushed to a vote before any individual member could read the bills.

I don’t know. Maybe I’ve got this whole representative democracy thing wrong. Am I silly to think someone I choose to run the government for me should actually understand the choices he makes, rather than push the voting buttons at random? By Mr. Hodes’ logic, why even show up at committee hearings to ask questions and hear witnesses? That’s got to be awfully hard, too, on the poor, overworked congresscritters.

Look, I don’t expect them to read every single bill that comes before the chamber, but on matters as consequential as a $787 billion “emergency” stimulus bill, or health-care reforms and cap-and-trade measures that aim to establish federal control over vast swathes of the economy… You’re damn right I expect Hodes & Co. to read and understand the bills, or recuse themselves from voting on it!

And maybe they should resign, too, if that’s too much to ask of them.

(via Hot Air)

On a related note, Iowahawk again turns over his blog to a guest-editorial, this time from Health and Human Services Secretary Secretary Kathleen Sibelius and Democratic Republican Democratic Senator Arlen Specter on a growing crisis in America – that America’s Government Losing Faith in Out-of-Touch Constituents:

Nowhere has this disturbing trend been more evident than in the recent debate over health care reform. Like hundreds of our fellow legislators and government officials, we recently traveled to a town hall meeting to distribute a grassroots press release explaining why this critical legislation is a done deal. Our advance staffs said that should anticipate a respectful, positive hearing from local media and bused-in union members. Instead we were greeted by a rude howling mob of idiot “voters” who refused to listen to reason, and ruined what should have been a killer photo op for our re-election ad campaign.

Have these arrogant ivory tower armchair quarterbacks ever had to live with the pressures of being a working stiff Senator or Cabinet Secretary in Washington DC? Have they ever had to juggle markup language on a supplemental appropriations bill, or deal with an incompetent Chief of Staff who constantly double-books fund raising dinners? Apparently not, if their whiny obnoxious chants are any indication. “Read the Bill! Read the Bill!” blah, blah, blah, as if we weren’t already exhausted from writing and voting for the damned thing.

Mockery. It’s what makes American politics great.

(Cross-posted from Public Secrets, my usual home.)

I pointed out yesterday the video in which President Obama states that he fully believes private insurance will be eliminated, in time, by the public insurance he is advocating.  Apparently this video caught the White House’s attention.

Later yesterday, the White House released a video intended to counteract the earlier video.  In this video, Linda Douglass tells us that the previous video was put together by people who are “trying to scare us” about health care reform.  She also tells us that because President Obama talks to sooooooo many people about health care it is easy to take a snippet here or a snippet there and present them “out of context.”

Hmmmm, “out of context.”

Would that be “out of context” like the President who told us that he didn’t agree with the positions of Jeremiah Wright’s black theology but when presented with a case in which he knew none of the facts he said that the white Cambridge police sergeant acted “stupidly?”

Or, would that be “out of context” like the President who told us that all important legislation would be posted on the Internet for several days before his signature so that everyone could read it.  Except that none of the important legislation has been posted before signature because everything in this administration is an emergency.

Or, would that be “out of context” like the President who told us he would not have any lobbyists in his administration and now the fastest growing segment of job growth seems to be back filling positions for lobbyists that have been hired into his administration?

Or, would that be “out of context” like Summers and Geithner increasing taxes even though Obama says no one under $250K will get an increase?  Oh, wait, that one hasn’t happened……YET

Or, would that be “out of context” like members of Congress and the President himself, telling us that many of the things that we read in the health care reform bill aren’t really in there but when those items are specifically addressed with amendments they are wholly rejected.

Folks, we went through an entire campaign with Obama telling us that what he said in his past is not who he was today.  Many people bought into that theory.  Some bought into it to the point of deluding themselves to believe that Obama would govern as a centrist rather than the far left ideologue he had always been.

If the video was really cherry picked and out of context, wouldn’t it be pretty easy for the White House to get the original video and release.  America has tired of Obama’s takeover attempt but still remains a country that understands a set up when it sees one.  Don’t hold your breath, the video won’t be coming.

I guess when it comes to what Obama really believes about private health insurance in comes down to that old saying:

Who are you going to believe, Linda Douglass or your lying eyes?

Update:  8/4 2:10 PM by Shoebox – So, out of context huh?  They can make him say anything they want if they just take snippets huh?  How about a full uncut version?

H/T Drudge

As the protests heat up a new tact has been taken by several of the offending electing officials.  When confronted with specifics about the bill circulating in the House some members of Congress and President Obama himself, attempt to claim that because the bill is final the interpretations that people are making of the language are invalid because they aren’t based on “final language.”  “Things could change” seems to be the line that these Congressional folks want to hold to.

Not hardly.

Heritage.Org goes through the recent mark up by the House Ways and Means Committee.  As a part of their review they look at several amendments that were proposed, their potential impact on the legislation and the result of the vote on the amendment.  Each of the amendments were intended to specifically address one of the issues that the offending Congressional folks are trying to tell us “isn’t in there.”  Let’s have a look at a few.

• An amendment was offered that would eliminate Obama care if people on the public plan had average wait times for medical procedures that were longer than for people on private plans.  The amendment was defeated by the Democrats on a straight party-line vote.
• An amendment was offered that would ensure that illegal immigrants would not gain access to Obama care.  The ammendment was defeated by the Democrats on a straight party-line vote
• An amendment was offered that would require members of Congress to forfeit their coverage under the Federal Employees Health Benefits Program.  This amendment was defeated by the Democrats.
• An amendment was offered that would guarantee that HSA plans would be private plans that would be eligible for future enrollment.  The amendment was defeated by the Democrats
• An amendment was offered that would keep abortions from being mandated as required coverage in Obama care.  A separate amendment was offered that would prevent tax money from being used to provide abortions.  Both amendments were defeated by the Democrats.

There were several other amendments offered, all defeated by the Democrats.

Funny, when challenged with their own language the Congressional cowards hide behind the notion that the language “could change.”  When challenged in committee to clarify the language and say specifically what they mean, they just hide.

I posted last week and Steve followed up here with things we could learn from “The Keystone Cops sells autos,” also known as CARS.  Today, another painful lesson is being learned in the CARS fiasco that can be directly applied to the health care take over.

CARS started July 25th, by last Friday it had been essentially halted.  The CARS program ran an entire 7 days.  Since last Friday government bureaucrats have been pontificating, arguing, pointing fingers, chest puffing and all the other things that bureaucrats do.  Bureaucrats have been doing everything except fixing the program.  The bureaucrats have now spent 50% as much time as the program actually ran debating whether the program should continue, in what form, how to fund it etc.  In the meantime, automobile dealers and potential purchasers are wondering when, if and how they may be able to get their deal done.

Roll forward five years.  Obama national health has been passed and we are in the second full year of its implementation.  Eighteen months into the full implementation of Obama care it becomes apparent that the budget Congress has allotted for Obama care is inadequate.  Let’s say that the amount needed to fund the program is double the original estimate (like what happened to Massachusetts Care) which means Congress needs to debate additional funding.   

Because the “solution” to the funding problem is not obvious on the horizon hospitals, doctors and other health care providers don’t know what will happen to their payments and reimbursements.  Because they don’t know how they will be paid they start slowing work or delaying admissions, a perfectly logical response and one which Medicaid patients have lots of experiences with to say that it does happen.

Finally, imagine you have a surgery scheduled.  Oh, it’s not life threatening.  You don’t have cancer, your heart isn’t about to stop.  No, it’s not life threatening, it’s just a kidney stone that needs to be removed.  How many days will you be willing to wait while Congress debates how they will pay your doctor to do your removal?

None?  Yeah, me neither.  That’s one more reason I like to have say in my health care.

President Obama continues to campaign for the health care reform bill.  He continues to tell people that he won’t get in between them and their doctor.  He tells people that this isn’t a government take over of health care. 

Just as the left can’t look at a simple document like the Constitution and understand the implication of plain language, The Kool-aid drinkers continue to argue about what the definition of is is rather than understanding the implications of the plain language of the health care bill.  Note the comment exchange on this post as evidence of the blindfolded obedience the Obamabots have given The Won in support of owning health care.

So, is The Won looking to take over health care or not?  The Bots say no, we say yes.  How about we let The Won himself tell us:

Huh, at one time he said definitely yes, today he says no. In my view that leaves him either as a schizophrenic or just your common, every day, garden variety liar. The sad part is that just like all of the numerous issues raised during last year’s campaign, the media will yawn and say “nothing to see here. Move along!”

A day hasn’t gone by in the past two weeks, and likely won’t for several weeks to come, where the President or some other proponent of “health care reform” speaks to constituents about their plan.  While the specific arguments for reform that are highlighted may vary from group to group, an argument included in each presentation that by implementing health care reform, health care costs will be reduced.

In economic terms a “cost” is:

Valuation in terms of money of (1) effort, (2) material, (3) resources, (4) time and utilities consumed, (5) risks incurred, and (6) opportunity forgone in production and delivery of a good or service.

in other words, a “cost” is something that goes into making a product or service.  By definition, because a “cost” is a component of a product or service, the only entity that can make a determination as to what “costs” to include in a particular product or service is an entity that has control over the production of that product or service.

If you think about it for just a minute, the fact that you can only control costs if you control the production of the particular product or service is common sense.  If I want to buy a boat I can negotiate with the seller about the price I will pay for the boat.  However, no matter how hard I negotiate, I can’t impact the amount that it cost to produce that boat.  If I want to hire an accountant I can negotiate the price I am willing to pay for their service but I can’t impact what that person paid for their education or the opportunity value of their specialized knowledge.

Just as it is true that you must have control over the production of a product or service in order to impact its cost, it is also generally true that the greater control you have over an item the greater ability you have to control the final cost of that item.  If you make a component for the boat we discussed earlier you have an ability to impact the cost of the boat by making your component less expensive.  However, no matter how large or small the component you make you will never have as much control over the cost of the boat as the company who does the final assembly of the boat. 

Again, if we think for a moment, the reason the final assembler of the boat has the greatest amount of control over the cost of the boat is common sense.  If one of the component makers adjusts the price of their component to a point where the boat assembler believes the price to be uneconomic, the boat assembler can choose from several options including finding another component maker, developing the ability to make the component themselves or even eliminate the component from the boat.  Each of these options has the ability to change the cost of the boat and in each case the assembler has final veto power over which of the options will be chose and its impact on the final cost of the boat.

Along with reducing costs, there is another argument that gets made in an effort to sell the health care reform program; the government won’t get between you and your doctor.

Let’s think about that for a minute.

Earlier we determined that you can’t impact or reduce the price of something unless you have some control over it.  We also know that the ability to control the cost of something is relational to the amount of control you have over that something.  How is it then that the government will reduce health care costs but not have control over health care?

It’s not possible.

The only way for the government to “bend the curve” on health care costs is to exert control over health care.  There is no way for the “reformers” to reduce costs without control.  Oh, they may not employ doctors and nurses directly but they don’t have to.  The government can control health care by controlling how, how much and for what, health care providers get paid.  Worse, with an additional 10% – 15% being added to total expenditures, “bending the curve” will not get the job done.  In order to have a meaningful change there will have to be significant reductions in costs.  The only way to make significant changes on costs is to have significant control.

Two arguments; reduce costs and not control.  The two can’t happen together.  Whether it’s specified in the current bill or not, which of the two do you think will give?  I have my choice!