No Runny Eggs

From the classic that is the original Star Wars movie (now Star Wars IV) during the attack on the death star:

As one of the rebellion pilots is heading to make the impossible shot that would destroy the death star Empire fighters are attacking from all directions.  The pilot loses his concentration as his head is spinning trying to keep track of the frenetic activity around him.  The leader of the attack then states his infamous line, “Stay on target!  Stay on target!”  In the end, he never gets his shot fired and is ultimately destroyed by one of the pursuing Empire fighters.

The month long Congressional recess has been an usually heady time for Conservatives.

First, after explaining to school administrators and the blogging world that we and our children “pledge allegiance to the flag” and not the president, the Obama acolytes resorted to using “in artfully worded” before redoing the “lesson plan” for Obama’s indoctrination speech to school children. 

Second, led by Worldnetdaily and Glenn Beck, Conservatives used the method that John McCain was too squeamish for and held Van Jones accountable for his extremist views, statements, actions and associates.  The result is that Van Jones has left the Obama administration “to seek other opportunities.”  Perhaps the most interesting aspect of both of these events is that neither of them had any of the D.C. Republican leadership leading them.  In fact, now now that I think about it, what was the last issue of substance that any of the D.C. Republican leadership?

Finally, Conservatives have successfully led an effort to expose the truth about the Democrat’s attempts to nationalize health care.  In town hall meetings, blogs, rallies and one on one discussions, Conservatives came armed with facts that left their opponents either lying or stumbling through things they made up.  Regardless of how many times President Obama or Democrat leadership claimed “it wasn’t in there,” the majority of Americans believe it is “in there” and they don’t like it.  The situation has degraded so far that President Obama will be addressing a joint session of Congress on Wednesday evening in an attempt put the plan on some new track that could lead to success.

While the first two items clearly sent a message to the Obama administration that he was not elected to a monarchy, the final outcome of the last issue is still to be decided.

Innumerable articles have been written in the past 10 days opining on whether Obama can save the health care reform bill.  Amongst other topics, the articles discuss the pros and cons of a 60 vote Senate approval versus a reconciliation process, dropping a public option or moving to a coop and which group of Democrats are more likely to support or jump ship from President Obama.  With so many different experts and theories it’s hard to guess what scenario may play out in the coming weeks.  In fact, depending upon your own personal preference, if there isn’t an article supporting your theory, just wait another day and there likely will be one written.

Over the next few weeks the fight over health care reform will take many new turns.  Some events will likely be complete surprises.  We can certainly expect that as President Obama reengages in the fight we’ll see him hang “shiny bright objects”that are meant to distract conservatives from their focus on health care.  Whatever transpires, one thing is certain, the fight is far from over.  We can’t allow the victories of small skirmishes to lull us into any sense of accomplishment.  We must keep pressure on every Congressional representative until health reform that has any increase, or might allow any possible future increase of government intervention is dead, dead, dead.

For the next six weeks or so we need to stay focused, stay aggressive and keep the White House on the defense.  Every morning for the next six weeks you should wake up to the admonishment of Gold Five:

(H/T – Ed Morrissey)

It is almost as if our friends across the Atlantic are warning us of what is in store if we follow them into socialized medicine. The Daily Telegraph ran a story of how (Not-So-)Great Britain’s health-care “scrutiny” body, the inappropriately-named National Institute for Health and Clinical Excellence, has adopted a particularily cruel end-of-life program called the Liverpool Care Pathway. I’ll let The Telegraph explain what this “last hours treatment”, now in place in nearly 1,000 British health-care facilities at the insistence of NICE, is:

Under the guidelines the decision to diagnose that a patient is close to death is made by the entire medical team treating them, including a senior doctor.

They look for signs that a patient is approaching their final hours, which can include if patients have lost consciousness or whether they are having difficulty swallowing medication….

When a decision has been made to place a patient on the pathway doctors are then recommended to consider removing medication or invasive procedures, such as intravenous drips, which are no longer of benefit.

If a patient is judged to still be able to eat or drink food and water will still be offered to them, as this is considered nursing care rather than medical intervention.

Unlike the Terri Schiavo situation, where there were conflicting interpretations of the level of care she wanted, what is missing is any decision by either the patient or a patient’s family. Considering the average person spends roughly a third of his or her life asleep, I guess one should not fall asleep in a British hospital with a sore throat.

Seriously, the story goes on to report on a letter signed by several leading British palliative-care experts calling the LCP a “national crisis”. Quoting The Telegraph’s reporting on the letter:

“Forecasting death is an inexact science,” they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.

“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients.”

Dr. Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer center in Guildford, told The Telegraph that he personally took patients off that pathway who went on to live for “significant” amounts of time because he did what many doctors don’t – keep monitoring the patient for signs of improvement. Those signs of improvement are harder to spot when a patient is under constant sedatement according to Professor Peter Millard, Emeritus Professor of Geriatrics, University of London.

Another problem with sedation while dehydrating is that a patient can enter a state of semi-consciousness and confusion. I wonder how many of the 16.5% of those who died in Britain in 2007 and 2008 during a state of continuous deep sedation, twice the rate in the Netherlands, which has a policy of physician-assisted suicide, suffered that state.

Of course, not all of those in Not-So-Great Britain are doomed to such a fate. Just ask Abdel Baset ali Megrahi, who got a get-out-of-Britain-free card after serving less than 12 days per person he and his Libyan associates murdered in the bombing of Pan Am Flight 103. Of course, he wasn’t a loyal subject of the British crown; he was a mass-murdering thug.

Every time attempt at a government run or mandated health plan has resulted in some form of rationing.  There is no exception to this rule.  The reason for this is quite simple.  Once people get something that appears to have no cost to it they will demand more and more of it.  As folks demand more and more it costs more and more to provide the service.  At some point, even the most arrogant printers of money will realize that there has to be some cap on the total costs.

Canada, England, Cuba and Massachusetts all have rationing occurring in their plans.  Rationing can take all kinds of forms; from the most blatant and obvious forms of outright denying the particular service to the less obvious like someone not answering a phone to accept an appointment. 

Since the rationing issue has been raised, those who support Obamacare have been besides themselves telling us that there will be no rationing in this plan.  As evidence, they often point to Medicare and Medicaid as shining utopian examples of everyone gettng all the health care they need without a hint of rationing.

An article from Tuesday’s USAtodayshows just how Medicaid is implementing rationing.  As a result of budget constraints the State of Louisiana has cut payments made to service providers of Medicaid by 10%.  The result?  68% of surveyed physicians will begin rationing of services to Medicaid patients.  Oh, they won’t refuse to perform a procedure that a patient needs, they’ll just quit accepting new patients, stop accepting referrals or for nearly 16%, quit seeing medicaid patients altogether. 

In a separate but related article, Bloomberg reportsthat the Obama administration’s plan to take $1.4 billion in payments from physicians who provide Medicare patients heart or cancer treatment and shift it to family practice physicians will likely result in fewer cardio and cancer physicians.

Folks, you can call it anything you want; cost shifting, benefit reduction or some other euphemism.  The fact remains that no matter what you call it, you will have to recognize it as rationing.

Earlier this year the Obama administration eliminated several words and phrases from the English language.  “War on terror,” “enemy combatants” and finally the word “terrorism” itself was eliminated from the Obama lexicon.  According to Janet Napolitano this is the officially approved, new language:

“I did not use the word ‘terrorism,’ I referred to ‘man-caused’ disasters. That is perhaps only a nuance, but it demonstrates that we want to move away from the politics of fear toward a policy of being prepared for all risks that can occur.”

Well, I guess we can all understand how emotionally charged the word “terrorism” is.  We can understand that using it does nothing but inflame a situation that might otherwise be solved by clear thinking adults. 

From BarackObama.com as part of an organizing call to flood Congressional offices with calls supporting health care reform on 9/11:

All 50 States are coordinating in this – as we fight back against our own Right-Wing Domestic Terrorists who are subverting the American Democratic Process, whipped to a frenzy by their Fox Propaganda Network ceaselessly re-seizing power for their treacherous leaders.

So now, according to President Obama’s own website, those of us (the majority of Americans) who oppose the government’s further involvement with our heath care are terrorists. 

You’re not a terrorist if you rape, brutalize and kill innocent children, but if you disagree with the President….watch out!

As I’ve been listening to various talk radio programs I’ve heard the following new meme proffered by Obamacare supporters, at least four times in the past 48 hours:

We have to pass a government option!  2/3rds of the bankruptcies in the US are caused by medical bills!

The basis for this argument is found in this recent study in the American Journal of Medicine.  A snippet of the conclusion of the study is as follows:

Using a conservative definition, 62.1% of all bankruptcies in 2007 were medical; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income.

At first look you’d have to say “Wow!”  Can nearly 2/3rds of bankruptcies be caused by the results of medical costs?  The answer, after you look at the study and some other information is “No.”

Brett J. Skinner did a great job of deconstructing the noted study.  His article, here, noted several items that left the study’s conclusions suspect.

First, Skinner makes the logical comparison with Canada.  With the bankruptcy law very similar in the two countries, and Canada having a government provided health care system, if the studies conclusions are correct, we should expect to see significantly lower bankruptcy rates in Canada.  We don’t.  In both 2006 and 2007 Canada had a higher bankruptcy rate per population than we had in the US.

Secondly, Skinner looked at other studies done on the topic.  One of those analysis was done by the Department of Justice:

finding that medical debts accounted for only 12 percent to 13 percent of the total debts among American bankruptcy filers who cited medical debt as one of their reasons for bankruptcy.

So now your question ought to be, “Is it possible to reconcile the study with the data Skinner found or is the study a fraud?”  Thanks for asking, I think I can reconcile the two.

Going back to the original study we find Table 1 shows that the mean negative net worth (the excess of debt over assets) is not materially different between those who claimed to file bankruptcy due to medical reasons (-$44,622) and those who filed for other reasons (-$37,650).  On page 4 we see that the average, total, not just the unpaid portion of out of pocket medical costs for those that filed bankruptcy for medically bankrupted families was $17,943.  If we assume that the entire amount of out of pocket costs were left unpaid and counted in the negative net worth (it wouldn’t be but let’s use it for a moment), that would still leave a negative net worth of approximately $27,000. 

A negative net worth of $27,000 would typically not be from a home mortgage as most of those would not be allowed to borrow more than the equity.  Also, remember that the study was done in 2007 before the current melt down and reduction in home values.  A negative net worth could be partially incurred from a vehicle as most new vehicles are upside down in equity for the first year or two of ownership.  However, with the average mean income reported as only $30,000, one wouldn’t expect a whole lot of really expensive new vehicles included in the negative net worth of this sample.  A negative net worth of $27,000 likely comes from one place, credit cards or uncollateralized loans.

While the study didn’t break it out this way, it appears to me that the average person who claims they filed for bankruptcy because of medical reasons also had significant credit card debt.  I suspect, but can’t prove it with what is in the study, that the individuals who filed for medical bankruptcy didn’t file only because of the medical costs.  Likely, the medical costs were the “straw that broke the camel’s back.”  And, while medical was the straw for these people  in this instance, the straw could have been any of a number of other things i.e. a major car repair, a major home repair or any number of other unexpected items. 

It appears to me that rather than any one specific issue, like most other bankruptcies, the folks that this study looks at had a series of issues with the last one in line, for them, medical expenses, being more than they could recover from.  In their case, medical costs were just one of the issues that led them to bankruptcy.  To say medical expenses were the reason that these folks filed for bankruptcy is about as accurate as saying that the Titanic sank because it was holding too much water.

On a conference call yesterday, Rep. Pete Stark, D-Calif, a key House liberal referred to Blue Dog Democrats who are bucking the government takeover of health care in this fashion:

“They’re for the most part, I hate to say, brain dead, but they’re just looking to raise money from insurance companies and promote a right-wing agenda that is not really very useful in this whole process.”

Isn’t that ironic?  I usually regard the Blue Dogs as the only part of the Democrat consortium that had any chance of having part of a functioning brain!  I would have guessed, based on all the polling and what not, that these folks might in fact, be doing the jobs they were elected to do.  You know, represent their constituents!

I guess by extension, if the Blue Dogs are “Brain Dead,” the constituents who agree with them would also be “Brain Dead” or worse.  The further extension is that according to Representative Stark, all of us who would rather keep the government out of our health care are also “Brain Dead.”

We’re “Brain Dead” and “Un American.”  Maybe it’s time to officially form the Zombie Reagan Nation!

If you didn’t pick up on it during his candidacy, there are two things we now know about President Obama.  First, he is a committed leftist; no government involvement or control is too much in his view.  Second, his ego is second in size only to the deficit that his leftist policies are creating.

Within hours of his death, Democrat leadership began attempting to breath new life to the health care bill by attaching Ted Kennedy’s name to it.

“In his honor and as a tribute to his commitment to his ideals, let us stop the shouting and name calling and have a civilized debate on health care reform which I hope, when legislation has been signed into law, will bear his name for his commitment to insuring the health of every American,”

was the lament from Senator Robert Byrd.  And:

“Ted Kennedy’s dream of quality health care for all Americans will be made real this year because of his leadership and his inspiration,”

From Speaker Pelosi.

Even with the new, paid for supportive astroturf that the Democrats have been able to get into their townhalls, the public remains fully against the implementation of a government run health care program.  Rasmussen reports that while “support for the health plan has quit falling,” it is still opposed by a majority of voters.  Additionally, by greater than a 2:1 margin, “voters believe the proposed reforms would make the quality of care worse rather than better.”  It seems like a long uphill slog for passage of the bill, at least in its current form.

Ted Kennedy’s public funeral will be held Saturday morning.  We’ve learned that President Obama will deliver the eulogy.  I have one question.

With Cap and Trade likely dead for the year and his other major push health care, on the ropes, will President Obama be able to control his personal ego long enough to deliver an eulogy that actually has Ted Kennedy as the focus or will he succumb and use the event of the funeral to fan his own ego and push the health care reform bill?

Remember, never let a crisis or a highly personal and emotional event, go to waste!

Back in the day, I played a real cut-throat Monopoly. However, I wasn’t nearly as cut-throat as the federal government. I’ll let MadisonConservative explain:

Now, let’s say I’m playing with four other people. The four other people are normal monopoly players, playing by the normal rules. They represent private insurance companies. Now, I’m going to join the game. However, I get a different set of rules because I say so. I represent the public option.

First, in normal Monopoly rules, everyone collects $200 from the bank when they pass GO. Let’s refer to this as the capital that insurance companies get in order to run their business. They get it from revenues earned by competing in the health insurance market. However, for me, the rule is different. When I pass go, instead of getting $200 from the bank(customers), I instead collect $50 from each of the other players. Why? Well, the government gets its revenues by collecting taxes, not by providing competitive services. So, while the other players are collecting their money from passing GO from customers, I’m collecting my money from them. Their wealth is going down, directly leading to mine going up. Already, I have an advantage, because I’m the government. Guess what, though? Not only do I collect $50 from each of the other players every time I pass go, but I get $100 from the bank! See, the government doesn’t only collect taxes from businesses, but they also collect it from their customers! Once again, I have an advantage, because I’m the government.

Of course, there is more over at the HotAir Greenroom, so enjoy it. Do also read the comments.

Maggie Thurber explains why the PermaCampaign that Obama is trying on health care is doomed to failure:

But that point aside, trying to convince people with the same ideology that you’re the best one of several to represent that ideology is much different from convincing an entire nation, the majority of whom claim no party or are Republicans, to join your cause.

Obama isn’t going to the opposing side and presenting his viewpoint on the issue, he’s handpicking audiences and ‘preaching to the choir’ and trying to re-energize his base. But that will only go so far as the vast majority of Americans are not in that group to begin with.

He’s still in campaign mode, trying to sell an idea, when the public would rather have the facts and the details – all the things they were too busy to bother with during the actual campaign. Now that Obama is in the White House, the public expects him to manage the operations, though he’s had absolutely no experience whatsoever in doing something even remotely similar. And now it shows, especially in how he blames everyone else for his failure in this regard.

As always, I highly recommend reading the entire thing.

As the health care debate heats up, President Obama and other Democrats have identified a new villian; insurance companies.

At a press conference on July 22nd, President Obama said:

“You know, there had been reports just over the last couple of days of insurance companies making record profits. Right now, at the time when everybody’s getting hammered, they’re making record profits and premiums are going up.”

At the end of July, Nancy Pelosi identifiedthe new villains with:

“They are the villains. They have been part of the problem in a major way. They are doing everything in their power to stop a public option from happening.”

These comments coupled with a House plan that looks a lot like an expansion of Medicaid and Medicare to all, would cause one to think that we should have some empirical evidence that shows that a government run option is more cost effective.  One would think that with nearly 40 years of history, the fine government employees that provide oversight to Medicare and Medicaid, and would be dramatically expanded to support Obamacare, would have been able to squeeze every last penny of savings from the existing programs.  If so, wouldn’t we expect to see particularly Medicaid’s cost or rate of growth, to be lower than private insurance?

Yes we would but, no we don’t.

A study done by the Pacific Research Institute shows that rather than becoming more efficient than private insurance, Medicaid spending per person has outpaced private medical spending by 35% since 1970.  If that isn’t enough to question government efficiency, understand that this study understated total Medicaid costs and overstated private costs for the following reasons:

First, my analysis doesn’t adjust for cost-shifting from Medicaid to the Medicare prescription drug program. Medicaid used to cover many of the costs of drugs that have now been shifted to Medicare. As of 2005, just prior to the Medicare drug benefit’s full implementation, Medicaid’s per-patient costs had risen 53 percent (rather than 35 percent) more than per-patient NHE apart from Medicare and Medicaid.

Second, my analysis counts the Medicare prescription drug program’s expenditures as part of privately purchased care, rather than as a part of Medicare.9 Because my analysis compares Medicaid’s costs to NHE apart from Medicaid and Medicare, this benefits Medicaid.

Third, it removes everyone on Medicaid or Medicare from the pool of patients receiving privately purchased care, even though a significant share of Medicaid patients’ care is covered not by Medicaid but privately — and even though, as of 2000, 32 percent of Medicare patients’ overall care (including
their Medicare copayments and Medigap insurance) was paid for privately.10 My methodology counts health care purchased privately by Medicaid and Medicare beneficiaries among the costs of private care, without counting its recipients among the people receiving private care. If privately purchased health
care costs are divided by the whole U.S. population, rather than by the population not enrolled in Medicaid or Medicare, then Medicaid’s per-patient costs have increased 54 percent
more than per-patient NHE apart from Medicare and Medicaid.

Fourth, it doesn’t adjust for any cost-shifting from Medicaid to the State Children’s Health Insurance Program (SCHIP). When SCHIP began in 1998, many Medicaid beneficiaries were shifted into that program. Over time, this has saved Medicaid billions without representing any actual improvement in cost containment. From 1970 to 1997, immediately prior to the start of SCHIP, Medicaid’s costs rose 81 percent more than NHE apart from Medicare and Medicaid.

President Obama and the Democrats claim that by implementing the government option they will be able to drive savings and reduce the overall cost of health care.  The fact is that if Medicaid and Medicare had been held to a rate of growth equal that of private insurance, last year alone these programs would have cost $201 billion less, nearly a 25% reduction of what was actually spent.

Before government takes over private insurance, under the argument of cost savings and efficiency, we would be wise to suggest the old adage:

Physician, heal thyself!

Early last year as the endorsement battle was fully engaged, videos and quotes of Obama’s long time pastor, Jeremiah Wright, came to light.  These videos and quotes showed the man that Obama referred to as his “mentor,” was a racist and anti-Semite.  Although he had spent the bulk of his adult life in Wright’s congregation, Obama denied that he knew of Wright’s heinous perspectives.  When challenged about Wright, Obama responded:

He does not speak for me.

In other words, Obama and the compliant media which echoed his defense, were telling us that this was a problem entirely with Wright, or as Obama might say “This isn’t about me!”  Those of us who had our own ability to think knew that the opposite was true, it was entirely about Obama and his acceptance of Wright’s ideology.

After the Saddleback Forum last August in which he denounced late term abortions, an audio tape surfaced of Obama arguing against an Illinois statue that would require medical support for babies that survived botched abortions.  In his attempt to reconcile his recently stated position with the past recordings, Obama tried multiple explanations.  All of the explanations were focused on issues that other people had created.  None of the explanations had anything to do with Obama changing his position, misunderstanding the issue or lying.  In other words, Obama could have said, “This isn’t about me!”  Again, a reasonably inquisitive mind was able to see that the excuses Obama rasied were red herrings and that in fact, the issue was all about Obama.

If you do a Google search of “Obama “not about me”” you’ll find numerous instances in stump speeches, his world reunification speech in Germany and even his endorsement acceptance speech where Obama told people that his candidacy was “not about me.”

During his last prime time media love fest, President Obama refuted that health care reform was a personal issue for him saying:

This isn’t about me!

In fact, you might say that Obama’s entire national political career has been spent with him telling people “this isn’t about me!

Since that last statement, President Obama has inserted himself directly and personally into the debate over health care reform.  At town hall meetings in New Hampshire, Montana and now Colorado, President Obama has personally defended health care reform.  At each stop he couriously debates and defends what is or isn’t in “the plan.”  Curious because President Obama doesn’t have a plan of his own and repeatedly responds to the few challenging questions by avoiding an answer or by making erroneous assertions about what the House plan contains.  Even the USAToday, a paper that is not considered unfriendly to Obama, identified numerous Obama falsehoods following the New Hampshire townhall.  Many of these falsehoods were repeated in Montana. 

What are the results?  In the month since he claimed it wasn’t about him, Obama’s dream of a government take over of health care has been met with stiff resistance.  Since Obama’s personal involvement, Rasumussen Reports polling shows that support for health reform has fallen 5% and those who disapprove of health care reform now represent a majority.  In a new poll by Rasmussen, 54% of voters now believe that doing nothing would be better than implementing the plan that is coming through the House.  This is especially important as independents favor doing nothing by almost a 3 to 1 margin.

Contrary to his protests, the health care debate is all about President Obama. 

Obama came into office on the sweet spot of a wave.  Iraq, a sagging economy and a Republican party that operated largely indistinguishably from the Democrats, gave Obama a populace that wanted change so badly they were willing to give an inexperienced, opportunistic, job hopper a chance to play president.  In fact, change was desired so badly that neither the media or those who supported Obama, stopped to ask much about the details as to what Obama wanted to change.  If they had, they would have found that from the start Obama was focused on the takeover of the health care industry via a single payer system and the takeover of energy via cap and trade.  These two items were/are cornerstone to the transformation of America that he envisions and promised.

After moving through the House with relative ease, Cap and Trade is sitting in the Senate.  60 votes are required to move the Cap and Trade bill through the Senate.  With Kennedy and Byrd rarely in the Senate due to their illnesses, the Democrats would need to get 2 Republicans to side with them if they can get the other 58 Democrats to support the bill.  That is a big IF, and moving towards “not likely,” as the economy continues to struggle, the economic reality of the bill continues to sink in and global warming “science” is finding less and less support amongst voters.  In fact, Cap and Trade has lost so much momentum that even Democrat Senators are now saying that it won’t receive a hearing until next year….if at all.

Having Cap and Trade in limbo is good and bad.  It’s good because passage of the legislation would be disastrous for the US economy.  It’s bad because as one of Obama’s two major pieces of legislation, having it in danger of dying puts more pressure on the issue of health care reform.  As the only other major legislation, if health care reform fails it will relegate the man once held in messianic admiration to that of purveyor of just another mystic religion that serves no purpose other than to provide emotional highs with no ability to resolve anything.  It is this fear that has Obama personally engaged in the health care debate.

President Obama’s personal insertion to the middle of the health care debate is much like Kevin Bacon’s appearance towards the end of Animal House.  Standing in the middle of the melee and shouting “All is well.  All is well,” didn’t calm the public for Kevin nor will it for Obama.  In both instances the acts were those of desperation.  As it didn’t work for Bacon, neither will it for Obama.

With President Obama fighting to find new scapegoats to blame and allies for support, the path and outcome of the health care reform debate is far from certain.  That said, one thing is certain.  The next time you hear Obama, discussing any topic, say “This isn’t about me,” you will know without a doubt that after sifting through all of the obfuscation and half truths, the one thing in fact it is about is Obama!

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!”