No Runny Eggs

On Friday, the Centers for Medicare and Medicaid Services released an actuarial report that analyzed the recently passed House version of Placebocare.  Chris Frates at Politico.Com reviewed the report and pulled out some very interesting insights and conclusions.  You can read Frates’ full review here. 

Of the many items that Frates pulled out of the report, a few require some additional comment.

Pg. 6 – A public plan would cost 4 percent more than private plans because its utilization rules would not be as strict as the private sector.

I thought the whole purpose of Placebocare was to reduce the costs of health care?  I guess we could look at total costs but with more people coming into the health care system there is no way that is going to happen.  That only leaves a reduction on a per person basis.  This report says that not only with the public option not be cheaper than private plans, it will actually be 4 percent more expensive.  If that is the case, wouldn’t the answer be to use the existing, cheaper, private insurance and provide tax subsidies for those that need assistance?

Pg. 7 – 18 million people will remain uninsured and choose to pay the fines for not carrying insurance rather than buy coverage.

I’ve lost track of how many “uninsured” we have.  The original number of 47 million went down the tubes with the anger over insuring illegal aliens.  Let’s use a number of 35 million to be generous.  If 18 million chose to pay fines, that means only 17 million additional will be insured.  While the final tab is yet to be determined, it’s pretty safe to say that if it was fully implemented on day one, Placebocare would cost at least $1.3 trillion for the first 9 years.  Finish the math equation and that comes to nearly $8,500 per person for health insurance.  Folks, that’s PER PERSON.  A family of four would be over $30,000 PER YEAR!

My family buys its own health insurance.  We have a few health issues so we actually pay the highest rated premium that can be charged.  Even with those issues, I can tell you that we don’t pay anywhere near $30K/year for all of our insurance AND out of pocket costs for a year.  No wonder costs are increasing!

Pg 16 – “The additional demand for health services could be difficult to meet initially with existing health provider resources and could lead to price increases, cost-shifting, changes in providers’ willingness to treat patients with low-reimbursement health coverage.” Translation: A crush of newly insured patients could be a shock to the system.

Well No shit!  I’ve laid out numerous times how there is no way to change the number of insured nearly overnight, and not experience a shortage of medical personell.  What the report doesn’t address is that this won’t be an “initial” shortage.  As reimbursements are reduced, work environments pinched, some medical personell will “go Galt.”  I suspect that what we experience short term will actually be our experience for an extended period of time; it could be our permanent go forward experience.

The more information that comes out, the more it’s obvious that the promises of Placebocare expire quicker than President Obama’s campaign promises.  That is to say, they never really existed.

First, watch Nancy Pelosi give her rational for Placebocare:

Did you catch that explanation?

Well, the point is that we want to make sure that everyone has access to health care.  For a long time now people who haven’t had health care or provided it had placed the burden on others.  Everybody is paying the price for uncompensated care.  I don’t need to tell you that in a hospital.  This is to say we all need to do our part and that is the point of the bill.

If we follow the logic of Ms. Pelosi’s statement, by implementing Placebocare, we should all see reductions in the cost of our insurance.  After all, if we’re paying a “hidden tax” today for those who get “health care for free”, we should see a reduction if everyone starts paying “their fair share.”

Except we won’t!

Pelosi will point to the recent CBO analysis which claims that premiums will decrease slightly under the House plan.  The problem with the analysis is that the CBO does not consider the cost transfer of over $1 trillion, in the form of taxes on “premium plans”, those who refuse to buy insurance, and others, as a part of the insurance cost.  Let’s see, if we don’t have the program, we don’t have the taxes.  It sure seems to me like they ought to be considered part of the costs of insurance.

As I pointed out here, studies are showing that rather than reducing the costs of health insurance, the implementation of Placebocare will actually increase the costs of health insurance.  In fact, according to the studies by Wellpoint, insurance premiums could increase by nearly 2X for certain segments of the population.

Pelosi is attempting to claim that a transfer in payments based solely on the health care program is not really a cost to be considered when comparing the two programs.  In fact, Pelosi’s argument is that if you are robbed at the point of a gun, rather than complain, you should thank the robber for making your wallet less cumbersome to carry.

Yes, Pelosi thinks we should all be happy to be victims.  In fact, she believes so much that we should be victims that if someone has the common sense to avoid victimhood, that’s a big problem! 

Should you choose to not buy insurance, the House bill provides for numerous penalties up to and including jail time.  When asked whether she thought jail was fair for people who choose not to be victims, Pelosi replied:

the legislation is very fair in this respect.

Just remember, if you don’t succumb to victim hood, Nancy Pelosi believes you should go to jail.  I wonder when she will expect those who survived the Fort Hood terrorism attack to begin serving their terms?

I attended Rep. Paul Ryan’s (R-WI, and my Congressman) townhall meeting at the Franklin Public Library, where he dropped off a copy of the 1,990-page present House version of PlaceboCare. If you have the 36 minutes to watch the entire townhall, the 4-part video is below (and yes, it is recommended). If you don’t read the Cliff’s Notes version while you watch the short version from Ryan’s office:

[youtube]http://www.youtube.com/watch?v=bN8O8-R45aw[/youtube]

• Ryan would have brought more copies, but with the bill being over a foot tall, he couldn’t carry more than one on the plane. Fortunately, he did put it up on his House website.
• H.R. 3962 would represent the largest tax increase in the history of the country, with a surtax of 5.4% on those making over $500,000 per year ($1,000,000 for couples) hitting most small businesses as well, a 2.5% medical device tax, a new payroll tax and the removal of the tax-exempt status of Health Savings Accounts.
• Abortions would be paid for under the public option, and the bill would also establish an accounting gimmick to justify subsidizing private plans that cover abortion.
• In order to make it appear to be deficit-“neutral”, it removed a $245 billion provision that would reverse a planned reduction in Medicare reimbursement rates, with plans to pass that as a stand-alone bill (or more-likely, attached to something else).
• The $170 billion in Medicare Advantage cuts will, according to Medicare’s actuaries, cause 64% of those on Medicare Advantage off that program and raise the rates paid by those remaining in it.
• Speaking of rate increases, Blue Cross/Blue Shield of Milwaukee estimates that the bill will increase the insurance rates of those in their twenties by 199% (that’s essentially tripling it), those in their 40s by 122%, and those in their 50s by double-digits.
• Instead of attempting to fix the joint state-federal Medicaid, which is currently bankrupting a lot of states, it increases its size by 50%.
• The malpractice tort “reform” will be limited to states that do not cap damages, thus making it anything but reform (Ryan called it a “fig leaf”).
• While the House Republicans will be offering a “consolidated” substitute amendment next week, it is unknown whether House Speaker Nancy Pelosi, as part of hers, President Barack Obama’s and Senate Majority Leader Harry Reid’s plan to use one-party rule to ram this through, will even allow it to see the floor.
• On the House side, the current plan is to get this to the floor on Thursday, with a vote on Saturday. On the Senate side, a cloture vote is expected sometime in the third week of November, but ultimately it won’t be necessary as the groundwork has been laid to pass this through “reconciliation”, which requires a simple majority instead of 60 votes to invoke cloture.
• Even though the current tally of the correspondence at the Ryan office is 9-1 against, he urged people to once again call Senators Kohl and Feingold to keep the pressure up, especially because it is not inevitable.
• He explained why this was his first opportunity to come back to the district after the August recess – Pelosi is trying to keep everybody in Washington so they don’t hear from their constituents.

[youtube]http://www.youtube.com/watch?v=_ww5jwQkip0[/youtube]

[youtube]http://www.youtube.com/watch?v=gGznTy69Bhk[/youtube]

[youtube]http://www.youtube.com/watch?v=ghgSq3K4law[/youtube]

[youtube]http://www.youtube.com/watch?v=0m7Fxnk_AM0[/youtube]

Revisions/extensions (5:02 pm 10/30/2009) – Just received word that the new bill has a new bill number. It is now H.R. 3962.

R&E part 2 (5:28 pm 10/30/2009) – The preliminary CBO first-decade scoring is in. Between the “meeting” with Obama resulting in some “technical” changes, the removal of planned fixes to the reduction in Medicare reimbursements (removing $245 billion in costs), a further reduction in those reimbursement rates (which, along wth other cuts in Medicare amount to $426 billion), and taxes/fees/penalties equalling $739 billion, they were able to squeeze out a debt “reduction” of $104 billion out of a bill spending $1,055 billion (that would be $1.055 trillion for those who missed the comma) in new outlays.

President Obama has acquired two more Czars.  Here’s a clip from their first meeting:

These are Czars I could accept!

H/T Big G

In May of 2009, President Barack Obama presented a commencement speech at Notre Dame. The belief that he is the most pro abortion President ever, caused a significant controversy both over his appearance at this Catholic University and even more so over the honorary degree he received that day.

Amongst some booing, catcalls and derogatory shouts, President Obama presented the graduates with a his view of how polarizing issues should be addressed in the United States. Here is a clip of President Obama as he applies his view to perhaps the single most polarizing issue in America, abortion:

In case you missed it, here is what President Obama said in this clip:

Now, understand — understand, Class of 2009, I do not suggest that the debate surrounding abortion can or should go away. Because no matter how much we may want to fudge it — indeed, while we know that the views of most Americans on the subject are complex and even contradictory — the fact is that at some level, the views of the two camps are irreconcilable. Each side will continue to make its case to the public with passion and conviction. But surely we can do so without reducing those with differing views to caricature.

Did you get that?  According to President Obama, even when debating what is arguably the most polarizing issue in America, he believes the cases can be made with “passion and conviction” and without “caricatures!”

Surely if abortion, an issue where people are polarized on the very point of whether to do it at all, can be discussed in the fashion that President Obama outlines, the discussion on an issue like health care reform should look akin to a love in from the 1970s!  After all, hardly anyone disagrees that something should be done with health care, the discussion is entirely over what specifically to do to improve health care and it’s costs.

It’s being reportedthat Nancy Pelosi will unveil her new and improved health care bill to the House on Thursday. Harry Reid is scrambling to find a way to 60 votes in the Senate so that he can bring his bill to the Senate floor.

Amazingly, well not really, while Pelosi and Reid are ready to debate their bills, not a single Republican has seen either bill.  In fact, what we know about either bill is that we really don’t know what is in either bill other than what Reid or Pelosi have told us.  It’s likely that neither bill will come close to satisfying President Obama’s pledge to not spend more than $900 billion and make it deficit neutral but we don’t know.

What we do know is that passage in either chamber is not even close to assured.  Pelosi has 52 “Blue Dog” Democrats.  Many of these Democrats come from districts that were previously Republican holdings.  With elections for each House member coming less than a year after a final vote, many of these folks are going to be torn between the promises of Nancy Pelosi and the expectations of the constituents.

In the Senate, it’s hard to see a clear path to 60.  With a public option in, it appears even the RINOs will hold with Republicans.  Add to them Lieberman, Bayh, Lincoln, Nelson and it looks like you’ve got a number of ways to hold 40 votes even if Reid suddenly drops the public option.  That said, I would never suggest Reid can’t get his 60.  Who knows what promises have been made that could put the Democrats back in lock step and get Snowe to come along.

I suspect the debate in both Houses will be filled with “passion and conviction.”  However, the “caricature” threshold was long ago bypassed.

The outcome of the debates and subsequent votes have the potential to dramatically change the United States as we know it.  While I’m hopeful that the bills as they are rumored, won’t pass both chambers it’s clear that President Obama has invested a significant portion of his political capital in the effort.  These bills aren’t going away in any natural fashion.

Stay vigilant, stay focused or the next caricature we’ll be talking about will be that of people who knew what it was like to live without an all controlling government.

Remember:  Stay on target, stay on target!

The folks pushing Placebocare are wanting us to believe that other than the $800 Billion or higher increase in the deficit, Placebocare won’t cost anyone another penny to provide all of its wonders.  On it’s face, this doesn’t pass the smell test.  How do you add tens of millions of additional users to a system without increasing costs?  How to you accept all health conditions without increasing costs?  How do you dramatically reduce the ability to rate differently for different health situations without increasing costs…at least on someone?  How, how, how?

The Politico is reporting that another set of Placebocare studies have been done by WellPoint.  While not received directly from WellPoint, Ben Smith has the studies posted on his blog.  Want to see the potential impact of Placebocare on your health insurance premiums?  From the studies posted on Smith’s site:

Note that these are projections of the increase in health insurance premiums. While they do assume that new taxes on things like hearing aids etc. are passed on via increased health care premiums, it does not include increases in your taxes that will be required to offset the significant increase in the deficit Placebocare will cause.

So, what do we see here?  Well, we see some very basic economic principles being reflected. 

In regular insurance analysis, the amount of risk assumed directly impacts the fees charged to assume that risk.  This principle is why in today’s health insurance, we see young, healthy people being charged significantly less for insurance than older, less healthy people.  Placebocare, like so many other government programs, does not treat people as groups of similarly situated individuals but rather, attempts to treat everyone the same.  The result is clear in the information provided from these studies.

Looking at the result of the studies we see several things.  First, the people or groups who are closest to the blended average of all have the least increase in their insurance costs.  Second, those who typically pay the least amount for their insurance will see dramatic increases in their rates so as to bring them closer to the “norm”.  Finally, we see that those who today, pay the higher premiums, will actually see some reduction in premiums.  Of course in this last case, the reduction in premiums will also come with a reduction in the overall services they receive as this will be the group that feels the required effects of reducing the provision of health care in an attempt to keep Placebocare from completely bankrupting the nation.

Folks, none of this is suprising.  There has never been a government run social program that hasn’t cost dramatically more than budgeted and resulted in increased deficits or costs over time.  Does anyone really think Obama and his acolytes have found a way to break this trend?  If they have, why don’t they focus that pixie dust on Social Security which is the number one problem for long term budget deficits.  Better yet, why don’t they fix Medicare and Medicaid, places where they already have near complete control on benefits and reimbursements?

Through Divine insight or shear luck, the Founding Fathers did not allow for the government to be involved in social programs.  If through insight, perhaps we can learn as every time the government wades into the social economic programs, they become a bigger mess than had it been left alone.  When government gets involved with social economic programs it does not create a “Free Lunch” but it sure as heck will create less liberty and an increase in taxes!

As amusing as the answer might be, the correct answer is not, “With a REALLY large mattress!”

A couple of weeks back, the Senate Finance committee passed the Baucus bill version of Placebocare.  Much heralded at the time, was the announcement that the Baucus bill had managed to meet President Obama’s promise that socialized health care would cost less than $1 Trillion for the first 10 years.  In fact, the Baucus bill purported to leave lots of wiggle room for CBO fine tuning, with a price tag of merely $829 Billion dollars.

Philip Klein at the American Spectatortook a look at the Baucus costs and found something interesting; the 10 years of costs really only included 4 years of the Baucus program being full implemented.  In the words of Desi Arnaz, “Oh Lucy, you forgot something!”

The graphical presentation from Klein clearly shows the problem in the cost analysis:

You can see that while there are some costs in the early years, the Baucus bill costs don’t hit their trend line until 2016. The graph shows clearly that 2010 through 2015 do not reflect the same program as that from 2016 on.

OK, we have a gap. The logical next question is, “If $829 billion isn’t the true 10 year cost, what is?”

I began with the information provided by Klein and look at the per person costs of the Baucus plan based on the projected estimation of the US population.  This review shows that the Baucus bill assumes that after adjusting for population, they have baked in an average of a 7% inflation rate from 2016 on.  I used this same 7% inflation rate and worked backwards from 2016 and further adjusted for the projected inflation.  I then did a calculation of what the Baucus bill might cost, with these assumptions, if it was fully implemented from day 1 in 2010.  The calculations are in the following spreadsheet:

Column “B” is in 1,000’s, “D” and “E” are $.  The others are in billions.

Assuming a 7% inflation rate and increasing population growth, my calculation shows that if the Baucus bill were fully implemented on day 1 rather than 6 years later, the total cost for the 10 years would be well over President Obama’s commitment of $1 trillion dollars.  In fact, the cost would likely be $475 billion, 57% more than what was trumpeted by the Finance committee.  Rather than $829 billion dollars, the true 10 year cost would be over $1.3 trillion dollars!

Q: How do you hide $475 billion dollars? 

A: Claim to pay for the program for only 40% of the time!

The latest Rasmussen poll is in and it’s not good for Placebocare.  Only 42% now support “reform” that is anything but.  24% strongly support the legislation and 42% strongly oppose it.

While most of the numbers in the latest poll, other than support is back near its lowest level, haven’t changed, there is one statistic that I found very interesting.  When asked what effect the proposed legislation would have on the cost of health care, 18% answered that the legislation would cause those costs to decrease!  Who the heck are these people?  I can only believe that they are the same folks who believe that the final plan will be a “bipartisan plan!”

While the tact the Democrats will take to attempt to pass this atrocity is not yet certain, one thing is certain.  The last time the polling dipped towards the low 40’s% support, President Obama showed up in prime time to buoy it.  With insurance companies, the Chamber of Commerce and other organizations now coming out against Placebocare, the public momentum is not on the side of the Democrat’s.  If polling support drops below 40%, even the Democrats won’t be able to hold together to push this through.  Expect to see another prime time address from President Obama.  You can set your DVR by it!

In case you haven’t heard the (lack-of-)reasoning Sen. Olympia Snowe (R-ME) gave for voting for the Baucus Vaporware version of PlaceboCare, she said, “When history calls, history calls.” I’ve got my fair share of Morons that supposedly read this place, so I know you can do better than the second half of that.

Have at it, and don’t worry about keeping it clean. I’ll even get you started off right…

“When history calls, I take a shit the size of Rhode Island.”

“Unprecedented consensus” from Republicans is what President Obama is calling the support of several RINOs and other Republicans who are not, and haven’t been in leadership roles for a number of years.

I don’t have much time to totally fisk his comments as I’m traveling and have little/weak wifi. Suffice to say it this way:

Drugs attached to the Presidency began with Bill Clinton claiming “he didn’t inhale.” They were elevated in stature when Barack Obama admitted he had tried cocaine. It now appears that drug use is regular fare at the White House. It’s the only way one could hallucinate any kind of “consensus” in support of placebocare amongst Republicans.

Once again, the two doctors of the Senate, Sen. Tom Coburn, M.D. and Sen. John Barrasso, M.D, will be taking to the Ustream airwaves at 4 pm Central (5 pm Eastern, 3 pm Mountain, check your watches on the Left Coast). They’ll likely be talking about the Baucus non-bill and the CBO’s scoring of said non-bill.

If you missed it; here’s the show courtesy YouTube…

[youtube]http://www.youtube.com/watch?v=PNdmGFzF-ME[/youtube]

Revisions/extensions (6:13 pm 10/8/2009) – Replaced the Ustream video of the previous show with the YouTube video of the current show.

Don’t miss the latest addition of the Senate Doctors show.  Unlike what’s contained in the various iterations of Placebocare, these guys actually know something about health care and how to provide reform that would actually be beneficial to Americans.  You can watch the latest episode below.

Free video chat by Ustream

Throughout the August recess, town halls across the country, were attended by grass root Americans who told their Representatives that they wanted no part of Obamacare.  As the pressure on the Representatives increased, Nancy Pelosi and other Democrat leaders attempted to discredit the notion that this was real angst, from real Americans, that was being projected towards their Beltway Masters.  Rather, Ms. Pelosi asserted that the angst was all ginned up and that it was not real grass roots but rather AstroTurf.

“I think they are astroturf, you be the judge.“

Yesterday, President Obama staged another photo op in an attempt to convince folks that the country supports his takeover of health care.  President Obama had 150 doctors attend the photo op.  He tried to use these doctors as representatives of the entire medical industry.  Obama’s logic seems to be that if the doctors say the medicine to fix health care is good, than you should take it.  Except, there’s a bit of a problem with the foundation of his argument.

Turns out, most of the doctors at yesterday’s event (those who brought their white coats and those who had to have one assigned to them) were members of Doctors for America.  Turns out that Doctors for America is not a new group.  Nope, DFA is the new reincarnation of the former Doctors for Obama.

If Doctors for America, formerly Doctors for Obama, had previously drunk the kool-aid for hope and change, is there any credibility in their support for more ingestion of the sugary drink?

If Nancy Pelosi thought the Grass Roots attending the town hall were nothing more than AstroTurf, can I now assume that support from a medical group that had already drunk the kool-aid is not real medicine but just a placebo?

Apparently, it has finally sunk into President Obama’s head that doing his Max Headroom impression on behalf of health care reform has not been a winning strategy.  To regain his Presidential gravitas he, Michelle and Oprah have taken on the self sacrificing task of going to Copenhagen to lobby for the lining of Valerie Jarrett’s pockets to bring the Olympics to Chicago.

Meanwhile, back at the ranch….

The manuevering continues in the attempt to have the Federal Government become the sole arbiter of health care in the U.S. 

I’ve linked before to the Senate Doctors show.  Senators Coburn and Barasso, the only two Senators who actually are doctors and not just playing one in the Senate, have had a regular video correspondence about the health care debate.  The Senators address issues, answer questions and even slap down the occassional Huffpo correspondent. 

In what could be described as “imitation is the sincerest form of flattery,” the Obama administration is ramping up their own health care video initiative.  The problem is that while they can imitate the use of a tool, they have no practicing doctors who can provide credibility to what will be another reguritation of left talking points (You remember….illegals won’t get health care, abortion won’t be covered, no death panels). 

Why get the cheap imitation when you have the original available?

The Senate Doctors will be on again at 5 PM Eastern.  You can watch the show live, below. 

The health care debate is far from over folks.  Stay informed, stay up to date on the issues and stay on target, stay on target!

Free video chat by Ustream

With the addition of the Baucus bill it’s getting hard to keep track of what proposals are included in which of the various health care proposals. Bottom line is that they all have a mandate for having health insurance and they all have a public option although it is hidden under different names (coop) depending upon the bill you are looking at.

If you are feeling confused by what is being discussed under the various scenarios, you can surely have empathy for the senility creeping into Harry Reid’s head. At the news conference yesterday, Harry was one of the few immediately greeting the Baucus bill:

“This is a good bill. This is a balanced bill,” he told reporters at a Capitol Hill news conference. Earlier, Senate Majority Leader Harry Reid, D-Nev., said, “Everyone should understand it’s just the beginning, but it’s a good beginning.”

But…..somewhere in his walk down the office halls he seemed to forget his earlier support:

“While this draft bill is a good starting point, it needs improvement before it will work for Nevada,” Reid said in a statement. “During this time of economic crisis, our state cannot afford to shoulder the second highest increase in Medicaid funding.”

Harry appears to believe that he can have his cake and eat it too.  He believes he can say one thing as leader of the Senate and something very different as the Senator from Nevada.

I wonder if Harry has ever heard Al Gore discuss the laters invention of the internet?