The Healthcare Bill: Why So Complex?

I saw two interesting panel discussions about the omnibus House healthcare bill on CNBC yesterday morning.

On one, a former FDA official, a representative for the bio-pharma sector, and former HHS secretary Tommy Thompson discussed how European pharma companies stopped producing innovative medicines a few years after imposition of universal healthcare programs in various countries. Their point was that, with government-imposed cost controls, pharma companies had less profit with which to fund innovative drugs, and little prospect of recovering any such investments, at a profit, by selling such new products to the same cost-conscious European country healthcare systems.

On the other, several industry executives and, I believe, at least one Congressional member, discussed the inadvisability of attempting to force through, hurriedly, such a complicated, voluminous and incomprehensible bill.

One noted the sudden fears rising among already-insured Americans who suspect that this bill will change what they have, and not for the better. Another mentioned a now generally-agreed brief list of legislatable fixes which, if implemented, would likely resolve more than 75% of the coverage and cost-containment issues now being debated, without redesigning the entire US healthcare system.

In response, the Hispanic co-anchor Carlos Q objected that sometimes big, broad programs are necessary to accomplish big tasks, such as Social Security in the 1930s and Medicare in the 1960s.

Two panel members immediately criticized Carlos for misunderstanding the current situation and needlessly complex, lengthy bill.

I have an additional criticism of the rather unintelligent, clueless CNBC co-anchor. It's a really simple one, but, never the less, one that escaped him.

Social Security and Medicare are both programs which offered benefits to individuals which had not existed before. That is, public pensions and medical care were not changed due to those two programs, but were provided by government for the first time because of them.

Universal healthcare bills are essentially and radically different. They, for the most part, promise not new coverage or benefits, but simply changed benefits.

Sure, perhaps 8-10MM new, poor, currently-uninsured will be served. But for the 250MM+ Americans who already have health insurance and access to good medical care of their choosing, life will change.

If it didn't, why the complicated bill? It's easy enough to just legislate tax credits or vouchers for government-offered or private health insurance without touching the rest of the system.

No, people are appropriately wary that such a large, unreadable, lengthy bill must be full of changes and traps which, if seen clearly in a 10-page or less bill, would provoke a terrible firestorm of voter fury and rejection.

Several of the panel members noted that if Wonderboy made progress on only one or two aspects of healthcare in his first term, e.g., interstate insurance availability, removal of mandates in policies, tax credits and vouchers for health insurance or no tax preference for anyone on the matter, and tort reform, people would credit him with real progress and accomplishment.

But, as they noted, fear is what you get when you deliberately pass a bill so long and complex that the average American knows the resulting administration of said law will subject them to a new, horrible nightmare.

This time, it won't be about retirement benefits, or old-age healthcare. It's going to be about every aspect of their most private family choices involving health and medicine.

About Those Death Panels: Wonderboy As Lawyer

Have you seen the video of Wonderboy's town hall meeting on healthcare?

He does something that is just what you'd expect a lawyer to do. It involves the so-called 'death panels.'

You see, buried deep in the bowels of the House healthcare bill are provisions for federal regulators to allocate medical care. Now, I can't recall exactly what the name of the commission is, but I can guarantee you it is not "Death Panel."

So when a colleague asked me how our First Rookie can stand in a town hall meeting and state so unequivocally that there are,

'no death panel that is going to deny care to your grandmother,'

he is, narrowly technically, correct.

But only a lawyer would think like that. Everyone else knows what the questioner meant. And that it is true.

It takes a true sophist, devoid of any principles or commitment to the truth, to so beguilingly lie, while technically telling not lying.

And that sophist is our president. A liar and a dissembler.

My colleague has said for a week now that someone should be cataloguing all Wonderboy's lies. I assured him that somewhere, someone is doing just that.

No doubt such a volume will be making an appearance by the next Congressional election cycle, as a reminder to voters everywhere of how they've been lied to by Wonderboy.

FDR & Wonderboy: The Scary Parallels

I've been reading Amity Schlaes' excellent book, "The Forgotten Man, A New History of The Great Depression."

In it, Ms. Schlaes carefully documents many of FDR's motivations and confused approaches to areas such as monetary policy and the gold standard, the NRA, TVA and the power industry.

Two things struck me about FDR's activities which seem to be shared by our current First Rookie.

First, FDR often had no clear conviction for his actions. For example, on monetary policy, he first disavowed leaving the gold standard, then formally severed the link, and, then, when this made gold price setting unable to affect the dollar's value, he returned the dollar to gold convertibility, albeit at a much higher $35/ounce, rather than the $20/ounce or so it had once held.

Schlaes' description of FDR's willy-nilly changes of mind to his own representatives to a gold conference he convened in London would be funny, if it were not so sad.

The other aspect of Roosevelt's activities which I had not realized was that the entire NRA was accomplished by executive orders. Congress had no say whatsoever in the autocratic agency which attempted to organize and regulate the entire US economy. Schlaes notes that, as of the mid-1930s, the NRA's regulations ran to some 10,000 pages, more than the entire Federal Register from the Republic's founding, in 1789, to that time.

One gets the sense that Wonderboy is also devoid of any clear sense of economic direction in his own deliberations. He demands a nearly-$800B stimulus bill, all to be borrowed, then claims his healthcare bill will not increase the deficit.

Too, as FDR did with his executive orders, Wonderboy has appointed a huge array of 'czars,' and is running the auto sector and supporting banks without meaningful Congressional oversight.

It's scary how much of FDR's approaches and overall game plan of explicit socialization our current president seems to have borrowed.

But, in contrast, there's hope, as well. Schlaes details how the tide eventually turned against FDR, as I will relate in an upcoming post.