Senior Democratic House Congressman John Dingell (D-MI) made some incredible admissions on WJR 760AM, a local Michigan station, on Tuesday morning in response to a question from local radio host Paul W. Smith. Smith asked, starting at about the 6:00 point on the tape, if the leftist rhetoric is correct that tens of thousands of Americans die per year because of a lack of health insurance, “are we are ready to let 72,000 more people die” between now and the implementation of Obamacare in 2014. Dingell then shockingly responded as follows:
“We’re not ready to be doing it. But let me remind you, this has been going on for years. We are bringing it to a halt. The harsh fact of the matter is when you’re going to pass legislation that will cover 300 [million] American people in different ways it takes a long time to do the necessary administrative steps that have to be taken to put the legislation together to control the people.”
Basically Dingell is saying there is so much to do to prepare the massive new federal health care system that the Democrats are “not ready to be doing it” now and four years are needed to prepare to launch the new system by 2014. Indeed, Dingell explicitly states that the Democrats need the next four years to prepare the “necessary administrative steps” to bring Obamacare online “to control the people” of America. Such commentary by such a senior Democratic insider is truly discomforting to centrists and independents, as well as some ideologues on both sides.
Further, it is quite revealing to hear the senior Democratic member of Congress, someone who was a featured speaker at the Democratic House leadership press conference on Sunday night after the historic passage of Obamacare by a 219-212 margin, make these admissions as GOP critics have been condemned harshly by the establishment media and many Democratic politicians for making claims similar (if not less sweeping ) to what Dingell admits here. Dingell’s frank admissions may spur another round of political acrimony between the Democrats and Republicans regarding the “big government” aspects of the Obamacare legislation and the plans for implementation as the Senate reconciliation debate begins.
Dingell then goes on to condemn the GOP just after the quote above for “not helping“, “carping and delaying” and “contributing nothing to this.” Perhaps the GOP is happy to have nothing to do with the wacky Obamacare scheme, as described by Dingell, to “control the people” after four years of preparing the “necessary administrative steps”. Considering the legislation is now the law of the land, and the “necessary administrative steps” referred to by Dingell are unknown outside of the close-knit Democratic power structure, Americans now need full disclosure of what exactly the Democrats have planned “to control the people” via the federal government’s newly minted comprehensive health care reform law.
Indeed, Dingell is part of a small group of Democratic politicians that are the insiders as to the true intent of the massive 2407 page long bill, receiving one of President Obama’s 20 signing pens he used to sign Obamacare today and further described by Obama-worshipping Newsweek as the biblical figure Aaron, who was the brother of Moses (Obama’s role as cast by Newsweek) and who played a critical role to get to the “promised land” of nationalized health care:
If Obama is the Moses of the new health-care law, Dingell is the Aaron—except that, unlike Aaron, he’s happily alive to reach the (incremental) promised land. “There is a certain satisfaction,” said Dingell as he kept an eye on the TV.
Dingell’s own father was a New Deal Democratic congressman and champion of a New Deal–style national health-care system, a bill he first introduced in 1943. When Dingell took over the seat from his late father in 1955, the old man’s bill was in the hopper—but never voted on. The son introduced a similar bill every year, starting in 1957. Every year, including this year. The new Obamacare law is far different from—and short of—that government-run New Deal vision.
But it’s fair to say that Obama and the Dems wouldn’t be where they are today (for good or ill, depending on your politics) had it not been for the efforts of Dingell over the years. In his youth and then heyday as a committee chairman and party leader, he helped pass Medicare in 1965—Nancy Pelosi used his ceremonial gavel on Sunday night—and every other expansion of health-care law and legislation.
Further, Dingell played a key part in pushing the winning block of anti-abortion swing votes, led by Bart Stupak (D-MI), to vote for Obamacare:
“Mr. Dingell had a piece of me (Saturday) for quite some time,” Stupak said.
Stupak said the dean of the House of Representatives was chief among a group of Democratic leaders who put pressure on him to reach a deal with the White House so he would switch to a “yea” vote on the bill.
Once it passed, Dingell’s Democratic colleagues acknowledged his long push for an overhaul of the nation’s health care with a standing ovation Sunday night.
Dingell called the final outcome “a long stride forward” in achieving his career-long goal of national health care coverage.
“I’m very, very happy,” said the beaming 83-year-old Dearborn Democrat, who got to bed well after 1 a.m. Monday but was up early to do his first TV interview at 6:45 a.m. A flood of TV, radio and newspaper interviews followed, underscoring how much credit he is given for helping the Democrats score the legislative victory.
Considering Dingell’s critical role in drafting and obtaining passage of Obamacare, as described by Newsweek and others, and the insider knowledge he must therefore hold regarding the “necessary administrative steps” planned by the Democrats to ramp up Obamacare so as “to control the people” starting in 2014, one can only hope that the establishment media awakens from its celebratory stupor and does a serious investigation as to what exactly the Democrats have planned for this country between now and 2014 so that the American people are fully informed and able to make appropriate decisions in November 2010 and 2012 at the ballot box. Should the Dingell interview end up disappearing from WJR 760AM, a copy can be found here on this site.
UPDATE: Ed at Hotair links over and wonders if Dingell’s crazy statements about Obamacare being designed to “control the people is a “Freudian” slip.
CentristNet salutes President Obama for the tenacity he has shown in continuing on in his fight to push through the Obamacare package despite setbacks such as the Scott Brown election victory and we hope for the country’s sake that the many questionable claims made by Obama, such as the claimed trillions in deficit savings, claimed coming reductions in insurance premiums and claimed maintenance of the unmatched quality, innovation and job creation of the present American health care system, will come true and the country will be better off from the passage of the bill.
Obama’s speech recycles most of the misleading talking points used by Obama and the Democrats over the past year despite the debunking of such claims by objective fact-checking organizations and simple reality, as will be outlined below. Obama began by accurately stating that the Obamacare debate is really “a debate about the character of our country.” Obama then goes off the rails somewhat with this rhetoric, stating that the question of passing Obamacare is about
“Whether we can still meet the challenges of our time. Whether we still have the guts and courage to give every citizen, not just some, the chance to meet their dreams.”
In fact, Obamacare is about whether the United States will move towards a new, radically altered system of strict federal government control and oversight of the health care industry or whether the United States will continue on its present path of substantially private-run health care. The drive of Americans to meet the challenges of “our time” is of course not epitomized by a massive increase in government spending and control over the health decisions of Americans, regardless of Obama’s expertly-crafted rhetoric above. Indeed, Obamacare will fundamentally alter the character of the United States, making most American citizens reliant upon a giant federal government bureaucracy, instead of themselves, for the provision of life-saving health care, forever altering the balance between citizen and government in this country.
As the American health care system is now the envy of the world, both in terms of innovation of new cutting-edge techniques and quality, and most world leaders come here for major health care for themselves personally, taking a giant step away from our present system via the massive new federal intervention into the health care industry in Obamacare can accurately be seen as risking America’s present dominance in the health care field internationally. Of course, Obama’s speech references none of these issues nor the 80% of Americans that presently approve of their personal health care arrangements.
Obama then moves onto a familiar rhetorical trick of framing all opponents to Obamacare as insurance industry hacks, stating that we cannot “accept a system that works better for the insurance companies than the American people” while “their lobbyists are stalking the halls of congress as we speak” and that “if this vote fails, the insurance industry will continue to run amok.” These arguments are substantially false as the health insurance companies will actually benefit in part from his bill as all healthy, young Americans who presently do not waste their money on pricey, unnecessary health insurance policies will now be forced to purchase same or face an IRS penalty and enforcement of same by IRS collection efforts. Of course, Obama’s speech does not reference this penalty on individuals, nor the additionally penalty on employers who do not provide benefits, in his speech today.
So the only question left is this: are we going to let the special interest win once again? Or are we going to make this vote a victory for the American People!
This claim, of course, ignores the fact that, at best, only about 35-40% of Americans support the passage of the President’s comprehensive health care plan into law, making its coming passage hardly a “victory” for the American people, 80% of which are presently satisfied with their medical care. Also ignored by this Obama claim that his bill is being opposed by “special interests” is the fact that Obama himself has made backroom deals with the large drug companies (“Big Pharma”), American Medical Association, the hospitals, the AARP, the unions, and even some insurance companies as the past year of backroom dealmaking between the Obama Administration and special interest groups has unfolded. The level of “audacity” required to claim his bill is not backed by special interests while he himself made deals with essentially every major special interest in the health care industry during meetings in his White House is substantial and this Obama claim is quite jarring when compared to the above-referenced publicly available facts.
Obama then continues in his speech to claim, as he has many times since the summer of 2009, that “the time for reform is right now. Not a year from now, not 5 years from now not 10 years from now not 20 years from now” while noting that “we have had a year of hard debate, every proposal has been put on the table, every argument has been made, we have incorporated the best ideas from Democrats and from Republicans into a final proposal that builds on the system of private insurance that we have.” These claims, of course, ignore the fact that the Republican ideas to reduce health care costs via tort reform and allowing increased competition between insurers across state lines are ignored by his legislation and those issues also go unmentioned in Obama’s speech today.
Obama then denies that his plan is “radical change” (somewhat contradicting his earlier comments extolling the major changes to come from his bill) and states that “what we’re talking about is common sense reform, that’s all we’re talking about.” Now, Obama unleashes three of the greatest lies ever told about Obamacare:
If you like your doctor, you’ll be able to keep your doctor. If you like your plan, you’ll be able to keep your plan. Because I don’t believe we should give the government or the insurance companies more control over health care in America. I believe it’s time to give you – the American people – more control over your health insurance.
Of course, the massive federal intervention into the American health care system will lead to many Americans having their present health care arrangements substantially altered, whether by a doctor who retires rather than face the increased costs of federal control, or by the new strict federal rules that require certain benefits to be covered, or by an employer who dumps their benefits coverage and just pays the fine to avoid the hassle, or by the elimination of nearly 10 million seniors “Medicare Advantage” coverage. amongst other ways such personal health care arrangements will be altered.
As for Obama’s claim that he does not want to “give the government or the insurance companies more control over health care” and instead wanting to give the “American people” “more control” over their health insurance, such a statement simply defies all logic and available facts known about Obamacare as many new federal rules and regulations will be implemented and enforced on the American health care system, hence increasing federal government control of same, as intended by its authors. Of course, Obama’s speech avoids any discussion of the massive increase in the federal government’s bureaucracy in his remarks today and instead Obama implausibly denies that his bill will increase federal power over the health care industry, as it is written and intended to do. Also unmentioned in Obama’s speech is the 15,000 new IRS employees to be hired to enforce the new Obamacare personal and company fines and taxes in Obamacare as well as cost of new federal health bureaucrats to “administer” Obamacare.
Obama then summarizes the parts of his nearly 3000 page bill that he wants to talk about, stating his Obamacare plan does three things: first, it “ends the worst practices of insurance companies” as implementing “a patients’ bill of rights on steroids”; second, “[f]or the first time, small business owners and others…will have the same kind of choice for private health insurance that members of congress give to themselves”; and third that it “brings down the cost of health care for families, businesses and the federal government.”
While the President does accurately state that insurers will be required to issue insurance policies to all those who have preexisting conditions that cost hundreds of thousands if not millions to treat every year at a cost that is not above a healthy person’s policy, the remaining two claims in his formulation are unequivocally false. All Americans will certainly not have coverage like members of Congress after Obamacare passes, this is simply a lie. Elite politicians will continue to receive gold-plated health care plans whether Obamacare passes or not, and the average American will either be fined for not purchasing such expensive coverage or the federal government will their own tax dollars (or borrowed dollars) pay to provide coverage made more expensive by Obamacare’s provisions.
Despite this reality, Obama makes this ridiculous claim during his discussion of his second main point that Americans will receive the same coverage as Congress:
“We will offer you tax credits to do so – tax credits that add up to the largest middle class tax cut for health care in history.”
Amazingly, Obama terms his planned new spending, in his own words, of at least a “100 billion a year” on a new federal health care entitlement program via Obamacare, as the “largest middle class tax cut for health care in history.” Such an explicitly misleading presentation of the new entitlement programs in Obamacare certainly recalls the works of George Orwell, such as the book 1984, and this Orwell quote in the aftermath of World War 2 in 1945:
People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. . . To appreciate the danger of Fascism the Left would have had to admit its own shortcomings, which was too painful; so the whole phenomenon was ignored or misinterpreted, with disastrous results…The most intelligent people seem capable of holding schizophrenic beliefs, or disregarding plain facts, of evading serious questions with debating-society repartees, or swallowing baseless rumours and of looking on indifferently while history is falsified.
Above and beyond the false and misleading claims above, President Obama’s ridiculous claim today that Obamacare is “one of the biggest deficit-reduction plans in history” is definitely the most odious and explicitly false statement made by President Obama in his speech today, which in our view ranks as one of the most misleading Presidential speeches in American history. Of course, the giant new entitlement spending in Obamacare (at least 100 billion a year according to Obama today) will not reduce the yearly federal budget deficit, and Obama knows it. However, Obama and the Democrats keep repeating this claim, even claiming it is “one of the biggest deficit-reduction plans in history” based on entirely misleading numbers from the CBO.
It is true that the CBO issued a preliminary report on the latest nearly 3000 page long Obamacare plan today in which the CBO states the bill will cost about a trillion dollars over 10 years (only 6 years of benefits, but 10 years of taxes and Medicare cuts) while allegedly “saving” over a hundred billion in deficit spending over those first 10 years and over a trillion in deficit spending over 20 years. However, the CBO is forced to score the language and assumptions provided to it by the Democrats in charge of Congress, and cannot interject the CBO’s own opinion as to whether those assumptions will bear out or whether subsequent Congresses will change the language.
The first major misrepresentation in the CBO’s claim of deficit savings is the failure to include the “doctor fix” in the CBO’s scoring of OBamacare. The CBO’s claim of deficit spending assumes a 21% cut in doctor and hospital fees, as present law requires. That law, a 1997 act to reduce Medicare spending over time, has been waived every year since then by Congress under pressure from the AMA lobby and others. The Obama Administration, of course, made a little-publicized deal between Obama and the AMA in July 2009 to purchase their support for Obamacare by promising a long term “doctor fix” as a part of the comprehensive health care reform procedure, as reported by Politico then:
In the bill, Democrats provide $245 billion to eliminate an annual shortfall in payments to doctors under Medicare. Democrats resolved this annual headache, in large part, to win crucial support for the bill from the American Medical Association. That money currently counts against the overall costs of the bill, but Democrats have introduced legislation that would remove remove this obligation from federal deficit.
Whether you take the $245 billion dollar figure over 10 years quoted here by Politico, or the $371 billion dollar figure reported by Politico today (before they pulled the story under White House pressure) for the cost in federal spending of a long term doctor fix, the claimed $138 billion in deficit “savings” over the next 10 years completely disappears and Obamacare ends up being in the red, even putting aside all the other budgetary tricks we will outline below. Indeed, the CBO just issued an update to their report, in response to GOP Congressman Paul Ryan’s (R-WI) letter, admitting that Obamacare will add to the deficit once the doctor fix is in place, as promised by both President Obama to the AMA to buy their support and by Nancy Pelosi today in her news conference:
You asked about the total budgetary impact of enacting the reconciliation proposal (the amendment to H.R. 4872), the Senate-passed health bill (H.R. 3590), and the Medicare Physicians Payment Reform Act of 2009 (H.R. 3961). CBO estimates that enacting all three pieces of legislation would add $59 billion to budget deficits over the 2010–2019 period.
Of course, Obama was well aware of these facts regarding the lack of deficit savings when the doctor fix is factored into Obamacare, and Obama still explicitly stated today that his plan will be “one of the biggest deficit-reduction plans in history.” This Obama claim, a willful misrepresentation of the true cost of his program by not “counting” the doctor fix that Obama himself promised to the AMA to purchase their support for his program in July 2009, brings to mind the Orwell quote above that “most intelligent people seem capable of holding schizophrenic beliefs, or disregarding plain facts, of evading serious questions with debating-society repartees, or swallowing baseless rumours and of looking on indifferently while history is falsified. Sadly, the explicit misrepresentation of the President in claiming that Obamacare is “one of the biggest deficit-reduction plans in history” is not solely based on the doctor fix lie, but many others as well.
They’ve stuffed the legislation with gimmicks and dodges designed to get a good score from the Congressional Budget Office but don’t genuinely control runaway spending.
There is the doc fix dodge. The legislation pretends that Congress is about to cut Medicare reimbursements by 21 percent. Everyone knows that will never happen, so over the next decade actual spending will be $300 billion higher than paper projections.
There is the long-term care dodge. The bill creates a $72 billion trust fund to pay for a new long-term care program. The sponsors count that money as cost-saving, even though it will eventually be paid back out when the program comes on line.
There is the subsidy dodge. Workers making $60,000 and in the health exchanges would receive $4,500 more in subsidies in 2016 than workers making $60,000 and not in the exchanges. There is no way future Congresses will allow that disparity to persist. Soon, everybody will get the subsidy.
There is the excise tax dodge. The primary cost-control mechanism and long-term revenue source for the program is the tax on high-cost plans. But Democrats aren’t willing to levy this tax for eight years. The fiscal sustainability of the whole bill rests on the naïve hope that a future Congress will have the guts to accept a trillion-dollar tax when the current Congress wouldn’t accept an increase of a few billion.
There is the 10-6 dodge. One of the reasons the bill appears deficit-neutral in the first decade is that it begins collecting revenue right away but doesn’t have to pay for most benefits until 2014. That’s 10 years of revenues to pay for 6 years of benefits, something unlikely to happen again unless the country agrees to go without health care for four years every decade.
There is the Social Security dodge. The bill uses $52 billion in higher Social Security taxes to pay for health care expansion. But if Social Security taxes pay for health care, what pays for Social Security?
There is the pilot program dodge. Admirably, the bill includes pilot programs designed to help find ways to control costs. But it’s not clear that the bill includes mechanisms to actually implement the results. This is exactly what happened to undermine previous pilot program efforts.
In its March 11, 2010, cost estimate for H.R. 3590, the Patient Protection and Affordable Care Act (PPACA), as passed by the Senate, CBO indicated that it has identified at least $50 billion in specified and estimated authorizations of discretionary spending that might be involved in implementing that legislation. The authority to undertake such spending is not provided in H.R. 3590; it would require future action in appropriation bills.
Finally, the President also plays misleading rhetorical games regarding the “cost controls” in Obamacare. The only significant cost control mechanism in the Obamacare package (as tort reform and interstate competition between insurers are omitted) is the “cadillac tax” on gold-plated health insurance policies, however, that tax was pushed off until 2018 because of pressure from unions who’s members have such insurance plans. Accordingly, in order to make the ridiculous claims of deficit savings referenced above, Obama pretends that Congress in 2017 will not waive the “cadillac tax” under political pressure, as he has just done with the delay until 2018 and as every Congress has done every year since the 1997 Medicare cost-cutting legislation (which is the source of the “doctor fix” problem in the first place). Indeed, if Obama with a huge Congressional majority cannot enact a cadillac tax within the next 8 years, why should anyone have any confidence that Congress 2017 will do so? Obama, and everyone else in Washington, knows this is an unrealistic fantasy, but Obama still made these ridiculous claims in his historically misleading speech today.
Finally, just as Congress has waived the planned reductions in fees for doctors and hospitals every year since 1997, future Congresses in all likelihood will also waive the planned nearly $500 billion in cuts to Medicare over the next 10 years to avoid a backlash by elderly voters who fear benefit cuts and pressure from medical provider lobbies. The cuts to Medicare are over half of the revenue Obama plans to use to fund the new health care entitlement spending of $100 billion a year, and everyone in Washington knows these cuts will never happen in full. Obama’s speech, of course, makes no reference to the “doctor fix” or the Medicare cuts themselves which form half of the revenue for his programs, but Obama certainly does claim that his plan is “one of the biggest deficit-reduction plans in history”, and all of his fellow Democrats are repeating similar claims all over the dial as this article is written. Such intentionally misleading statements by American leaders again remind centrist and independent Americans of the words of George Orwell as referenced above, reinforced by Obama’s ridiculous claim his “reduced” health care costs from Obamacare will mean that employers “can afford to give you a raise.”
A final Obama quote from today sums up the fraudulent nature of his speech, as he claims “more than $1 trillion” in deficit savings, considering the facts noted above. This comment is the only reference to the $500 billion in cuts planned for the Medicare system, and of course Obama does not reference Medicare by name:
And by the way, if you’re curious, well, how exactly are we saving these costs? Well, part of it is, again, we’re not spending our health care money wisely. So, for example, you go to the hospital or you go to a doctor and you may take five tests, when it turns out if you just took one test, then you send an e-mail around with the test results, you wouldn’t be paying $500 per test. So we’re trying to save money across the system. (Applause.) And altogether, our cost-cutting measures would reduce most people’s premiums. And here’s the bonus: It brings down our deficit by more than $1 trillion over the next two decades.
The pure idiocy of Obama’s example of emailed tests as his primary cost-cutting mechanism to cut nearly $500 billion from Medicare speaks for itself. Obama gave his speech to an auditorium of students at George Mason University, as such young college students are Obama’s last remaining base of support with his approval slipping underwater, as more Americans disapproving than approving of his performance in all major polls released this week. One can only hope that America does not have to find out the hard way, via renewed economic instability emanating from runaway deficit spending as envisioned by the actual provisions of Obamacare, not to mention the loss of medical innovation and job creation from the health care industry and the historical alteration of the relationship between American citizens and the federal government, that the claims made in Obama’s speech today are wholly false and that his speech was likely one of the most misleading speeches ever given by a sitting American President.
As noted a few days ago by CentristNet, the establishment media had been scrupulously avoiding any discussion of the Democratic plans to use the “Slaughter Solution” in the House of Representatives to completely avoid an up or down vote on the Senate bill and instead have the bill “deemed passed” by the rules of debate created by House Rules Committee Chairwoman Louise Slaughter (D-NY). Obamaphile “news” organizations like Newsweek even went so far as to condemn Republicans just days ago for even making this argument because it was unthinkable to Newsweek, apparently, that the Democrats would actually go down this “deemed passed” path.
On this final week of the Obamacare battle, the Democrats are actually attempting to defend the use of this procedural trickery to avoid an up or down vote in the House on the pork-filled, special interest deal laden Senate bill. Today, after ignoring the entire issue of the “Slaughter Solution” since Chairwoman Slaughter’s announcement of her intent to use same about a week ago, the narrative-setting New York Times actually reported on it, noting that House Democrats intend to avoid an up or down vote via the use of yet more procedural trickery re Obamacare:
WASHINGTON — As lawmakers clashed fiercely over major health care legislation on the House floor, Democrats struggled Tuesday to defend procedural shortcuts they might use to win approval for their proposals in the next few days.
House Democrats are so skittish about the piece of legislation that is now the vehicle for overhauling the health care system — the bill passed by the Senate in December — that they are considering a maneuver that would allow them to pass it without explicitly voting for it.
Under that approach, House Democrats would approve a package of changes to the Senate bill in a budget reconciliation bill. The Senate bill would be “deemed passed” if and when the House adopts rules for debate on the reconciliation bill — or perhaps when the House passes that reconciliation bill.
The idea is to package the changes and the underlying bill together in a way that amounts to an amended bill in a single vote. Many House Democrats dislike some provisions of the Senate bill, including special treatment for a handful of states, like Medicaid money for Nebraska, and therefore want to avoid a direct vote on it.
Of course, the NYT “news” article goes on to condemn Repuoblicans for pointing out this odious procedural trickery by Democrats on a bill that will directly affect 16-17% of the US economy. Not to be outdone, the Washington Post also reports for the first time on the “Slaughter Solution” in much the same way as the New York Times, framing it as just another partisan battle as opposed to an attempt to avoid the very “up or down” vote clamored for by President Obama over the past few weeks:
An obscure parliamentary maneuver favored by House Speaker Nancy Pelosi (D-Calif.) suddenly ignited Tuesday as the latest tinder in the year-long partisan strife over reshaping the nation’s health-care system, triggering debate over the strategy’s legitimacy and political wisdom.
Republicans condemned Pelosi’s idea — in which House members would make a final decision on broad health-care changes without voting directly on the Senate version of the bill — as an abuse of the legislative process.
Instead of focusing on the use of this procedure trickery by Democrats in relation to the enormity of the comprehensive health care reform package at issue, WaPo and the NYT misdirect their readers into believing this “Slaughter Solution” issue is just another vapid partisan battle. In fact, the “Slaughter Solution” explicitly rejects President Obama’s rhetoric about an “up or down vote” on the Senate bill by allowing the Senate bill to be “deemed passed” and signed by President Obama without an up or down vote:
The debate centers on a parliamentary technique that is a variant on the “rule” that the House adopts for every bill that comes to a floor vote. Rules define the ground rules for the vote, including amendments, length of the debate and other terms. Under a self-executing rule, the House essentially agrees that a vote on one measure is tantamount to, or “deemed” as, deciding on something related.
In this instance, the self-executing rule would say that the Senate’s version of health-care legislation would be deemed approved if House members adopt a set of changes to that bill. The Senate then would have to approve the changes, but the original bill could go directly to President Obama to be signed into law.
Sadly, White House Spokesman Robert Gibbs explicitly lied about this issue on Sunday on CBS’s “Face the Nation”, claiming that the House would pass two separate bills, one in which the House would vote up or down on the “underlying Senate bill” and another, separate vote on the reconciliation “fix” package. The establishment media gave Gibbs a pass on these intentionally misleading claims made on national television of by senior federal official, and only today are they even reporting on Democratic plans to have only one vote on the “fixes” after the Senate bill is “deemed passed” by the “Slaughter Solution” without an actual up or down vote.
Regardless of which side of the Obamacare debate you fall on, fair-minded centrists and independents, as well as those on the right and left, should demand that the House hold an up or down vote on the Senate bill if the Democrats want to make the Senate bill the law of the land via President Obama’s signature. Passing a massive comprehensive health care reform bill into law without an up or down vote by the House of Representatives, as is now intended by the “Slaughter Solution”, poses grave risks to the future functioning of the American system of governance and such efforts must be resisted, strongly, by all Americans, regardless of their leanings on the bills themselves. If Obamacare is to become the law of the land, it must be passed constitutionally with an up or down vote, not via a procedural trick cooked up by Democrats desperate to avoid an up or down vote on the pork and special interest laden Senate health care bill.
Obama’s present strategy to use reconciliation to pass Obamacare through the Senate after passing the present Senate bill through the House of Representatives has no guarantee of success considering the present bills’ massive unpopularity with the American public and the reluctance of House Democrats to make a career-ending vote for Obamacare. Further, a new entitlement passed without bipartisan support would be difficult to maintain in years to come and could poison American politics for a generation. With all that in mind, we offer several straightforward centrist policy prescriptions that the GOP and Obama can agree on. Each centrist incremental federal reform could be worked out between the parties in a matter of weeks, perhaps by fast-tracked policy commissions with an equal split in members between the parties and tasked with producing preliminary reports two weeks from the end of the summit.
1. Federal Incentives To Encourage States to Decrease the Number of Involuntarily Uninsured Americans.
A large part of the issue that many Americans have with Obamacare is the central role of the federal government in the regulation and operation of the American health care industry, with numerous new federal bureaucracies, and attendant federal health bureaucrats to be added to the payroll, that is at the heart of the design of Obamacare. We believe that instead of creating a giant new federal government structure, federal policy should focus on incentivizing the states into experimenting with new measures to reduce cost and the involuntarily uninsured. New federal mandates to states, as are included in Obamacare, would inappropriately constrain the states and hamper the great “laboratory of democracy” from properly operating as it has throughout American history.
States play a critical role in advancing coverage expansions and other health reforms by testing new ideas, both politically and practically. Because health care delivery is largely local, states are closer to the action when it comes to implementing some of the delivery and payment systems changes that are needed to truly transform the health care system. This proximity and flexibility in system redesign is a key strength for states. In addition, states have first-hand knowledge of their local landscape and relationships with the stakeholders that will be necessary to change the system. Much of the work related to implementing insurance reforms, delivery system redesign, and public health strategies traditionally have been led by states.
Some say that the Massachusetts health care plan was a failure because health care costs are rising faster in that state than nationally since the reform passed, the cost overruns regarding projected state spending and the lack of attainment of true universal coverage. However, the State of Massachusetts passed a bipartisan plan with Republican Governor Milt Romney, a 90% Democratic Massachusetts legislature and a cheerleading Teddy Kennedy present for the signing of the bill by Romney. If Massachusetts desires to change or reverse its programs, the people of Massachusetts will make that happen. Every other state in the Union should have the same opportunity to decide how to proceed regarding its health care systems and the federal government should not straight jacket the states into a one size fits all federal mandate via Obamacare. Federal incentives could also be accessible to several states who wish to forum a regional health care system with uniform rules – but the decisions effecting Americans health care should not be left to a faraway bureaucrat in Washington, D.C.
By maintaining the flexibility of states to engage in policy innovation, the probability increases that a health care policy that is proven to work by empirical evidence will emerge and spread around the country once the benefits of such policy are made clear by results. Creating a huge federal bureaucracy with many new mandates on state governments regarding health care policy will stifle this state innovation and risk damaging the present high quality of care provided by American medical professionals across the land. As 70% to 80% of Americans approve of their present health care arrangements, federal health policy must follow the medical maxim of “first do no harm” and avoid the risk of reducing the present quality of care with too much federal government control over states and medical professionals.
2. Reform Medical Malpractice Laws:
There is no serious dispute over the need for substantial medical malpractice reform, or tort reform, on the federal level. Some on the right advocate Texas-style tort reform, which involves caps on damage awards and limiting “jackpot justice”, while some on the left wholly reject any tort reform and others advocate a system of specialized health care courts to replace the present courts of general jurisdiction that handle medical malpractice cases. Both policy approaches have pluses and minuses, and to that end the federal health reform effort should provide incentives to the states to attempt either systemic change. It may be that in the long term, specialized health courts, similar to the workers compensation system, are the better choice, but the states should be free to choose how to design their system, as they are in the workers compensation arena. The left-leaning Progressive Policy Institute outlines some benefits of health care courts:
A Better Way: Health Courts
There are many proposals for health care reform that are focused outside the medical justice system. All are well intentioned and some may be practical, but without legal reforms none will likely succeed in containing costs. Clearly, we need major reform, and we can achieve it in part by instituting a network of specialized health courts to replace the current medical justice system.1
Under health courts, malpractice cases would no longer be heard in civil courts. Instead, they would be handled in an administrative system overseen by the states. The system would be similar to the state-run workers’ compensation system. It would give more injured patients access to quicker and less expensive justice.
Health court rulings would establish new standards of practice to cover medical circumstances for which common standards have not previously been settled. The health court system would thus yield an essential benefit that our current system of medical justice fails to provide: consistent, rational rulings that send clear signals to health care providers about what constitutes good medical practice. In so doing, it would help eliminate the legal uncertainty that encourages doctors to practice defensive medicine and the silence among practitioners and patients that very likely contributes to medical errors.
It is possible that if even a few states chose to institute health care courts based on incentives in an incremental, centrist federal health reform plan, the benefits of such specialized courts could become empirically proven in a few years. Once proven successful, such a system may become the standard throughout the country; however, as far as a federal policy is concerned, a state should be free to try traditional tort reform, health care courts or any other solution they can create. A federal plan to incentivize the states in the tort reform arena could not be seriously opposed by either party and legislative language could be worked out relatively quickly by bipartisan negotiators.
3. Create a Federal/State/Insurance Companies Mechanism for Covering the Uninsurable with Preexisting Conditions:
The American public believes by a large majority that some federal action should be taken to assist those Americans who cannot obtain health care insurance because they have an uninsurable preexisting condition. Indeed, logically speaking, requiring an health insurance company to provide insurance to an individual that faces certain, and substantial, medical expenses is similar to requiring a car insurance company to provide insurance to an individual with an already wrecked car. It is simply not economically feasible for the private sector insurers to insure against an already existing condition. Because of this, federal government intervention in the health insurance market is appropriate in the instance of uninsurable individuals.
A centrist proposal to deal with uninsurable individuals is to set up comprehensive high risk pools jointly funded by federal and state governments to enable uninsurable individuals to purchase health insurance and a supporting, pro bono role for health insurance companies in administering the program. 31 States presently have high risk pools, and the inclusion of the federal government and insurers into a comprehensive risk pool policy could reduce the cost to the uninsurable while providing folks with care they otherwise would not have received. Both parties already support the use of risk pools, and the Senate version of Obamacare provides for high risk pools between now and 2013. Health insurance companies should be required to participate in this program as a consequence of the federal law, perhaps conditioning a continued exemption from antitrust laws on cooperation by the insurance companies with the risk pool program. This will be an expensive proposition, and many on both sides of the aisle could object to the high cost and some on the left are sure to argue that a comprehensive health care reform plan would be a cheaper alternative. However, as noted earlier, there is no chance of a bipartisan agreement on a comprehensive health care reform plan this year, but neither party could seriously oppose a serious risk pool program for uninsurable individuals and again, the details of this policy could be worked out in a matter of weeks.
4. Create Bipartisan Commission to Study Medical Billing Reform:
Anyone who has reviewed medical bills as provided by doctors and hospitals and then reviewed the payments actually made, and their variance, between insurance companies, government entities and cash-paying individuals knows that the present medical billing system needs substantial reform. Unfortunately, this issue has gotten little attention in the health care reform debate and does not figure prominently in the Obama Health Plan. A single procedure can be billed at $10,000.00 by a hospital to an individual, yet the same procedure could bring in only $4,000.00 from an insurance company and either more or less from a government entity. Greater transparency is needed in medical billing, and health care consumers need to be more involved and aware of what procedures cost and their various choices to create a more efficient and effective medical billing system. While this policy prescription may not be amenable to a quick bipartisan agreement on legislative mandates, neither party could seriously oppose the creation of a Bipartisan Commission to study the medical billing problem and issue recommendations for negotiations between the politicians in a few months.
5. Create a Medicare/Medicaid Sanctions Database and Act to Reduce “Waste, Fraud, and Abuse” in Medicare and Medicaid:
The President’s Proposal establishes a comprehensive Medicare and Medicaid sanctions database, overseen by the HHS Inspector General. This database will provide a central storage location, allowing for law enforcement access to information related to past sanctions on health care providers, suppliers and related entities. (Source: H.R. 3400, “Empowering Patients First Act” (Republican Study Committee bill))
Republicans will also likely sign off on some of the other provisions listed on this page by President Obama in his Health Plan, as some are geared towards cracking down on wrongdoers who abuse the payment procedures of Medicare and Medicaid. A good first step, and one that neither party could seriously object to, is the creation of the sanctions database to make sure wrongdoing individuals cannot continue to defraud the government under any circumstances. Again, bipartisan negotiators could work out legislative language on this issue in a matter of weeks.
The five point plan listed above is no panacea, and will not solve all the problems in the American health care system. However, these above-enumerated centrist health care reforms could not be seriously opposed by either party and compromise legislative language could be worked out in a matter of weeks. Instead of acrimony about Obama’s planned use of reconciliation and the GOP’s obstructionism, one can only hope that the participants in today’s health care summit put aside the pressures of party ideologues on both sides and decide to forge real consensus where it is actually possible: centrist, incremental health care reform.
WASHINGTON — President Obama will propose on Monday giving the federal government new power to block excessive rate increases by health insurance companies, as he rolls out comprehensive legislation to revamp the nation’s health care system, White House officials said.
The president’s legislation aims to bridge differences between the bills adopted by the House and Senate late last year, and to frame his debate with Republicans over health policy at a televised “summit” meeting on Thursday.
By focusing on the effort to tighten regulation of insurance costs, a new element not included in either the House or Senate bills, Mr. Obama is seizing on outrage over recent premium increases of up to 39 percent announced by Anthem Blue Cross of California and moving to portray the Democrats’ health overhaul as a way to protect Americans from predatory insurers.
The timing of the leak to the NYT tonight appears designed to control the media narrative tomorrow, when Obama’s specific language will be released on the internet. Obama’s emphasis on being tough on insurance companies appears designed to paint the GOP as soft on insurance companies should the GOP continue to refuse to go along with Obama’s health care plans. Additionally, the price controls would take effect immediately, giving the Democrats something to point to in the short term should Obamacare pass as most individual benefits are not set to begin until 2013. Specifically, the price control system proposed by Obama would work as follows according to the NYT:
The president’s bill would grant the federal health and human services secretary new authority to review, and to block, premium increases by private insurers, potentially superseding state insurance regulators. The bill would create a new Health Insurance Rate Authority, comprised of health industry experts that would issue an annual report setting the parameters for reasonable rate increases based on conditions in the market.
Officials said they envisioned the provision taking effect immediately after the health care bill is signed into law.
The legislation would call on the secretary of health and human services to work with state regulators to develop an annual review of rate increases, and if increases are deemed “unjustified” the secretary or the state could block the increase, order the insurer to change it, or even issue a rebate to beneficiaries. States would be eligible for a portion of $250 million in grants finance premium review and approval.
The new price control provisions will also provide the GOP with an opening to paint Obamacare as a big government takeover of the health care system, especially as they are to take effect immediately and potentially disrupt private insurance company operations and plans for the ongoing fiscal year 2010. Conversely, the large new increases in a small subset of non-employer obtained health care insurance in California have provided political fuel to those on the left who advocate strong federal price controls. However, even some Democratic Senators, such as Sen. Jeff Bingaman (D-N.M.), who participated in Democratic Senate Finance Committee Chairman Max Baucus’s bipartisan health care negotiations, reject health insurance price controls, notes the LA Times in September 2009:
But Democrats have shied away from regulating premiums in the face of charges from business leaders and Republicans that controlling what insurers charge would be meddling too much in the private sector.
As a result, while states have long supervised what companies charge for mandated automobile and homeowners insurance, the idea has been largely banished from the healthcare debate.
“That would be a very substantial additional intervention in the marketplace,” said Sen. Jeff Bingaman (D-N.M.), a member of a bipartisan group of lawmakers who worked with Senate Finance Committee Chairman Max Baucus (D-Mont.) on his healthcare bill. “I just don’t think the support would be there for that kind of a change.”
Another wildcard in the health care debate this week is the role of the nation’s governors, who are increasingly upset about being shut out of the intra-Democratic health care negotiations and desire “more of a voice” in the negotiations:
Leaders of the National Governors Association meeting in Washington on Sunday expressed frustration that that they had been largely shut out of negotiations over the future of the health care system, even though they would be responsible for carrying out many of the changes envisioned by federal officials. They said they want more of a voice in shaping those changes.
“It’s important that governors be at the table and bring our perspective to the debate,” said Gov. Jim Douglas of Vermont, a Republican who is chairman of the National Governors Association.
Mr. Douglas said governors were deeply involved in discussions with Congress and Mr. Obama on the economic stimulus law adopted early last year. But he said, “We have not had that kind of relationship in the current debate” on health care.
Gov. Phil Bredesen of Tennessee, a Democrat, said: “Governors have something unique to contribute. Washington, D.C., is full of think tanks, theoreticians and advocacy groups. Governors are the ones whose feet are on the ground. We have a sense of what will work and what won’t work. Our perspective is not the only one. But we can bring some practicality to this discussion.”
In what is sure to be an exciting week for those interested in health care reform, the addition of federal price controls into the mix is will spark renewed disputes between liberals and conservatives over whether increased government power is the answer for the issues facing America’s health care system.
UPDATE: Hotair and others follow CentristNet’s lead regarding Obama’s proposed price controls.