Last Weeks Top-Ten Catholic Posts

Sunday, June 27, AD 2010

Here are this past weeks Top-10 most visited Catholic posts from The American Catholic for June 20-26:

1. Parish Shopping by Michael Denton

2. McChrystal Should Be Fired by Donald R. McClarey

3. Sharia in Dearborn? by Donald R. McClarey

4. G.K. Chesterton on Lincoln by Donald R. McClarey

5. Healthcare Reform & the Magisterium by Chris Burgwald

6. Real Sex vs. the Contraceptive Mentality (Part 2) by Darwin

7. Toy Story 3 by Michael Denton

8. Planned Parenthood, What Happened to the Money? by D.R.M.

9. Under the Roman Sky by Donald R. McClarey

10. I Am Shocked, Shocked! by D.R. McClarey

Honorable Mentioned

Top 25 Catholic Blogs by Technorati Authority by John Henry

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4 Responses to Last Weeks Top-Ten Catholic Posts

Healthcare Reform & the Magisterium

Saturday, June 19, AD 2010

In this spring’s debate over the healthcare bill, one of the disagreements that raised eyebrows most in Catholic circles was that between the US bishops conference and the Catholic Healthcare Association and other similar groups. The bishops claimed that the healthcare bill would lead to federal funding of abortions, while CHA et al. concluded that it would not.

In my opinion and that of numerous observers (including most of my fellow contributors here at TAC), the bishops were correct and CHA was horribly, terribly wrong.

There is another question, though… was CHA disobedient? That is, were they obliged as Catholics to accept the conclusions of the bishops conference? Was the activity of the bishops conference an act of their teaching charism which American Catholics were obliged to give their assent to?

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34 Responses to Healthcare Reform & the Magisterium

  • Thank you for raising this important question, Chris.

    I do not think the Catholic Health Association was “disobedient” for not taking the same position as the Bishops. I do think it was a bad political decision and I am not sure if the official stance reflected the views of every member of the CHA. The responses in the media and the internal “church war” did little to serve the visible unity of the Church. I think it could have been a more tactful disagreement — a suggestion, perhaps, that the Bishops’ reading of the legislation might need a second analysis. But it was a very pronounced disagreement that was unfortunately hijacked by the political operatives and partisan Catholics more than ready to paint the USCCB in bed with the Republicans — and we’ve surely gotten portraits of the opposite, that is, of the USCCB having succumbed to liberal politics. I’d like to think that both sides seriously needs to rethink their Catholicism before trying to translate their faith into contrived, acceptable political platforms rooted in secular schools of thought.

    I do thinks the Bishops were right in their basic analysis, but I do think some of the criticisms of their conclusions were actually very legitimate. I think there more at stake in the health care debate — something deeper than — than health care policy, or even the right-to-life issues.

    There was a lot of misinformation, single-word slogans, and rhetoric and willful partisan fighting to simply win. This was most unfortunate.

    I do not think the Senate compromise on the abortion language was necessarily immoral. Politically, it was not what we would desire first, but I don’t think it was a riot. It surely wasn’t the Capps’ language that required in explicit terms abortion funding. I thought that claims that the language was absolutely unacceptable were terribly exaggerated. I believe the scare over CHC’s were a bit naive.

    The serious overriding issue was that the legislation did not say explicitly, leaving room for no ambiguity that no provision in the Act would allow funds to be used to subsidize abortion. The Act did not say that abortion could be funded rather it remained silent. The problem is — to my understanding — is that abortion jurisprudence in the last few decades has a clear tradition of allowing abortion funding when Congress does not explicitly exclude it when it calls for, say, “comprehensive services.” The logic obviously being that abortion is a legal medical procedure and if it is not singled out, then it should be included amongst “comprehensive” and/or “preventative” services.

    There was a Colloquy (a pre-scripted dialogue that goes on the record to clarify and illuminate Congressional intent on certain provisions of a bill) before the House vote on the health care bill that clearly stated that the legislation would be subject to the spirit of Hyde as is all other federal programs.

    Such a colloquy could be cited in Court as evidence to clarify the intention of Congress (when debating whether Congress intended to allow abortion to be funded). An Executive Order obviously would be overturned if it contradicted an explicit statutory law. The problem is that President Obama’s EO does not contradict statutory law and therefore is not absolutely guaranteed to be overturned by a court. But that doesn’t mean that it would hold up in Court either. It could, but then again, it could not.

    Therefore the security of the pro-life provisions are undesirably weak. I think this would be reason enough — even though there were plenty of other reasons — to hold out for amendments to statutory law to ensure that there would no insecurity and no ambiguity over the fate of the pro-life provisions of the bill.

    This is obviously a prudential assessment of the situation and it is clear that I, with a few disagreements, came to agree with the Bishops.

    However, anyone who sincerely and honestly disagreed may not be “disobedient” or a dissident Catholic. Obviously they could be. But I’m not really talking about party operatives or Catholics who are pro-choice or for whom abortion was never really an issue.

    Someone may come to a different conclusion and I’m sure they would present the case for the EO and the final abortion language quite differently. I don’t think they would be correct but I’m not ready to claim that they are a “disobedient” Catholic.

    This brings us back to your fundamental question: was the Bishops’ position on health care an act of the Magisterium? No. I think the approach was very political and pragmatic. The Bishops mostly focused on abortion, conscience clauses for health care professionals, and access for legal immigrants. But there was so many other concerns — voluntary and involuntary euthanasia, government and private-sector rationing of medical care, abuses regarding organ donation (particularly those resulting in euthanasia) mostly because of the dubious concept of “brain death,” not to mention, financial sustainability and the overall structure of the health care system itself. The moral principles are all there but there be an array of policy perspectives from those who fundamentally agree. So I’m not sure sharing the conclusion of the Bishops (as long as one was agreeing morally) was necessary to remain a Catholic in good standing. I’d say it is probably wise not to tread too far from the Shepherds for they have a vast resource pool from which to draw to form very informed and moral conclusions.

    But if the Bishops’ analysis of legislation is an act of the Magisterium then their endorsement or opposition to any legislation whether it’s health care, immigration, or any such thing, no Catholic could disagree. And I’m pretty sure a number of Catholics, particularly in conservative circles, don’t share the USCCB’s position on immigration and therefore I’d suspect that wouldn’t go so far as to say we must always agree with the Bishops’ prudential policy judgments.

  • Can one be disobedient and not violate the Magisterium? If so, I think that happened here.

    I don’t think there was anything close to dogmatic in the bishops’ evaluation of the bill (other than abortion funding is wrong). That said, even in non-dogmatic matters deference is owed to the bishops. If one disagrees with them, one must do so after prudential consideration. Furthermore, I think one ought not to be actively campaigning against them.

    So while the CHA could disagree with the bishops, I don’t think they cared one hoot about what the bishops thought. Indeed, many of the liberal Catholics started painting this picture of the bishops as silly old buffoons easily misled by the NLRC and other Republican groups masquerading as pro-lifers. Worse, the CHA and others went out of their way to show their Catholicism in support of the bill, clearly frustrating the bishops message.

    Nothing the left did shows any support or obedience to the bishops, even if dogma did not require them to agree with them.

  • “So while the CHA could disagree with the bishops, I don’t think they cared one hoot about what the bishops thought. Indeed, many of the liberal Catholics started painting this picture of the bishops as silly old buffoons easily misled by the NLRC and other Republican groups masquerading as pro-lifers. Worse, the CHA and others went out of their way to show their Catholicism in support of the bill, clearly frustrating the bishops message.”

    Bingo! The magisterium that they are loyal to has little to do with the magisterium of the Catholic Church.

  • The misnamed Catholic Health Association was in bed with the Obama administration from the beginning on ObamaCare:

    Abortion simply was not a priority for them in comparison to passing ObamaCare.

  • It seems to me that Sr. Keehan, the CHA et al. went out of their way to snub the Bishops, ignored the Bishops prudential judgment, and were indebted to helping the liberal establishment in passing any type of socialist or national health care regardless of what the consequences are going to be for unborn babies, elderly, and the rest of the most vulnerable human beings. They did not feel any obligation to follow the Magisterium and avoid scandal or a scandalous perception.

  • Obviously the bishop’s position on the health care bill was not a magisterial teaching. Lay Catholics take no vow of obedience to their bishops.

    I am one who thought Capps-Stupak would’ve been great but not absolutely necessary for me to support the bill. I ultimately opposed the bill on the grounds that the bishops told me to and, considering the politics, there was more to be lost in opposing the voice of the Church in America than opposing the bill.

  • Every time I see “the bishops” presented as some kind of Magisterial body I nearly want to go postal. The USCCB and “the bishops” in NO WAY have any teaching authority.

    Cardinal Ratzinger addressed this in “The Ratzinger Report” where on page 60 it says;

    “No episcopal conference, as such, has a teaching mission; its documents have no weight of their own save that of the consent given to them by the individual bishops.”

    In other words the USCCB is not an “American Magesterium” – despite the efforts of the bureaucrats who manipulate “the bishops” efforts to pose as such.

    There is an old saying that there are two things you never want to see being made – sausage and the law. I would add a third, a document from the USCCB.

    Their watered down “documents” more often than not muddy crystal clear church teaching after laborious twisting and contorting aimed at preventing anyone form being “offended”. If you don’t believe me – watch the TV coverage of the next USCCB Conference where endless debates over every punctuation mark will bring you to tears. Our “Shepherds” have become congressmen.

    Call the USCCB what it is – an administrative body stuffed with career bureaucrats that speaks out on politics – mostly with liberal positions. The entire mess should be shut down.

  • It could be their hospitals’ solvency was the main motive. Yet that is not supportable, unless . . .

    Else, the “nuns-in-pants-suits'” prudential judgement is that “free lunch/something for nothing” always overshadows liberalisms’ insidious aspects – exterminating 47,000,000 more unborn persons, class envy/hatred, ESCR, gay privileges, immoral public school brainwashing of youth, etc.

    Their priorities seem to lie with secular, humanist progressives. For the secularist, man is the end all and be all and the greatest good is not saving souls but making life better for the convict, drug addict, drunk, felon, fornicator, illegal invader, murderer, rapist, thief, et al: all at the expense of the evil, racist, rich unjust American taxpayer.

    The COMMON GOOD???? Likely (my opinion), every (except the rulers in DC) American will be reduced to an equal level of health care misery and desperation.

  • It is a moral teaching and directive – not to support a law that promotes or supports abortion.

    It has Magisterial binding power coming from each individual bishop who concurred with that. And the pols under the bishop’s authority is obliged to obey as the Lord is to be obeyed. “He who listens to you, listens to me.”

  • I don’t think it’s a matter of being obedient or disobedient to the Bishops per se…it is a matter of being obedient or disobedient to the teachings of the Roman Catholic Church. Lawyers studied the bill and I have read part of it where the bill gives Kathleen Sebelius major authority down the line to distribute federal funds as she sees fit and we know that ‘Catholic’ Kathleen Sebelius is rabidly proabortion, was a friend and colleague of George Tiller who terminated viable babies in the womb…abortion is a grave evil and anyone participating in any way is cooperating with this evil…Sr. Keehan and her group can disagree or not with the Bishops but – they have defied the teachings of the Church which teaches that abortion is the killing of a human in the womb…Canon Law states clearly that anyone publicly promoting such evil cannot receive the Eucharist…our Bishops do not enforce this which is, I believe, why these ‘Catholics’ are becoming more and more defiant and arrogant in their advocacy for abortion. I was told that Joe Biden went to Africa to convince them to legalize abortion in order to receive aid…the Africans don’t want to kill their babies!!! Pelosi preaches about how ‘the Word’ is so important to her…the word was made flesh…where does she think the word became flesh???? In the womb of Mary the mother…would Pelosi have fought so ferociously to exterminate the baby in the womb of Mary? I don’t think we are obliged to follow the advice of Bishops but we surely are not meant to publicly defy them…I think it’s time for the Vatican, for Pope Benedict,to speak into this issue just as he did in his letter to the Irish Bishops – he spoke strongly and forcefully against the abuse of children in Ireland…well, we are talking here about the extermination of human babies in the wombs of their mothers…millions and millions of them!!!!! It must be stopped…please God the Bishops will have the courage to tell Pelosi and Biden and others who advocate for abortion that they are not Catholics in good standing and that until and unless the publicly reject their pro abortion stand they cannot receive the Eucharist…until they do, the slaughter will go on…and on and on…

  • Samwise,

    I completely agree!

    But, I would like to point out that the Pope just recently talked to the priests about using the “rod” against heresy.

    “The Church too must use the shepherd’s rod,” he said, “the rod with which he protects the faith against those who falsify it, against currents which lead the flock astray.”

    “Today we can see that it has nothing to do with love when conduct unworthy of the priestly life is tolerated. Nor does it have to do with love if heresy is allowed to spread and the faith twisted and chipped away, as if it were something that we ourselves had invented.”

    This is a step in the right direction.

  • The Health Care Bill put together with the USCCB and CHA equals a headache. But I’m glad that you’ve narrowed down the discussion with your last paragraph: “Does the authority of the Magisterium extend to this sort of legislative analysis? If it does not, then how ought faithful Catholics respond to this sort of activity on the part of bishops?

    As previous commentators have said already very thoroughly, the USCCB has no teaching authority. They do serve as a guide for how to apply real Church teachings to real life for Catholics but this does not mean everything they say or suggest is infallible and in fact is sometimes quite the contrary.
    Faithful Catholics ought to listen respectfully and try and understand what the USCCB stands for and may be trying to teach us. I think though, that if one does disagree with some or all of a statement or a posistion of the USSCB they do have a duty to disagree tastefully and respectfully. If love is not part of the motivator behind the disagreement then there’s a problem.

  • Does the authority of the Magisterium extend to this sort of legislative analysis? If it does not, then how ought faithful Catholics respond to this sort of activity on the part of bishops?

    It does not. The bishops do not, as bishops, have the authority to interpret the meaning and consequences of civil legislation. If the bishops had this authority and competency, they would be able to provide an official Catholic interpretation of other documents, such as the U.S. Constitution. But, of course, we don’t look to the bishops for whether we ought to interpret the Constitution as a “living document” or as its writers intended. Such questions reside outside their domain.

    On the other hand, I understand the frustration the bishops feel at the very public disagreement with them made by the CHA and others. They have sought to understand the legislation as best they can, have judged it to be morally problematic, and have, because of their concerns about the potential immoral consequences of the legislation, spoken out against it. Then they see other public Catholics disagree with their conclusions about it. A messy situation, to say the least, but then, the moral life is messy.

    In the case of “Obamacare,” at least, we will soon know who was right. Either it will fund abortions or it won’t.

  • Kyle,
    I agree that the Bishops don’t have the authority to make it obligatory for Catholics to either support or oppose specific pieces of legislation when it comes to the Bishops’ prudential judgments. But, if after researching a particular piece of legslation the Bishops oppose that piece of legislation because of coming to a conclusion that that particular piece of legislation will indeed cover abortions or fund abortions, wouldn’t that fall under the Magisterium’s authority since abortion is an intrinsic evil?

    I would rather be safe than sorry, and be absolutely sure that this piece of legislation does not have federal funding for abortions on demand or taxpayer funded abortions then find out later that Obamacare does fund abortions.

  • But, if after researching a particular piece of legslation the Bishops oppose that piece of legislation because of coming to a conclusion that that particular piece of legislation will indeed cover abortions or fund abortions, wouldn’t that fall under the Magisterium’s authority since abortion is an intrinsic evil?

    Nope. The question here isn’t whether or not abortion is evil or whether or not funding abortion is evil – questions Catholics believe the bishops have authority to speak on. The question here is whether or not this legislation will fund abortion, which isn’t a question of faith and morals, but of legal meaning and consequence.

  • Kyle,
    Then one could draw a similar consclusion when referring to legislation related to border security or immigration, and matters of national security.

  • If the question is “Will immigration legislation do X?” or “Will national security legislation do Y?”, then sure.

  • “…we will know soon know who was right. Either it will fund abortions or it won’t.”

    Though on the question of conscience I think it may take longer.

    Are there any protections for health care workers or hospitals that are Hyde Ammendment-like. That is, will Catholic health care workers and hospitals be able to refuse medical treatments that violate medical ethics? Can the state say to them that if contraception or abortion, etc. is not provided, then they can be denied health care dollars?

  • I would also say that Bishop conferences can teach with magisterial authority but that this is limited to a doctrinal matter and seems to require a unanimous vote (see Apostolos Suos). When it comes to prudential application of doctrinal principles, a Catholic may licitly disagree.

    Thus the arguments that some (not all) in CHA and others offer are licit though I think wrong especially beyond questions regarding abortion. When others disagree with immigration policies or even the general thrust of a document such as Faithful Citizenship, they are also free to do so.

  • Here is an example of why we need to heed our Bishops words, and why our perceptions as to what constitutes “prudential” judgement may not merely fall under the umbrella of prudential judgment in the case of health care reform.

    “Federal funds in the Act can be used for elective abortions. For example, the Act authorizes and appropriates $7 billion over five years (increased to $9.5 billion by the Health Care and Education Reconciliation Act of 2010) for services at Community Health Centers. These funds are not covered by the Hyde amendment (as they are not appropriated through the Labor/HHS appropriations bill governed by that amendment), or by the Act’s own abortion limitation in Sec. 1303 (as that provision relates only to tax credits or cost-sharing reductions for qualified health plans, and does not govern all funds in the bill). So the funds can be used directly for elective abortions.
    The Act uses federal funds to subsidize health plans that cover abortions. Sec. 1303 limits only the direct use of a
    federal tax credit specifically to fund abortion coverage; it tries to segregate funds within health plans, to keep federal funds distinct from funds directly used for abortions. But the credits are still used to pay overall premiums for health plans covering elective abortions. This violates the policy of current federal laws on abortion funding, including the Hyde amendment, which forbid use of federal funds for any part of a health benefits package that covers elective abortions. By
    subsidizing plans that cover abortion, the federal government will expand abortion coverage and make abortions more accessible.
    The Act uses federal power to force Americans to pay for other people’s abortions even if they are morally opposed.
    The Act mandates that insurance companies deciding to cover elective abortions in a health plan “shall… collect from each enrollee in the plan (without regard to the enrollee’s age, sex, or family status) a separate payment” for such abortions. While the Act says that one plan in each exchange will not cover elective abortions, every other plan may cover them — and everyone purchasing those plans, because they best meet his or her family’s needs, will be required by federal law to fund abortions. No accommodation is permitted for people morally opposed to abortion. This creates a more overt threat to
    conscience than insurers engage in now, because in many plans receiving federal subsidies everyone will have to make separate payments solely and specifically for other people’s abortions. Saying that this payment is not a “tax dollar” is no help if it is required by government.”

    I found this here:

  • Teresa,
    First, I agree that disagreement with the USCCB is not in and of itself disobedience in any proper sense. So I have no quarrel with the CHS if its interpretation of the law differs.
    That said, the explanation you quote is pretty compelling. Has the CHA ever responded with similar clarity? As an attorney, I am well aware that reasonable people can in good faith interpret a law differently. I am prepared to believe that is what is happening here, but given the USCCB’s general affection for liberal causes its opposition to the health care legislation does seem credible.

  • For example, the Act authorizes and appropriates $7 billion over five years (increased to $9.5 billion by the Health Care and Education Reconciliation Act of 2010) for services at Community Health Centers.

    CHAs haven’t performed abortions. Many if not all of them would have to change charters in order to do so.

    These funds are not covered by the Hyde amendment
    This is a point of dispute.

    The Act uses federal funds to subsidize health plans that cover abortions.
    It is presently legal for health plans to offer an abortion benefit. Federal highway dollars cover roads driven on by drunk drivers too. More anon.

    Sec. 1303 limits only the direct use of a
    federal tax credit specifically to fund abortion coverage; it tries to segregate funds within health plans, to keep federal funds distinct from funds directly used for abortions. But the credits are still used to pay overall premiums for health plans covering elective abortions.

    There is no moral requirement to limit indirect funding. Federal housing dollars do not discriminate between women that have and have not had abortions. The tax code does not distinguish deductibility of premiums between plans that offer abortion and those that don’t. Further, there is no substantive difference between this and the USCCB’s endorsed Stupak compromise of requiring a rider be offered to the policies. With an executed abortion rider, a subsidy would still be offered to plans that “cover abortion.”

    everyone purchasing those plans, because they best meet his or her family’s needs, will be required by federal law to fund abortions.

    And this is really no different than today. As a consequence of where one works, one may be forced to subscribe to a plan that covers abortion. However, the idea that the plan that will “best meet his of her family’s needs” will be the one that covers abortion is malarkey and product of closing one’s ears to what insurance company’s have been saying. Insurance professionals have been claiming that they hard pressed to offer a plan with abortion due to the additional costs involved. Due to the additional costs, insurers believe they will have difficulty capturing subscribers on plans that offer abortion benefits.

  • Any thoughts on conscience protections?

  • I’m not sure Phillip. Do you (or anyone) happen to know what is current law regarding conscience protections?

    What are the laws on the books and are they being properly enforced? I think this question is getting regularly overlooked and new laws are being crafted unnecessarily when we could simply enforce or clarify existing law.

    But that is all contingent on whether existing law is sufficiently pro-life.

  • A primer:

    Don’t know what it will all mean with the new Health Care legislation.

  • Finally, how something like this might play in to the discussion:

  • Thank you Phillip for doing a bit of research.

    The next time there is a Republican Congress, the Hyde amendment needs to cease being an budgetary amendment attached to appropriation bills and voted on year-after-year and rather introduced as federal-wide legislation governing any and all monies. This could in effect end domestic subsidizing abortion and act as a permanent “Mexico City Policy” that prohibits funding of abortion on the international stage.

    The other thing is with such widespread abuse on conscience rights as the Bishops note (which I’m assuming didn’t just start happening post-November 2008), current conscience laws should be updated and clarified.

    I’m not sure how this has just now become an issue. We most certainly have dropped the ball on the first item.

    I think the latter story involving the Catholic college could be solved with contracts and this is a solution from a perspective of subsidiarity. But all employers of Catholic institutions should sign a contract stating in clear terms that all medical care and benefits offered to employers, spouses, children, etc will be in line with the clear and consistent teachings of the Catholic Church and no comprehensive plans or benefits will include abortion or birth control.

    The obvious point is that such things if people were to choose those things — unfortunate as it is — they would have to use their own funds.

    There really shouldn’t have to be a need to resort to such protective measures, but it has become increasingly necessary.

  • I think the conscience clause became an issue in Jan/Feb 2009 when the Obama administration stated it was rescinding Bush era protections. Before this it was undoubtedly a problem at local levels which prompted Bush era efforts. Prior to Bush I think most organizations/states accepted that health care professionals could refuse certain procedures that violated their conscience. I know as a medical student and resident I refused to take part in abortions, sterilizations and prescribing birth control. No one gave me grief over this (this was in the 80’s after all.)

    In the new millenium this started to change when organizations such as the American College of OB/GYN insisted that residents be trained in abortion procedures and some states supported this. See here:

    This may have been further made urgent by the Benitez case:

    Thus the prompting of the Bush efforts. It seems to have taken on import with the USCCB with the Obama administration efforts noted above.

    A brief history that may require more unearthing and likely has more parts.

  • The position from the USCCB that points out the need to conscience protections. The threats seem to originate as I noted in the new millenium. Thus the Bush protections and the threat to such protections from Obama administration efforts:

  • “…because the issue here is the competence of the Magisterium to determine the consequences of a particular legislative bill.”

    I suspect that the National Bishop’s council is a different entity than the “magesterium” and as such has “no hierarchal authority.”

    I still await their justification of failing to engage the Catholic issue of solidarity and their earlier approval of “the Welfare state”(Obamacare without abortion) so excoriated by JPII – not to mention their silence on the “death panels” government intrusion into end of life moral decisions by free citizens.

    I wonder why the eccleasial construction of the three bishops who wrote the final turnaround letter after the Stupak fiasco blew up in their faces was labeled the “migrant” bishop? Could that be that socialized Obamacare was really about immigration which the Catechism says is the business of the laity?

    Do they yet have any outside objective investigation ongoing or in the pipeline to find out how they jeopardized charity for the poor itself, by funneling all those millions to ACORN (long known to be of questionable character) to help elect the most pro- abortion pro-infanticide president in history. (thy still haven’t written a pastoral letter of protested about Obama”s installation of the principle of intent allowing the slaughter of a baby outside the womb because the mother intend to abort or simply asked -how long Obama, does such intent last?

    There are far too many unanswered questions about the national bishop’s council to blindly follow what appears to be their politics, as opposed to their obligation to lead souls to salvation.

    I also think the question of the “smoke of Satan in the tabernacle” finally raised by the late Pope Paul continues to require some housecleaning and serious redirection of the American Chiurch at its highest levels. Notre Dame honoring Obama (the first openly infanticide president in history)and the public silence of more than two thirds of our shepherds in the face of that scandal ought to have been the clue that more than healthcare needs to be reformed.

  • These nuns think they can speak for the Church. So, they offer an alternate teaching. And the media whores quickly pick up on the scandal that they’re causing. They’re applying American principles of independence and feminism in places where those do not apply. The community of faith is not a democracy even if they want to make it such and have themselves voted into power. The community of believers are not independent from their traditional and historical origins and an American revolution will not change that nature. But deluded with their degrees and having too much time in their hands plus the limelight of a secular press, these women forge on and wound the very people that they pretend to serve.

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U.S. Catholic Bishops' statement on the Health Care Bill: "Profoundly flawed"

Tuesday, March 23, AD 2010

USCCB Statement on the recently-passed health care legislation (March 23, 2010):

For nearly a century, the Catholic bishops of the United States have called for reform of our health care system so that all may have access to the care that recognizes and affirms their human dignity. Christian discipleship means, “working to ensure that all people have access to what makes them fully human and fosters their human dignity” (United States Catechism for Adults, page 454). Included among those elements is the provision of necessary and appropriate health care.

For too long, this question has gone unaddressed in our country. Often, while many had access to excellent medical treatment, millions of others including expectant mothers, struggling families or those with serious medical or physical problems were left unable to afford the care they needed. As Catholic bishops, we have expressed our support for efforts to address this national and societal shortcoming. We have spoken for the poorest and most defenseless among us. Many elements of the health care reform measure signed into law by the President address these concerns and so help to fulfill the duty that we have to each other for the common good. We are bishops, and therefore pastors and teachers. In that role, we applaud the effort to expand health care to all.

Nevertheless, for whatever good this law achieves or intends, we as Catholic bishops have opposed its passage because there is compelling evidence that it would expand the role of the federal government in funding and facilitating abortion and plans that cover abortion. The statute appropriates billions of dollars in new funding without explicitly prohibiting the use of these funds for abortion, and it provides federal subsidies for health plans covering elective abortions. Its failure to preserve the legal status quo that has regulated the government’s relation to abortion, as did the original bill adopted by the House of Representatives last November, could undermine what has been the law of our land for decades and threatens the consensus of the majority of Americans: that federal funds not be used for abortions or plans that cover abortions. Stranger still, the statute forces all those who choose federally subsidized plans that cover abortion to pay for other peoples’ abortions with their own funds. If this new law is intended to prevent people from being complicit in the abortions of others, it is at war with itself.

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7 Responses to U.S. Catholic Bishops' statement on the Health Care Bill: "Profoundly flawed"

  • “By intervening directly and depriving society of its responsibility, the Social Assistance State leads to a loss of human energies and an inordinate increase of public agencies, which are dominated more by bureaucratic ways of thinking than by concern for serving their clients, and which are accompanied by an enormous increase in spending.” — John Paul II, Centesimus Annus, 48

  • “. Subsidiarity is first and foremost a form of assistance to the human person via the autonomy of intermediate bodies. Such assistance is offered when individuals or groups are unable to accomplish something on their own, and it is always designed to achieve their emancipation, because it fosters freedom and participation through assumption of responsibility. Subsidiarity respects personal dignity by recognizing in the person a subject who is always capable of giving something to others. By considering reciprocity as the heart of what it is to be a human being, subsidiarity is the most effective antidote against any form of all-encompassing welfare state.” — Benedict XVI, Caritas in Veritate

  • “In order for the principle of subsidiarity to be put into practice there is a corresponding need for: respect and effective promotion of the human person and the family; ever greater appreciation of associations and intermediate organizations in their fundamental choices and in those that cannot be delegated to or exercised by others; the encouragement of private initiative so that every social entity remains at the service of the common good, each with its own distinctive characteristics; the presence of pluralism in society and due representation of its vital components; safeguarding human rights and the rights of minorities; bringing about bureaucratic and administrative decentralization” – CSDC, 187

    “As an instrument of the State, public administration at any level — national, regional, community — is oriented towards the service of citizens: “Being at the service of its citizens, the State is the steward of the people’s resources, which it must administer with a view to the common good”.[844] Excessive bureaucratization is contrary to this vision and arises when “institutions become complex in their organization and pretend to manage every area at hand. In the end they lose their effectiveness as a result of an impersonal functionalism, an overgrown bureaucracy, unjust private interests and an all-too-easy and generalized disengagement from a sense of duty” CDSC 412

    Where we ought to be looking, as opposed to the federal government and its bureaucracy:

    ” Meaningful testimonies and examples of self-organization can be found in the numerous initiatives, business and social, characterized by forms of participation, cooperation and self-management that manifest the joining of energies in solidarity. These are offered to the market as a multifaceted sector of work activity whose mark of distinction is the special attention given to the relational components of the goods produced and of the services rendered in many areas: instruction, health care, basic social services and culture. The initiatives of this so-called “third sector” represent an ever more important opportunity for the development of labour and the economy.” CSDC 293

  • In other words, I profoundly disagree with the idea that abortion is the only problem with this otherwise supposedly fine and upstanding bill.

  • For the record, I’m right there with you Joe. Funding for abortion is a crucial issue but not the sole evil in this bill.

  • Looks like Mr. Stupak’s defense may be to go on the offense against the Bishops. I’m not familiar with the source, but it appears he is charging the Bishops with hypocrisy and trying to use the abortion issue as a ploy to bring down health care reform. What alternate universe is this guy from?

  • He is either delusional or a liar. I suspect the latter.

Far Better Than Nothing

Tuesday, March 23, AD 2010

While pro-lifers, conservatives, and conservative pro-lifers all have different reasons for not being very pleased with Stupak and his fellow pro-life Democrats at the moment, because of their caving in to the Senate Bill abortion language and Obama’s vaporware executive order, I think it’s worth keeping in mind that if all Democrats were of the Obama/Pelosi persuasion in regards to abortion, we would undoubtedly have a “health care reform” bill which provided complete subsidies for abortion on demand for poor women, if not all women. The Senate language is not nearly as good as Stupak’s, and even with Stupak’s language included I think that the bill would have been deeply irresponsible for financial reasons. But let’s face it, the Democrats have a solid majority in the House and had until Brown’s election a filibuster-proof majority in the Senate. Without some Democrats breaking ranks with their party’s hard core pro-abortion platform, there would have been no way for the pro-life movement to keep the most extreme support for abortion possible out of the bill.

And while Stupak’s last minute flake-out is disappointing from a pro-life perspective (if he’d stuck to his guns, I would have happily donated to his re-election fund, simple because I admire steadfastness to pro-life principle, even in someone I disagree with on other issues) let’s also be honest about this: Those of us who retain a belief in fiscal responsibility and oppose statism would have been disappointed in the health care bill passing even with Stupak’s language. So while I admired his apparent steadfastness to pro-life principle, I like many other conservatives also appreciated that fact that his principle (had he stuck to it) would have resulted in the bill not passing. We can hardly be surprised that he didn’t share such a hope.

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24 Responses to Far Better Than Nothing

  • I never confused Stupak with a conservative. I did confuse Stupak with a pro-lifer. My mistake. I also confused him with a truthful man. Once again my mistake. The fact that his cave in led to ObamaCare becoming a law I regard as a national disaster. That Stupak revealed himself as a man of no principle I regard as a tragedy. He was a hero to pro-lifers everywhere and he revealed himself at the end to be anything but.

  • Darwin, I applaud your charitable attitude and posting, and I agree with it, for the most part, even from the depths of my disappointment. What really makes it unpalatable for me to be charitable to Stupak was the disgusting slap in the face that was his House floor speech during the motion to recommit on Sunday evening. I genuinely believe that he lost it temporarily, on an emotional and psychological level, when he declared that the Democrats were the pro-life party protecting life from unborn till death. That speech was so contrary to reality in its claims that I can’t imagine he’ll look on that speech in the future with anything but deep shame and guilt.

  • “What really makes it unpalatable for me to be charitable to Stupak was the disgusting slap in the face that was his House floor speech during the motion to recommit on Sunday evening.”

    Ditto, Kevin. What a disgraceful display that was. He was doing a victory dance with salt-coated shoes over freshly-opened wounds. It was despicable.

  • I wrote a (small) check to Stupak’s Republican challenger, Dan Benishek, on Sunday night. Benishek is a UP surgeon who seems a decent man – a pro-life conservative, the son of a miner. But I confess, on Sunday night I would have mailed a check to Mr. Ed if he was running against Stupak. Better a talking horse than the horse’s patoots that populate Congress now.

    Speaking of horse’s patoots, our elected reps are now debating this:

    Shouldn’t Obamacare provide Viagra for sex offenders. After all people who’ve “paid their debt to society” shouldn’t continue to be punished by using health care as a weapon. Believe it or not the issue is being debated in the Senate, because unless sex offenders are specifically excluded, they’ll get Viagra too.

  • I wish the other side in this debate could come up with statements as thoughtful and charitable as this one. The honest truth is that most people who supported the Stupak language really did not want to see this bill passed–for many reasons, some better than others. Stupak always made it clear that he did want it to pass because he sees universal government-controlled health care as an example of what government should be doing. It’s interesting too to see what he thinks government should NOT be doing: in that under-the-radar vote on the war in Afghanistan a few days ago, Stupak voted against the war.

  • “But I confess, on Sunday night I would have mailed a check to Mr. Ed if he was running against Stupak. Better a talking horse than the horse’s patoots that populate Congress now.”

    Brilliant Donna!

  • How badly were we gamed by this man? (And I say “we” because I too was under the impression that Stupak was a man of integrity, although I was against the healthcare bill for other reasons besides abortion.)

    “Stupak Defends District’s Planned Parenthood Clinics”

    PICKET: Then how come you didn’t vote for Pence’s amendment to de-fund Planned Parenthood back in 2009?

    STUPAK: I don’t think I ever voted to de-fund Planned Parenthood. Planned Parenthood does not do abortions…in my district. Planned Parenthood has a number of clinics in my district that provide health care for my people. Therefore, these clinics do quite well in my district, and I’m all for health care and extending it to everybody–access to health care, so that’s just another way. Also on Planned Parenthood , when they do it, there is a segregation of funds that go with it. It’s usually about four hundred million they tried to de-fund on Planned Parenthood. Maybe this time, I’ll look at it again if Pence brings it up. Maybe I’ll vote differently this time, but you’re right I did vote against it.

    Stupak also says, in practically the same breath:

    I’ve done all I could as one member to protect the sanctity of life

  • You know what, I’m sick of these defenses of Backstabbing Bart.

    Ron, I’m not going off on you personally – I like a lot of your comments on issues – but you’ve raised a couple of points here that I’ve seen OTHER people I typically like and respect bring up in Stupid’s defense as well.

    “The honest truth is that most people who supported the Stupak language really did not want to see this bill passed”

    I suppose it could be the case that there are people who were in denial about the whole thing. But most people I know who supported the Stupak language did so for one or both of these reasons:

    1) If Obamacare was determined to become law, AT LEAST the restrictions of the Hyde Amendment would stay in place. Stupak’s precious EO offers no such guarantees, and his speech during the debate following the vote was delusional.

    2) If the Stupak language was a part of the bill this time around, at least 40 rabidly pro-abortion Democrats in the House would have voted no, killing the bill. That’s why I supported it. And I see no reason to be ashamed of it. There’s nothing wrong with that motive.

    “Stupak always made it clear that he did want it to pass because he sees universal government-controlled health care as an example of what government should be doing.”

    But he also told us all that he wouldn’t vote for a bill that allowed public funding of abortion. And yet he did. So either he’s monumentally stupid for putting enough faith in this EO nonsense to change his vote – and we have a right to be angry with him for that alone – or he knew full well that this EO promise was weak, but it gave him just enough so that he could vote yes, to take the pressure off, to not be hated by everyone in his own party, or whatever.

    Stupak portrayed himself as a leader, as a fighter, as a man of principle. At the last hour he caved for a handful of magic beans that offers no guarantee of the things that he was so intransigent about for all these months.

    Stupidity or weakness, take your pick, either way, he deserves our contempt.

  • “Shouldn’t Obamacare provide Viagra for sex offenders. After all people who’ve “paid their debt to society” shouldn’t continue to be punished by using health care as a weapon. Believe it or not the issue is being debated in the Senate, because unless sex offenders are specifically excluded, they’ll get Viagra too.”


    I understand the Parliamentary tactic they are playing, but I have to wonder why Viagra or any similar prescription drug is covered by a health plan. Why would the cost of a recreational drug be paid by a health care plan. If Viagra isn’t a recreational drug nothing is. This thought struck me as odd a few years ago when I heard on CNBC (IIRC) that GM was the single largest purchaser of Viagra because of their retiree health care plan. What??? Up until that moment I naively believed people spent their own money on crap like that.

    That is the sad punch line to this horrendous health care “reform” bill. Some people actually believe it will not exceed the cost estimates without considering how much health care can be consumed once it is “free.” How many people will sign up for Viagra or a hundred other medical treatments that they would not if personally paying for it themselves.

  • Largebill: exactly. But that’s government and the entitlement mentality for you. Contrary to leftist belief, no conservative I know argues that the present system needs no reforming or that uninsured people should be left to die in the street.

    But this changes everything and drags the government into everything touching on healthcare issues. It’s one thing to help pay for people who, say, have lost coverage because they were laid off and have serious health conditions. But paying for somebody’s Viagra? Someone who sees Viagra as an entitlement? They’ve got to be joking – except they’re not.

    (Not to mention the disgust I feel at having to foot the bill for somebody’s abortion…)

  • I think you guys are getting a little off track here. I’m no fan of this bill, and I get the idea that’s setting you off about the Viagra, but I think it’s wrong headed. I’m sure some people use Viagra to enable themselves to do things they shouldn’t be doing, but that doesn’t mean that it’s not a drug that should be covered by insurance. We’re Catholics, not Puritans or Stoics. As Catholics we view intimacy between spouses as a great good, even a necessary condition for their marriage and their souls. If someone’s plumbing stops working, that is a medical issue, and thankfully something has been developed that can help people get around the condition. There’s absolutely no reason to object to the use of such medicine or that it would be covered by medical insurance.

    Oh, and lest you think this says something about my condition – my plumbing still works fine, thank you. 😉 Still, nobody knows what’s going to happen in the future to any of us, and a drug like can help marriages stay strong and that keeps families together, and even saves souls.

  • If the Stupak language was a part of the bill this time around, at least 40 rabidly pro-abortion Democrats in the House would have voted no, killing the bill.

    I’m not sure this is plausible. After all, the original House bill passed despite having the Stupak language in it.

  • “[L]et’s also be honest about this: Those of us who retain a belief in fiscal responsibility and oppose statism would have been disappointed in the health care bill passing even with Stupak’s language.”

    Huh? I’m shocked.

    So what does it matter if we’d all be disappointed anyway? Is that the sum of it?

    Evidently the intrinsically evil nature of abortion escapes you. Please let me clarify. Children born into a bankrupt dictatorship (worst case scenarios, both, for fiscal responsibility and statism) are still born. They have the chance to live and breathe and giggle and laugh and clap their hands.

    Children killed by an state funded abortion don’t enjoy any of that. They’re dead before they could draw their first breath of air, before they could look upon their mother and father, before they could so much as eat and sigh and sleep.

    I would much, much, much rather I lived in a country that financially impoverished itself with a crazy healthcare bill (i.e. giving viagra to criminals) than one that morally bankrupted itself by using my taxes to kill babies.

    Further — you write ‘So while I admired his apparent steadfastness to pro-life principle, I like many other conservatives also appreciated that fact that his principle (had he stuck to it) would have resulted in the bill not passing. We can hardly be surprised that he didn’t share such a hope.’

    ‘[H]ope?’ Yeah, right. Sorry, but you have to swallow a whole lot to not recognize that he held out so as to sell his vote more dearly. That or he just doesn’t comprehend the nature of abortion, the nature of evil.

    Please let me translate your equivalence into practical terms — well, the bill is just going to pass anyway (i.e. they’ll kill the babies anyway), so I might as well vote for it (participate in an intrinsically evil act) (and condemn my soul to hell for all of eternity).

    Do you see what you’ve written? Do you understand my perspective?

  • BA,

    It is what they pledged to do after the first time it passed.

    And they were threatening to do it all the way up until the day of the vote.

    I don’t know why they settled for it the first time around, but evidently they changed their minds.

    I read reports of some pro-abort female House Dems breaking down into tears after the first vote because of Stupak.

  • Joe,

    They settled for it the first time around because they very openly expected that after the Senate passed its version, that provision would be stripped out of the final bill in conference.

    Brown taking Kennedy’s Senate seat derailed those plans.

  • Joe,

    Talk is cheap. Stupak was also pledging to vote against the bill if he didn’t get his way until the day before the vote.

  • Joe,

    But here’s the thing, while many of us who opposed the bill in its entirity (while also wanting to have it be as anti-abortion as possible if we had to swallow the bitter bill at all) Stupak clearly thought the bill itself was a good thing so long as it didn’t fund abortion.

    I’m guessing that this massively pissed Stupak off, and was one of his prime motivating factors in that bitter floor speech.

    I disagree with him and think he’s wrong in seeing those of us on the conservative side of the pro-life movement as the bad guys in this. But I can see why he was becoming increasingly angry with his position — feeling like he was being used by people who opposed the bill regardless.

  • I think you’re right Darwin. I also think part of the problem is that we thought Stupak was standing for something more than what he was standing for. We thought he was for this bill other than the abortion issue – and not without reason – by his own words we had it that as much as he wanted HCR passed, abortion was a non-starter and the Senate bill didn’t pass the test, plus the Senate bill was bad legislation and the means by which it came was unacceptible.

    He generated a lot of goodwill from pro-lifers from most political persuasions and they admired his principled stand. In hindsight, we discovered he was indeed fighting to get abortion provisions out of the legislation, but it wasn’t that important to him where he wouldn’t still vote for it. Many of his supporters feel betrayed by him and he feels betrayed by his supporters. It’s actually quite understandable. I think he’s wrong to have done a 180 the Senate bill, or to think the EO satisfies any concerns, or to think that abortion shouldn’t be a deal breaker for Obamacare, but his equation is different. Aside from those understandable differences, his speech at the time of the vote and subsequent comments take it to a different level. A level where it’s difficult to respect him in spite of those differences and reveal a rather bitter partisan bordering on the delusional.

  • Stupak led the most successful pro-life insurgency within the Democratic Party in recent memory. Nobody expected his amendment to pass with the support it did, and pro-choice organizations reacted with horror that a new front was opening within their stronghold.

    His amendment was dead in the Senate though. His insurgency failed.

    A man in Stupak’s position can’t afford to appear totally uncompromising all of the time.

    But he extracted a concession from the President, which can help hold Obamacare accountable. He also helped his party by allowing Pelosi to give vulnerable Democrats the chance to vote “no.” (She likely had enough votes in reserve, but because of the pro-life Dems she didn’t have to use them.)

    Here’s some comments from the end of Stupak’s Sunday press conference that have been under-reported:

    “…the statutory language, we’d love to have it. But we can’t get it through the Senate. And we’re not giving up. If there was something we missed, we’re coming back with legislative fixes. These right-to-life Democrats, who really carried the right-to-life ball throughout this whole debate, we will continue to do that. We will work with our colleagues to get the job done.”

    In my view, Stupak cut his losses while raising the profile of pro-life Democrats and getting Obama to commit to something. He can be held accountable too.

    The speed with which many pro-lifers turned on him is disturbing to me. If there were more Democrats like him, he would have won. But he lost, and so he tried to lose in a manner most advantageous to his cause and to his career. I think he deserves gratitude for that failed attempt, and criticism of him has gone overboard. The Senate and those who excluded the Stupak Amendment from the Senate bill bear far more blame, as do the Catholic groups whose misinformation sapped his coalition’s strength at a critical time.

    If the GOP’s incompetence and the Hispanicization of America have barred Republicans from Congressional majorities for the foreseeable future, Stupak & co. are the best hope for the pro-life cause in Congress. Don’t punish a man who stood up for months against his party leadership and activists. Punish the leadership and the activists, so that that man won’t have to surrender again in the future.

  • BA,

    Evidently the House leadership and the White House assigned a higher value to that cheap talk than you do – it’s the main reason why they cooked up this EO nonsense to begin with. They had to please their own first, and then try to rope in Stupak. It shouldn’t have worked, but it did, because of the weakness of one man.


    Frankly, I don’t give a damn about his feelings. This bill will fund abortion, and I maintain that he was either a fool or a coward for accepting the empty promises of an EO from Obama, the most pro-abortion president in American history.

  • Though to be fair, all this really does is reduce Stupak to the level of an average politician, whereas before, we had reason to believe he was at least trying to be a decent human being.

  • Evidently the House leadership and the White House assigned a higher value to that cheap talk than you do – it’s the main reason why they cooked up this EO nonsense to begin with.

    They cooked up the EO nonsense to get Stupak’s vote, not the votes of pro-choicers, who they already had.

  • There were 23 Democrats who voted for the Stupak Amendment and voted against the Senate “reconciliation” bill on Sunday. 23, out of 253. 9%.

    175 out of 177 Republicans voted for the Stupak Amendment and against the reconciliation bill. That’s 99%.

    Remember those percentages the next time someone tells you that the GOP isn’t really pro-life, that Scott Brown and Rudy Giuliani prove that the Republicans are secretly pro-abortion, that the Democratic Party is moderate on life issues, that there’s really no difference between the parties at all.

  • BA,

    The EO was all they had left to offer Stupak once they satisfied the pro-choicers.

    Though I don’t have the link saved (darn it), Pelosi was going to allow another vote on the Stupak amendment until the radical pro-choice Dems threatened to vote no if it passed – which, like the first time around, it would have. This was in the news. I remember reading it and thinking that it would be great.

    But after the radical pro-abort Dems renewed their threat, Pelosi et. al. had to deny Stupak another vote. But they still needed his vote on the bill – hence the EO. Garbage!

Health Care Predictions

Tuesday, March 23, AD 2010

In the debate over the now-passed health care reform bill, a great number of statistics were brought out as to why the US desperately needed a bill like this: Numbers of bankruptcies supposedly caused by high medical costs and lack of insurance.  Numbers of people who supposedly died each year because of lacking health insurance.  Infant mortality rates, etc.  With the bill now passed, Megan McArdle is curious to see those who supported it make some firm commitments as to what the results will be over the next five years:

1) Ezra Klein is confidently predicting that it will save hundreds of thousands of lives.
2) Nick Kristoff expects miraculous improvement in our national life expectancy.
3) Michael Moore thinks this will stop people from getting thrown out of their homes in a Medical bankruptcy.
4) At least one of you must be willing to claim massive improvements in infant mortality, after you’ve cited those statistics to me over and over.

These sorts of things should all be pretty easy to measure, and McArdle goes on to make her won eight predictions in regards to the effectiveness of the bill:

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7 Responses to Health Care Predictions

  • On a slightly tangential note, the prediction going into the 2008 election among Catholics and other Christians supporting Obama that the abortion rate would drop under his administration (based on data from during the Clinton administration) is turning out to be wrong so far. From a January 2010 article:

    “The pregnancy rate among 15-to-19-year-olds increased 3 percent between 2005 and 2006 — the first jump since 1990, according to an analysis of the most recent data collected by the federal government and the nation’s leading reproductive-health think tank.”


    “The abortion rate also inched up for the first time in more than a decade — rising 1 percent — intensifying concern across the ideological spectrum.”

    I think this was clearly a case of wishful thinking and makes me not optimistic about comparable predictions related to health care legislation.

  • Spamb

    Two things. Obama’s first year will include effects from the Bush legacy. Indeed, it is several years of effects based upon the wars Bush got us into and the financial crisis he inherited.

    Second, and more importantly, those stats are about 2005-6. Under Bush.

  • Henry, you’re right on both counts. I need to slow down.

  • First, that there will be a change in life styles is not a given. Acturialy the figures are guesses and until there is more data on changes figures are not credible as cost reductions are not in enacted bill. Insurance of every kind since its inception has been based on risk. Auto,H/O,Life,Workers Comp., Health, etc. State governments enacted no fault auto, mandatory auto, assigned risks pools, uninsured coverage.Life Ins added suicide clause and along with Health pre existing contract exclusion like wars, etc. H/O have left areas where natural disasters occur like costal regions. Ins Co have pools of their own for many risks to limit the losses. One thing is sure when health cos have to take all risks regardless of healtth or preexisting illnesses they know they are going to pay ( NOT A RISK BUT A SURE THING ) if you think their actuaries will not figure a cost and spread it to the healthy with an increase in health premiums you are living in a dream world. Mandatory auto has not elimninated uninsured drivers nor will this bill prevent healthy people who will still refuse health ins. and the joke of the IRS fining people when there will be no civil enforcement or interest on the so called fines , is about as ricdiculous as a bill can get. Flood Insurance did not solves flood losses, and all insurance polices have exclsuions, including WC, plus and which policies takes preference over another. The bill will not admittedly solve Medicare’s certain insolvency either. As to abortion, there is another certainy, it will continue unabated and perhaps increase. We tried the big fiaso of banning booze in he 20’s..people will do what people want to do and their actions can not be legislated til morals and culture is changed, but government never seem to realize this fact as our forefathers know inalienable rights..created equal..

  • It’s interesting how quickly people back down when it comes to making actual testable predictions about what will happen.

  • Here’s my prediction: Jay Cost is correct.

    Our entitlement crunch is going to get very, very, very nasty – and in short order.

  • I agree that Jay Cost has nailed it.
    I suspect the Dems next step will be a VAT. Conservatives don’t like it since it is a largely hidden tax funds large government. Libs don’t like it because it is regressive (or at least not progressive). Libs will come to terms with it once they realize it can fund their huge programs, and conservatives will accept it as better than 50%+ marginal income tax rates. We will look a lot like Western Europe, which is what the Dems want. We will trade social and economic mobility for greater economic security. Not the end of the world, but sad nonetheless. I disagree with those who claim that such a system violates the Catholic principle of subsidiarity; I think this is pretty much all prudential. But I do wish the folks who are so attracted to Western Europe would just go and live there instead of trying to change the US.

What We Know Now

Monday, March 22, AD 2010

As it so happened, I was in Washington DC on that National Mall as congress was voting on the mess which is our “health care reform” bill. I hadn’t been to our capitol city before, and it was a simply beautiful afternoon — one on which it was hard to believe that our elected representatives were bringing us one large step closer to a major budgetary crisis point, and Representative Stupak was busy selling out the principles everyone had imagined to be as solid as the Rock of Gibraltar for a rather paltry executive order which may (or may not) come after the fact. (Call me a cynic, but I could well imagine the EO never coming. Though in a sense, why not issue it: It would have no effect and could be repealed at any time. Still, there would be a great deal of justice and truth in Obama using the old Microsoft line, “Your mistake was in trusting us.”)

Still, though sun, green grass, and stone monuments are fresh in my mind, and the largest looming problems in my mind revolve around children wailing that they need a bathroom right now while traveling on the metro (let’s just say that didn’t end well) I don’t want to seem as if I’m discounting the importance of what we’ve just seen. And there seem to be some fairly clear conclusions we can draw:

1) Stupak had no desire to be to abortion what Joe Lieberman chose to be to foreign policy. Lieberman was hounded out of his party and continues to hold office only because of people who disagree with him on nearly every other issue admired his principled stands on Iraq, Israel, etc. If Stupak had brought down the Health Care Reform bill in defense of the unborn, he would have received similar treatment from his own party to what Lieberman has received, and he clearly didn’t want to be that person. Instead, having talking himself into a corner he really didn’t want to be in, he seized upon a fig leaf when it was offered and did what he’d clearly wanted to do all along:

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21 Responses to What We Know Now

  • Thanks for your thoughts on this Darwin. Though I will say this: I am not so sure Stupak’s principles failed today as much as his intelligence. What was he thinking, putting the status of abortion in the health care program in the hands of Obama?

    He was willing to go to war just to keep the Hyde language in the bill, but now he caves and gives the president what amounts to carte blanche? What idiocy. What foolishness! It’s irrational behavior.

    The rabidly pro-abortion Dems who threatened to block the passage of any bill that denied public coverage of abortion are clearly confident that this EO would have little to no effect. Pro-life Republicans also clarified how EOs really work during the debate running up to the vote.

    I will be writing soon on the prospects of nullification.

  • I mentioned upon the election of Brown that it’s possible that his election would result in a more liberal bill. Without Brown, Stupak would’ve had a much better chance of getting his amendment.

    Anyway, surprising indeed.

  • It is rare for a political party to walk off a political cliff in lockstep, but that is precisely what the vast majority of Democrats did in the House last night. Most of them I assume have no idea of the political whirlwind they sowed last night.

  • Donald,
    I hope you are right, but if ‘pro-life’ Dems have not figured out their party by now is there any chance that they ever will?

    Party affiliation first and foremost!!!

  • What do you guys think of Bill McCollum, et al and their posturing to kill this in the courts? Do you think they have a shot? I mean, large parts of this monstrosity strike me as blatantly unconstitutional, but I’m no lawyer.

  • restrainedradical,

    Given that the text of the Senate bill, with its more liberal abortion language, predates Brown, I’m unclear how it is the result of his election. Are you theorizing that if the Democrats still had a 60 seat majority in the Senate they would have been more willing to accept Stupak’s language even though they’d initially refused.

  • I mentioned upon the election of Brown that it’s possible that his election would result in a more liberal bill. Without Brown, Stupak would’ve had a much better chance of getting his amendment.

    Nice try, rr, but I do not think the psychology commonly attributed to battered wives is salable in this forum, whether the huckster is you or David Frum.

  • Nice try, rr, but I do not think the psychology commonly attributed to battered wives is salable in this forum, whether the huckster is you or David Frum.

    Oh yes, pro-lifers were the victims in all this. Aren’t they always? I can’t say I didn’t warn you, not like you were listening anyway. Pro-lifers got more out of this than they deserved politically. It’s time for the pro-life movement to stand up, and admit they are facing the adult consequences for their adult choices. Of course that would mean actually holding leaders accountable and not continually giving them a pass. For all the complaining about McClarey’s favorite representative, he’s probably the only reason you have the half loaf you have.

  • Victims? Not particularly, that I can see. We lost lost a battle but won some side engagements along the way, and while it could have been a lot better, we certainly did better than if we’d simply sat around on our hands. (BTW what’s with all this 2nd and 3rd person?)

    That said, we did lose, and in directly because of a loss of either wisdom or principle on the part of one of the main players. In that sense, it’s hardly surprised to see him blamed.

    The point about battered wife syndrome is more that it hardly makes sense to argue that we somehow would have got even more concessions if we hadn’t pushed for anything at all. The Democratic Party is overwhelmingly pro-abortion at this point, and they run congress, so clearly, if pro-lifers had not tried very hard to get pro-life restrictions forced into the bill, the folks who think that killing the unborn is a form of health care would have had their way in its entirety. If there’s a lesson in all this, it’s that the “let’s shut up and be good patsies for the Dems because they’re only ones who care about people” crew would never have got any pro-life concessions at all if they’d been left to their own (lack of) way.

  • I mentioned upon the election of Brown that it’s possible that his election would result in a more liberal bill. Without Brown, Stupak would’ve had a much better chance of getting his amendment.

    I’d considered this possibility too, but ultimately I don’t think it works. The language to be included in the Conference bill had already been worked out prior to Brown’s election, and it wasn’t the Stupak language (that’s what the whole Cornhusker Kickback thing was all about). If Brown hadn’t been elected we would have ended up with the same result w/r/t abortion.

  • MZ, rr fancies we are responsible for this mess because we did not play the angles in some complicated way, e.g. being frightfully clever and casting a ballot for Martha Coakley. Now, I am not impressed with such a thesis or the bloke who offers it, but then I am just an ass who doesn’t want to take responsibility for anything.

    not like you were listening anyway.

    You got me there. I do not pay you much mind, for reasons you should be able to discern.

  • DarwinCatholic, I disagree with you assertion that “the Democratic Party is overwhelmingly pro-abortion at this point…”

    I’m a 30-year-old pro-life Catholic and spent the last decade voting Republican solely on the abortion issue. But I’m done with that. The Democrats of 2010 are a far cry from the party that silenced Bob Casey 18 years ago. Case in point: as Stupak took the podium last night he was greeted with loud, sustained applause from his caucus. Imagine that, 250 Dems cheering a pro-lifer as he champions the pro-life provisions of a piece of Democratic legislation.

    Frankly, the fact that you and others on this blog find yourselves in the same camp as Planned Parenthood and NOW, lambasting Obama over abortion, should give you pause.

  • What a ludicrous thing to say Mr. Kelley. The Democrat party is the most pro-abortion that it has ever been. Stupak sold out the pro-life cause for a meaningless Executive Order that is unenforceable. That is why he was getting cheers from the overwhelming pro-abort Democrat caucus. Vote Democrat if you wish, but do not delude yourself that you will be voting pro-life when you do.

  • Frankly, the fact that you and others on this blog find yourselves in the same camp as Planned Parenthood and NOW, lambasting Obama over abortion, should give you pause.

    Put that bong down, and crash.

  • Donald:
    I didn’t say I was vetoing Democrat, just said I’m done with the Republicans.

    Art Deco:

  • oops. “voting”

  • Chuckling at Art Deco.

    If the Dems weren’t overwhelmingly pro-abortion, there wouldn’t have been any provisions in this bill for abortion from the beginning. Only a handful of Democrats in the house held out for an abortion exclusion. “Pro-life” senators were bought off with promises of pork. The leadership maintained that the bill will still allow funding of abortion and consider that a cost saving measure. Even going as far as to call this a “life-affirming” bill.

    We know to some Catholics abortion isn’t a big deal to begin with, and to most of them the end justifies the means. But the Church’s teaching on life, abortion, and justice resonates with and informs some of our consciences.

  • I don’t blame those who voted for Brown. I wouldn’t have voted for Coakley. But I did think the celebration was premature.

  • RR,

    Yes, the celebration was premature.

    Let’s see if the Democrats can control both houses of congress come the November elections.

  • ” as Stupak took the podium last night he was greeted with loud, sustained applause”

    Whereas just days before, he was greeted with vicious hate. For everyone from the liberal bloggers to the House Dems to suddenly love Stupak says one thing, and one thing only to me: that he agreed to a deal that will do absolutely nothing for the pro-life cause, because any bill that would, would have been shot down by the pro-abort Dems.

    The viciousness with which he then attacked pro-life Republicans during the following vote was like a victory dance with salt-coated shoes over open wounds. And all they were trying to do was get HIS language in the bill – his reason for berating them was that he had the utmost confidence in Obama’s EO.

    What a chump. What an irrational, foolish man.

  • We also know that the people begging and praying for the congressional critters to obey God and the Constitution aren’t being heard by most, both those in the Capitol and anyone outside of the four block radius.

    According to the reporting there were a 1000 ‘Tea Partiers’ and hundreds of Catholics for Health Reform making their cases.

    The sad fact is there is no such thing as a Catholic who is in favor of this ‘health care reform’. I know you misguided lefties are going break your keyboards responding, but the fact is you are wrong. You may have won this battle, but you are still wrong. Engage whatever mental gymnastics you want, you can’t contort the Catholic faith into making this OK.

    I spoke to these poor fools when I was on the hill the past two days and nights. At one point there was some confusion over the boundaries of the pro-Constitution group and the anti-life group and I ended up on the anti-life group side. I admit that after the confusion was cleared up I stayed there because I wanted the cameras to know that we are not all nuts, in favor of collectivism and that there is NO SUCH THING AS A PRO-ABORTION Christian. The camera men told me to, ‘get out of my face, I’ll film whatever I want’. I was told by Capitol police not to cause a commotion and I told them that I was just correcting a lie. The cops were very cool, they did there job well with a few minor exceptions who were chastised.

    One poor woman holding one of the professionally fabricated signs that were given to them by Demon Pelosi ‘catholics’ told me that I wasn’t allowed to be there. I responded that Catholics aren’t allowed to be for killing babies. I was met with silence. No matter how much we sin, that conscience is always there, as misguided and disfigured as it is – even Judas could have repented.

    The interesting thing was that after the ‘staged’ pro-abortion promoters were scheduled to leave – the pro-life, pro-Constitutionalists stayed and prayed and chanted and prayed. Sure I found the Our Father a little long, you know with the Novus Ordo doxology tagged on to the end of the Lord’s Prayer, but that was OK. We sang the national anthem and said the pledge of alliegence and emphasized REPUBLIC and UNDER GOD! (tangent: funny how Bible-only Chrhstians pray the Lord’s prayer differently that it says in the Bible). Some of the younger fools came to our rally carrying their professional signs and acted like fools – some of us fell for it and engaged, sadly, I wish I had recalled that Jesus didn’t say one word to Herod – but I caved into temptation and engaged.

    I am not sure that all of the ‘Catholics for Health Reform’ were actually Catholic or just very, very poorly catechized Catholics, but they are certainly wrong and misguided. They behaved like ignorant fools. It is sad that each subsequent generation since the 60s is devolving into barbarism. Having attended Mass in DC, I also noticed that the Washington DC diocese is not nearly as conservative and traditional as the western part of the Arlington diocese just across the river. That may have something to do with it – lefties and unorthodox, even downright heretics are in our Church and to be silent is to allow the Devil to sweep souls away.

    Oh – as for those racial slurs – I saw none of that – it hasn’t been proven and none of the thousands that I met behaved that way. Not to mention I met many black Americans that were with the alleged perpetrators. There were also many agent provocateurs among us to malign patriotic Americans – don’t fall for the lies. As for Barney Frank being called a fag**t, I didn’t see any of that either, despite the fact that he is a proud Sodomite. We did call him a treasonous traitor – another term that is accurate for that man.

    There were thousands standing up for life, for America and for freedom to worship and honor God. If you can’t be there in person you must pray and fast with those on the front line. This isn’t a joke. This is how a society succumbs to Jacobins, Leninists and Brownshirts. It is so sad that so many have been mentally conditioned into believing that it can’t happen here and that it isn’t happening.

    Of course, this bill is not ushering in collectivism tomorrow – we’ve been working on that for 100 years and the Enemy bides his time. The damage from this will be slow enough for most to not notice it and that will fool many into thinking their conscience is OK with it and then one day they’ll look back and wonder when it happened – when did we become Communist slaves? Or, worse, actually be happy about it and embrace it.

    Thanks for coming to DC – perhaps we bumped into each other. 🙂

Health Care Reform and the Great Switch

Sunday, February 28, AD 2010

Personally, I thinks it’s fairly likely at this point, that one of the current “health care reform” bills will become law. However, though I come to this with characteristic lateness (increasing busy-ness seems to make topical blogging near impossible) I think it’s worth spending a moment on one of the fascinating contradictions which has gone mainly unremarked in the whole debate.

One of the primary arguments put forward by advocates of health care reform over the last 2-3 years has been, essentially, that health insurance companies are evil. People froth at the industry term of “medical losses” for when insurance companies pay out for medical expenses. (Something which, in fact, happens with over 80% of the monies collected in the form of insurance premiums.) Others rail against how the profit motive has destroyed health care and driven costs to astronomical levels — apparently oblivious to the fact that there are several major not-for-profit insurers, and they don’t provide care any more cheaply than for-profit ones. And yet, despite these and many other rhetorical assaults on the whole idea of health insurance as a commercial product, the centerpiece of the proposed health care reform bills was to legally require everyone in the US to purchase health care insurance, and then provide government subsidies for those who couldn’t afford the premiums. (Thus “shoveling” government money into the insurance industry in the same way in which Medicare Part-D, which all good progressives are now against, did with the pharmaceutical industry.)

Why in the world did a movement which had so long railed against private insurance suddenly decide to require and subsidize it, rather than pushing for the government or non-profit approaches to health provision which had so long appealed to it?

Continue reading...

34 Responses to Health Care Reform and the Great Switch

  • I think if that were the plan Democrats wouldn’t have pushed so hard to include a public option in the bill.

  • “Plan” is a strong word. I just think it’s exactly how the aftermath of passing such a bill would be likely to play out. (Though whether progressives would be successful in then passing price controls or conservatives would win with some other approach instead I have no idea.)

    Also, I’d note that while I think it’s pretty sure that price controls would result in a government take-over being necessary, many progressives seem to imagine that price controls are perfectly healthy for an industry.

    I’ll put it this way: I think that progressives demanding price controls would be the inevitable result of the current health care reform bill passing — and my opinion is that this would result in the insurance companies being effectively or actually nationalized before much longer after that.

  • I thought your post was about why progressives support subsidies for insurance companies (i.e. the motivations behind the policy, not its likely results).

  • I think I’d say that for most there’s a “deal with the devil” element of “we’ll play with private insurance if that’s the best way of getting everyone coverage now.” In that sense, mandating private insurance may seem like the metaphorical crap sandwich when you’re rather have single payer, but if it’s the only thing possible, it’s considered acceptable. However, I think that willingness to compromise with “capitalism” would vanish the moment that rates went up and rhetoric about “record profits” started flying.

    I would imagine that there are, however, a number among progressive policy wonks who’ve thought the thing though and see pretty clearly that the next step after this would be price controls and increasing amounts of regulations in regards to what policies cover until one incrementally reaches a point where insurance companies aren’t functionally private entities.

    But like I said in the post, I think for most rank and file progressives anything put forward by Democrats with the title of “health care reform” is considered acceptable at the moment, and there’s not a whole lot of thought put into the inconsistency of a reform bill which funnels customers to the very companies they’ve been denouncing for so long.

  • I don’t think they’ve pushed that hard for the public option. Certainly, the White House isn’t trying to push it now, even though there’s no real disadvantage at this point to including it. People like Yglesias have been fairly indifferent to the public option for months now.

    I’ve thought the idea Darwin outlines above was basically the official plan. First, mandate insurance. Then, when people complain about the costs, introduce regulations to reduce costs. As time goes on and regulations increase, this would result in de facto public control over health insurance. Certainly, health insurance companies have spent a fair amount lobbying against the proposal for precisely this reason. And I think the outlined scenario explains rather well why the wonks were so strongly in favor of the plan, even without the public option. I can’t imagine it was because of a newly found affection for insurance companies.

  • In terms of the effect of the bill, my understanding is that the plan no longer includes community rating, so insurance companies will be able to charge people more based on risk factors like age or medical history. True, they won’t be able to deny coverage based on pre-existing conditions, but the insurance mandate limits the cost increase that this would normally involve. Bringing lots of young healthy previously uninsured people into the pool will also put a downward pressure on premiums for people who already have insurance, which will help offset some of the new inefficiencies in the system, at least temporarily. Overall I’m not sure that passing the bill would result in huge premium increases for most people, at least in the short term.

  • Money, Money, and more Money. Why isn’t anyone looking at 2 of the biggest problems? 1. Doctors are specialized because the cost of medical school is on the rise and they have to pay it back eventually so no one goes into family or internal/ preventive care ( there is no money in it)
    2. adding more patients to a system that most doctors are specialized or even leaving the profession would make the price go up more.

    My solution would be to address the doctor crisis first then worry about who is not getting care…. Maybe we should work on Medical Education 1st then the patient problem … but what do I know…

  • BA,

    Well, my understanding was that the individual mandate enforcement mechanism is rather weak in the bill – which makes the skyrocketing premiums scenario much more likely. Also, even without higher profits, continued cost growth (which seems to be unavoidable as new and more expensive treatments are developed) would make additional regulation more likely (and popular).

  • My understanding was that the House bill required no more than the 2x difference between highest and lowest rates (due to age and health condition) and the Senate bill required no more than a 3x — thus a modified community rating of sorts.

    In this regard, I’d be taking MA and NY as pretty good proxies for how the bill would work out.

    If I’m wrong on this (and given the massive size and constantly shifting nature of the bills, I may be) I’d be less sure on the bills themselves driving up insurance costs. Though at John points out the guaranteed issue and very low fines for non participation might lead to a nasty case of selection bias costs.

  • DC, JH , and BA :
    You may speak about the insurance problem, but you are only modeling the cost factors based on the model of patient-insurance(risk). Yet you are not looking at a bigger problem:
    1. HITECH law will make more doctors retire earlier as they did when HIPAA was adopted. Less doctors more patients ( supply decrease and demand increases ) it will cost more.
    2. More people are going to have problems since less doctors are in preventative care fields so more people will get sick later since they will not see a GP or cannot since they will be packed with 40 million more people able to book an appointment.
    3. Doctors are not given any incentives to get into these fields since the average doctor leaves med school with 150k in debt… plus 100,000-500,000 premium for the docs own insurance ( yet no talk of a national physician cap on how much you can sue a doctor for)
    4. We are addressing the patient problem but how about law suits against complications (not accidents )

    5. there is more yet this blog nor the US is looking at these problems … the AMA and the insurance companies are not talking about it either since it is the biggest problem!!! Supply and demand folks !!!

  • I truly do not understand the wide spread opposition to health reform, especially from Catholics. The truth is we in this country have the most expensive and lowest quality (in terms of errors) healthcare system among the wealthy countries and a large number of our citizens are not covered. I know this is what you have heard over and over from progressives, but this makes it no less true. Real healthcare reform that covers our citizens regardless of their means has been supported by the USCCB and Pope Benedict, how can supporting it not be the Catholic approach?

    I hear about arguments over these bills and wonder what is going on. The goal here is to provide health care to our citizens. We can not do that unless we also find a way to reduce the costs we currently have. The only models anywhere in the world that do this have a significant government run component (call it socialized medicine, I’m ok with that). There is no example of the medical system we have in this country that reduces cost, covers more people and improves quality. To continue to do the same thing and expect different results has been described as the definition of insanity.

    As I’ve tried to express on other blogs, being Catholic does not involve bending the teachings of the Church to the conservative or liberal point of view. Rather it requires bending the conservative and liberal points of view to the ways of Christ.

  • Paul,

    These are all valid points, and thank you for expressing them in such a charitable and articulate manner. My opinion is that the health care reform bills in question are fiscally irresponsible and would on balance reduce the quality of health care received (as opposed to promised) in the U.S. I certainly agree with you that health care reform needs to happen, and I favor increasing access to health care – particularly for the chronically uninsured. I simply think the current bill is harmful to the common good, for a variety of reasons that would take a while to spell out in this comment thread.

  • Paul DuBois,
    I agree with you, but how can we fulfill a goal without looking at every angle. I want a first payer system, but that is not what will happen. I am afraid what will happen is that we will have a bigger mess if we do not take our time. I am glad we are talking about it but we need to face the facts we need too look at the whole system not just parts of the system. By concentrating only on the insurance problem we are not looking at the patient and doctor problems to the model. The how can you cover someone that will not be able to be seen likewise how can a doctor do his job if he is seeing a patient for less than 5 mins. we need to address the whole problem. The mistake is that we are hoping to throw money at the issue without address the problem. Much as with the bank bailouts… we throw money and it got fixed a little yet we still see bonuses for those who ran the system to the ground we needed to make conditions to the banks on how they could use the money we didn’t because we were not addressing the WHOLE problem. we need to do it right this time we need to address the whole problem not just insurance…. If not you will get a national policy at the sacrifice of even worse care we have now as we are ranked 37 of 40 industrialized countries for health care (

  • I find it remarkable that I know brilliant people who both claim it is likely to pass or that it is dead…at the same time.

    My understanding is that Pelosi won’t have the votes without the Stupak Amendment, that even with the S.A. she doesn’t have Cao, Wexler (FL), and Murtha, and that moderate Dems are scared about poll numbers and possible Scott Brown reduces.

    Perhaps I’m grasping at straws here because if this bill passes it will destroy a lot of progress in the pro-life movement the last five years.

  • Steve, I doubt if Pelosi has the votes in the House with or without the Stupak amendment. I also doubt if Reid can muster 50 votes in the Senate, with Biden as tie-breaker, to proceed with this via Reconciliation. I think Obamacare is dead and we are merely observing now the final twitching of the corpse.

  • I have to say, this is the one of the most paranoid takes on HCR I have read.

    First off, you claim without substantiation that the cost of health insurance would go up for most people. Where do you get this? And why do you ignore the CBO, which said otherwise, and has always been accepted as the honest broker here? You focus only on community rating – and yes, community rating alone would cause costs to skyrocket, and the risk pool to deteriorate. But this is not the proposal. The proposal is to twin some form of community rating with the individual mandate plus a number of promising delivery system reforms. Again, I defer to the costing of the CBO on this.

    As for why we support reform, it’s simple – this is the best we can get. Reform MUST be underpinned by community rating and the individual mandate. If that is a given, then insurance can be delivered pretty efficiently by the private sector -as in Germany, Switzerland, Netherlands. Single payer gets you geater efficiency savings by economies of scale, and by eliminating the profit motive. But let me nuance that last point – inusrance company profits are actually not the leading cause of healthcare cost increases. The focus on profits is a moral point – these people are out to maxizmize shareholder value even if this means denying or dropping coverage from people who could conceivably die or go bankrupt.

  • MM,

    As I said, I’m partly basing my expectation that rates would go up on the experience of MA and NY, which have in fact seen pretty lousy results from similar measures. (Admittedly, MA has, if you look at things funny, some help from a mandate, but only because they took the idiotic step of passing community rating without a mandate earlier. Their rates remain some of the highest n the country.)

    Also, the CBO _did_ estimate that rates would increase — certainly for the House bill. I’d have to double check on the Senate one at this point, but the provisions aren’t that different.

  • [Y]ou claim without substantiation that the cost of health insurance would go up for most people. Where do you get this? And why do you ignore the CBO, which said otherwise

    Actually, I believe the CBO said that the average person’s premiums would go up, but that this would be offset by a greater amount of coverage.

  • I’m partly basing my expectation that rates would go up on the experience of MA and NY, which have in fact seen pretty lousy results from similar measures.

    I think the experience of NY and MA shows that passing community rating and guaranteed issue without a mandate is a bad idea (I’d note, btw, that if the Democrats really were interested in having insurers jack up rates to create popular sentiment for more regulation they probably wouldn’t be insisting on a mandate at all). On the other hand, there are places (e.g. Switzerland) that have community rating plus a mandate and haven’t seen health insurance costs spiral out of control.

  • Well, let me be clear, I don’t think that the Democrats want to come up with the scenario guaranteed to jack up rates as much as possible, I just think that price controls will be called for as the logical next step when insurance companies “abuse the chance they were given” by posting record profits after seeing an infusion of new enrollees.

    I’d be curious to read more about Switzerland’s experience. For the record, though, I don’t think that community rating, mandate and guaranteed issue will cause rates to spiral out of control indefinitely — I just think they’re likely to go up strongly for 2-5 years as the system adjusts to the new equalibrium. Then, all things being equal, rates would go back to increasing at something like their present rate.

    The issue is, insurance costs are already very high, and I strongly suspect that that average voter who basically supports the idea of HCR (admittedly, a rather diminished group by this point) imagines that this will cause an end to rate increases. So just a solid 10-20% rate increase over a year or two would be enough to cause another political “crisis”, which would be the one in which the obvious progressive move is to demand price controls and regulation of what insurance does and does not pay for (cost controls).

  • There’s a difference between “most people’s premiums will go up” and “the average premium will go up.” But in this case, both are true according to the CBO, though for very different reasons.

    Most people’s premiums will go up because there are a lot more healthy people than sick people under 65. If you cap premiums at three times the cheapest plan, the healthy masses will see premiums go up and the sick minority will see premiums go down. A mandate alone would actually reduce the average premium since (1) more healthy people will enter the system than sick people, and (2) economies of scale will drive down costs.

    But the government subsidies will drive up the average premium because people will be able to afford more expensive plans. The CBO says the net effect will be an increase in premiums.

    IMO, neither of those facts are reasons to oppose ObamaCare. If the relatively well off should pay higher premiums so that the less fortunate can be covered, I’m all for it. The question should be “Is there a better politically feasible alternative?” If Obama’s bill contained the Stupak Amendment and taxed employer-sponsored plans, I don’t think you can get a better bill. Sure, there are better theoretical plans (e.g., replacing insurance with HSA’s) but they’d require political will that doesn’t exist.

    Fear of government encroachment is legitimate. For the last 30 years or so, the government has shied away from price controls, opting instead to subsidize. I think larger subsidies and a public option are inevitable. But again, “Is there a better politically feasible alternative?”

  • Catholic Chump,

    Increased demand for medical services means more people will go into the medical profession. In the long run, it’ll even out.

    I agree that we need more doctors but the cost of med school isn’t the problem, at least not one of the major problems. Even med school students who don’t have to worry about debt want to go into the more lucrative areas. Who wouldn’t? I think the AMA’s artificial restrictions on supply is the bigger problem. Some are proud that Canadians come to the US for medical care. Meanwhile, Americans go to Jamaica for med school.

  • MM,

    On premiums:

    CBO and JCT estimate that the average premium per person covered (including dependents) for new nongroup policies would be about 10 percent to 13 percent higher in 2016 than the average premium for nongroup coverage in that same year under current law. About half of those enrollees would receive government subsidies that would reduce their costs well below the premiums that would be charged for such policies under current law.

    CBO estimates were the small group and large group business coverage would be flat to very, very slightly down, but since those people are covered already they’re going to notice little difference.

    The people who will actually being mandated to go buy themselves coverage, meanwhile, will see a noticable rate increase.

    Thanks for giving me the motivation to go look up the details, as obviously it’s been a few months.

  • Given all the moving parts in this legislation, I have to wonder if any of the projections are worth a pitcher of warm spit.

  • @ Art Deco

    Indeed, the CBO report basically does the waving-hands motions saying that the projections are simply estimates. But the disclaimer basically is CYA.

    Also despite the claims to the contrary the CBO reports states that premiums go up for non-group plans, about 17% of the plans out there. Group plans stay the same or fluctuate very little.

    Given that virtually every projection for government spending has been wrong on the “too little” side, I’m skeptical.

  • This WSJ op-ed would seem to bolster Darwin’s point:

    Last month, Democratic Governor Deval Patrick landed a neutron bomb, proposing hard price controls across almost all Massachusetts health care… [A]verage Massachusetts insurance premiums are now the highest in the nation. Since 2006, they’ve climbed at an annual rate of 30% in the individual market. Small business costs have increased by 5.8%. Per capita health spending in Massachusetts is now 27% higher than the national average, and 15% higher even after adjusting for local wages and academic research grants. The growth rate is faster too.

  • Darwin,

    Why are individual group premiums rising? As the CBO takes great pains to show, this increase is completely explained by the fact that the quality of the package will get better, in terms of more comprehensive benefits. In fact, this improvement leads prices to rise by 30 percent. The fact that they only rise by 10-12 percent suggests some countervailing cost savings, coming from the insurance reforms and the individual mandate. And when we add in the subsidies, it looks better still. Almost 60 percent of people on the exchange will get subsidies, and these subsidies will reduce premiums by 56-59 percent. Bottom line: 30 percent better, 10-13 percent more expensive, and lowering premiums by 60 percent with subsidies. That’s not bad…

    And yes, it’s been months since I’ve looked into this too!

  • The fact that they only rise by 10-12 percent suggests some countervailing cost savings, coming from the insurance reforms and the individual mandate. And when we add in the subsidies, it looks better still. Almost 60 percent of people on the exchange will get subsidies, and these subsidies will reduce premiums by 56-59 percent. Bottom line: 30 percent better, 10-13 percent more expensive, and lowering premiums by 60 percent with subsidies. That’s not bad…

    If you start @ 7:26 and watch through the end, Curly provides a demonstration of the history of public policy on this issue since 1965.

  • MM,

    Well, if you assume that the people who currently have private insurance have been dying to get better coverage if only they can spend just 13% more instead of 30% more — and that those without coverage will be very excited to get coverage so long as it is 30% better than today and only costs 13% more — then clearly everyone will be very happy.

    Personally, I think people will see that as costs going up.

    Though it’s true that the subsidies are so generous that people may actually be thrilled until congress fails to actually make the Medicare cuts to pay for it all and the budget melts down.

    Also, I would tend to expect that things will not be as rosy as currently projected by the CBO, though perhaps your expectations deviate in the opposite direction. At this point, though, I suspect it’s a rather theoretical exercise, as I don’t think either of the bills will pass at this point. The window passed.

  • MI’s comments aren’t argumentative yet lacking any argument. No there not.

  • Q. I truly do not understand the wide spread opposition to health reform, especially from Catholics.-Paul DuBois

    A. The opposition comes from two sources; conscience and a clear understanding that “health reform,” whatever it is, is not the same as medical treatment.

  • Paul Dubois:

    Mark Steyn expresses it much better than I can:

    “President Ford liked to say: “A government big enough to give you everything you want is big enough to take away everything you have.” Which is true enough. But there’s an intermediate stage: A government big enough to give you everything you want isn’t big enough to get you to give any of it back. That’s the point Greece is at. Its socialist government has been forced into supporting a package of austerity measures. The Greek people’s response is: Nuts to that. Public sector workers have succeeded in redefining time itself: Every year, they receive 14 monthly payments. You do the math. And for about seven months’ work: for many of them the work day ends at 2:30 p.m. And, when they retire, they get 14 monthly pension payments. In other words: Economic reality is not my problem. I want my benefits. And, if it bankrupts the entire state a generation from now, who cares as long as they keep the checks coming until I croak?

    We hard-hearted small-government guys are often damned as selfish types who care nothing for the general welfare. But, as the Greek protests make plain, nothing makes an individual more selfish than the socially equitable communitarianism of big government: Once a chap’s enjoying the fruits of government health care, government-paid vacation, government-funded early retirement, and all the rest, he couldn’t give a hoot about the general societal interest; he’s got his, and to hell with everyone else. People’s sense of entitlement endures long after the entitlement has ceased to make sense.”

    Steyn notes that the European-style welfare state is careening off the cliff – and our leaders, instead of taking note and hitting the brakes, are running as fast as they can to follow the Euros into the abyss.

    Why is being opposed to burdening future generations with an incredible amount of debt un-Catholic? If the GOP had the sense God gave a goose, they would steal the Dems mantra and proclaim that they are opposed to nationalized healthcare “for the sake of the children.” And they would actually be right.

Poll Shows Americans Would Like to Have Their Cake and Eat It Too

Wednesday, February 10, AD 2010

The Washington Post has a new poll out which will please both political parties, since the American people in the main agree with both of them. A majority of people want Congress to scrap the current Health Care Reform bills, and a majority also think Obama has done a bad job of handling the health care issue. Yet a majority also want Health Care Reform passed this year and blame Republicans for lack of progress.

Solid majorities think that the current HCR bills are too complex and too expensive, but majorities also approve of the main components: require employers to provide insurance, require people without insurance to buy it, subsidize people who can’t afford insurance, and require insurance companies to give everyone insurance regardless of their medical histories or problems. So basically, people would love the bill as is, so long as it didn’t cost anything and wasn’t complex.

And in the results most likely to give legislators pause: People say they’re looking for new candidates of incumbents in the next congressional election by a 56 to 36 majority. 71% of people disapprove of how congress is doing its job. And of the 62% of the population that has private insurance (15% have MediCare, 3% have Medicaid and 17% have no insurance) 74% trust their insurance companies to do a “good” or “great” job of processing their claims fairly.

If people like the idea of health care reform, but don’t want it to cost anything or be complex, while distrusting congress and trusting their insurance companies, it sounds to me like nothing is likely to happen on the health care front this year.

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22 Responses to Poll Shows Americans Would Like to Have Their Cake and Eat It Too

  • Over four decades of brain-washing has caused cognitive dissonance and an inability for critical thinking. Oops, sorry I didn’t regurgitate a talking point. I promise not to think anymore and fall the alleged left-right divide.

    If nothing happens on the health care front this year is that an accident or is that by design? Could it be that despite the political class completely ignoring the Constitution and the general populace completely ignorant of the document it might actually still be working and preventing the trans-national elites from completely destroying this country?

    Me thinks the Founding Fathers might be smarter than our history books tell us.

    Shakespeare posited that first we should kill all the lawyers. I disagree, some of those lawyers are my friends. Perhaps we can just exile all the politicos and their financiers to Gitmo and start over from the Constitution, properly amended.

  • Harvey Mansfield is relevant to some of these points, Darwin:

  • Truly people – regarding human nature, who doesn’t want their cake and eat it too?

    The problem is that our recent presidents and presidential candidates have for many years told the American people that they CAN have their cake and eat it too.

    I can’t remember the last time Mr. Obama has been truthful about the healthcare bill. He ascertains that it won’t cost the American people more but will cover more people and contain no cost control measures that are readily understandable.

    How about pulling a rabbit out of a hat?

    Both common sense and reality dictate that we have not been told the truth. I think that is why there is such a lack of consensus regarding this issue. Who really KNOWS what this bill is truly about? Who wants to both read and study over 2600 pages? Who would trust that.

    You can fool only some of the people some of the time…

    Thank God our founding fathers created a system of power separation, which causes all change to be slow.

  • What Americans (and the rest of Western civilization) will get is:

    No electricity, lighting or heating as our power plants shut down
    No fresh food
    No medicine
    No refridgeration
    No gas for cars, so no car travel
    No nothing.

    50 years of neglect with no investment in cheap clean energy like nuclear – we’re gonna get it right up the whazu! And we deserve it.

  • Given that this polling would seem to suggest the status quo will continue, I would think that Americans will continue to get very much what they’ve got in the past.

  • From a purely materialist perspective America has been getting better and better. We have the fattest most well entertained poor people. The cleanest air and the biggest cars, etc. As for energy and the rest of Paul’s list we will keep getting more of that too. The question is what are we selling to keep material enriching ourselves? Perhaps that price is too big.

    It is just as foolish to think any materialist solution is the answer whether it is altruistic (universal health care) or selfish (monopoly privileges). We are not ordered toward God; however, if I am going to live in an ungodly world for a while I’d rather live in a materially successful country and not an impoverished one.

    Perhaps it is time to give up this idea that government fixes things and makes life better. May be instead of forging new progressive ways of empowering government to do more for or to us. What would happen if we went back to the Ten Commandments, The Declaration of Independence and the Constitution, properly amended we may actually be free to reach for higher things.

    God made Creation good and He made us very good. Although sinful, we can participate in his creativity to improve things, as in order them more to Him. Government cannot be creative, it is only coercive.

    Americans are naturally looking for men of virtue to wield the reigns of power and knowing that the most virtuous man is still a sinner we shackle government with the Constitution.

  • Americans are schizophrenic !

  • No I’m not. Me either. 😉

  • Among the more interesting points is that employers should pay for health insurance. Then when the insurance becomes too costly for the employer, he goes under: leaving the former workers without insurance.

    This also affects employment. The attempt to increase the minimum wage law is similar. It makes the hiring of new employees more expensive.

  • I’m sorry the blog post seemed like the old ‘bunny in the hat’ trick, jillions of little baby bunnies just jumping out of that proverbial hat. Which little bunny to attempt to catch first?

    After a year of President Obama’s open discussion with the American people, I’m pretty sure most folks have got to realize a change simply has to happen…
    sky-rocketing costs…spiraling fragmentation of services…increasing levels of disparity among those working or disabled and even those that can afford paying cash (Warren Buffet? Self-pay? Doubt it.)

    In my early professional health care training many years ago, it still seemed debatable whether it was as bad it seemed. Back then, the main focus was ensuring that Social Security funding would last through the time the baby boomers would be eligible. It seems as if we were still quibbling about funding Social Security not that long ago while allowing the snowballing of events that led to the crash, while events were ‘crashing and burning around us’.

    I never in my wildest dreams considered the solution to insufficient funds for retirements would be resolved by perpetuating iniquities in health care; resulting in poor statistics about chronic illness and inadequate prenatal care as evidenced by one of the lower live birth rates due to prematurity compared to other civilized countries.

    The words paint a more vivid picture than simply saying health care reforms has been needed for a long time, and the business stockholders in health care businesses have been the major beneficiaries in the advanced health care available to US taxpayers.

  • Truly people – regarding human nature, who doesn’t want their cake and eat it too?

    The problem is that our recent presidents and presidential candidates have for many years told the American people that they CAN have their cake and eat it too.

    Yes, but the politicians tell us that because that’s what we want. The American people aren’t willing to sacrifice so we elect politicians who tell us that we don’t have to.

    He ascertains that it won’t cost the American people more but will cover more people and contain no cost control measures that are readily understandable.

    I don’t think he’s ever said that it won’t cost more. In fact, he’s been pretty explicit about the fact that he’s going to raise taxes to pay for it.

    The cost control measures aren’t readily understandable because the implications of cost control measures are not easily predictable. That’s why it’s a shotgun approach. Future reform will have to build upon what we learn from these measures.

    Thank God our founding fathers created a system of power separation, which causes all change to be slow.

    We could have a system that requires consensus that isn’t so darn slow. After all, good changes should be made immediately and bad changes never made. The founding fathers had to settle for this highly flawed system because it was too politically difficult to ratify a better one. Would it be so bad if we abolished the Senate and the presidential veto but required a 2/3 majority in the House?

  • “After all, good changes should be made immediately and bad changes never made.”

    Too bad the changes never seem to come with identifying signs on them?

    “Would it be so bad if we abolished the Senate and the presidential veto but required a 2/3 majority in the House?”

    For people who live in less populous states it would be a staggering loss of influence on the Federal government. It would be also another step down the road to treating states as mere provinces rather than co-equal members of the Union.

  • For people who live in less populous states it would be a staggering loss of influence on the Federal government. It would be also another step down the road to treating states as mere provinces rather than co-equal members of the Union.

    So are there any negatives?

  • Only for those who support the framework of our Republic restrainedradical as established by the Founding Fathers.

  • Of course everyone wants to have their cake and eat it too.

    Cut government spending — but only on programs “other people” less worthy than me use (Medicaid, food stamps) and not those I use (student aid/loans)

    Raise taxes if we must — but only on people who make more than I do, or on stuff I never do or never buy (cigarettes, liquor, gambling).

    Get rid of corporate and government waste — as long as it’s not my job that gets cut.

    Stop all pork projects — unless those projects are in my district or my community.

    Soak the rich — but only until I become “rich.”

    Vote all the “bums” out — except for my Congresscritter, legislator, mayor, alderman, etc.

  • What we should do is go back to Senators being representative of the state or commonwealth instead of popular elections. Repeal the 17th.

    The House is supposed to represent the passions of the people and the Senate is supposed to sober those sentiments when made into law. Both are bound by the Constitution.

    When you destroy this, and we have eroded it dramatically in the last 100 years, we are on the road to serfdom. It is called the Tragedy of the Commons. What belongs to all, belongs to none, or sometimes one. As Elaine illustrated, when we vote for largess at the expense of the ‘other guy’ we fall victim to the lie. As Thatcher stated, I am paraphrasing, “the problem with Socialism is eventually you run out of other people’s money.”

    People with an attitude like (notso)restrainedradical will be the ruin of what’s left of the Republic if we allow them to get their way. A Constitutional Republic is a bulwark against tyranny, a Democracy is a sure way toward anarchy followed by absolutism.

    Long live the Republic. In the end the Jedi win and the Empire loses. Darth Obama and his minions will be evicted and sensibility will be restored. Pray, vote, pray!

  • A faulty diagnosis, Darwin.

    A solid minority–and I would include myself in that–aren’t wild about insurance reform as it sits today in Congress because it doesn’t go far enough. The reform–including the president–tacks strongly to the middle, tries to ameliorate insurance companies, who obviously have large profits at risk, and who care little that middle class folks like me rack up four-figure hospital bills for our families as deductibles and premiums rise.

    As for those who favor keeping the status quo, I can’t identify them as pro-market or pro-business. With medical costs going way up, there’s no practical way for comparative shopping and competition. And my employer only offers me one choice of insurer. The GOP has taken “Just Say No” to a new and more ineffective level.

    So all the fears the insurance companies are drumming up: death panels, and the like, are already in place.

    If only we had a third and fourth choice in political parties: more difficult for corporations to spread their money around, more ways to represent the interests of citizens, and a way to ensure that being in last place as a political party was no guarantee of being second. As far as I’m concerned, the Dems are in second-last place in voters’ minds. And if you don’t believe it, consider what the effect of having a ballot line of “none of the above” would do to congressional races this Fall.

    Aetna drops 600,000 to boost profit margins–likely those overweight cake eaters….with diabetes.

  • Todd,

    That might explain why people want to throw incumbants out, but it doesn’t show why people are saying they want to vote for Republican congressional candidates at the highest levels since 2002, nor does it explain why people think the current HCR bills are too expensive (more reform would be more expensive, not less) and why they generally rate their insurance companies highly. Clearly, there’s a small core in the progressive camp who think that insurance companies as wicked and out to get people, but overall people who have insurance trust their insurance companies to do a good job much more than they trust congress.

    That may well not be a reasonable attitude for them to have, but it is what the poll shows.

  • I guess we’ll see how it plays out on Election Day instead of in the heads of pundits.

    The last polling I saw had about a 40-40 split between support and oppose, with about 16% thinking insurance reform was too timid. Thirty million-plus adults is hardly a small core.

    I’d have to say I also have confidence in the job my insurance company does: they are efficient; they let me delay payment on many co-pays and on my deductible. They haven’t cut me off yet for being in middle age.

    That’s not to say I don’t think the profit margin for stockholders is too high. I have a basic objection to making profits without working for them.

    I’m no polling expert, but I bet I could come up with some questions that would swing the confidence away from the corporations.

    Nevertheless, I think your title diagnosis is inaccurate. I think Americans want a greater degree of fairness, and frankly, I don’t see any other entity capable of enforcing it other than the federal government. If I thought my city council or state senate or the president of my neighborhood association could stand up to BC/BS, I suppose I’d be for “small guvmint” too.

  • Hmmm. Well, one assumes that the stockholders earned the money which they then invested in stock. For stance, if you have a 401k invested in mutual funds, or participate in a pension, which in turn invests in mutual funds, you may well be a stockholder of one or more insurance company.

    I’m curious: What profit margin do you think that the stockholders are currently getting for major insurance companies? What would be a fair profit margin?

  • DarwinCatholic…like the little bunnies analogy, let’s keep the focus on ensuring a certain level of quality health care is available to everyone (especially the workers in the US economy on Main Street, if they still have their jobs), and not go off on a tangent whether stockholders ‘earned’ their berth in the business? Most, if not all Americans contributing to the tax base have ‘earned’ a certain measure of tangible health benefits, that shouldn’t be doled out dependent on the beneficence of the stockholders of health business companies.

Life Under Health Care Reform

Friday, November 13, AD 2009

Time being scarce the last few weeks, I’d originally planned on writing a post of this format about one of the Senate bills, but since the House bill (HR 3962: Affordable Health Care for America Act) is currently the one in the news, I’m focusing on that. The purpose here is to try my best to cut through the hysteria and hype coming from both sides and take a realistic look about what changes we would notice as US citizens if the House health care reform bill becomes law.

The first thing to keep in mind is that nothing much happens until 2013. This could probably called the “keep incumbents from being hurt by this act, especially Obama” provision. Whether the long term effects of the bill are good or bad, change often causes pain and confusion at first, and one of the key ways of getting legislators on board for the bill is to assure them that they’re unlikely to be immediately booted out of office by voters upset about their premiums. This kind of cynicism is hardly unique to this one bill or to either party — it just is what it is. So take the below as a discussion of how thing would be under HR 3962 in the period 5-6 years from now, assuming that is passes and there are no changes made between now and then.

The bill provides several new regulations on insurance companies and on you, which you’ll notice quite clearly.

1) You will be legally required to purchase insurance. If you don’t (and unless you fit criteria for financial hardship as defined in the bill) you will be fined either 2.5% of you income, or the average cost of the plans in the lowest tier of the health insurance exchange. So, if you make 40k/yr, you would be fined $1000. If you make 60k/yr, you would be fined $1500. If you refuse to pay your fines, you’ll be treated exactly like any other tax evader (which means you can potentially be sent to jail.) The Senate bill specifically exempted non-payers from being sent to jail, but the House bill fails to differentiate those who refuse to pay health care fines from those who refuse to pay other taxes, so it is believed that standard tax evasion rules would apply. There will also be penalties placed on employers who do not offer their employees health insurance.

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5 Responses to Life Under Health Care Reform

  • Is it also true that if you have health insurance, but it does not meet the government standard, you are in the same position as if you had no insurance at all? (i.e. buy ‘approved’ insurance or face a fine)?

  • This is great. I can’t wait until 2013 so that the government can make all of these difficult health care and insurance decisions for me. Life is so much simpler when you don’t have to think or be responsible.

    I wish they would do this with my real estate, car, job, spouse, size of family, diet, entertainment and the most difficult choice of all what religion to believe in.

    Maybe we can all finally be happy and peaceful in 2013 since we won’t have to make these hard choices ourselves, eh, comrades?

    And I was told salvation comes from the Jews – turns out it comes from Kenya by way of Hawaii, Chicago and community organizing.

  • Mmm, sure hope there’s a streamlined process for informing on neighbors and family members who resist collectivization.

    /oh wait that will be me

  • I found the answer to my question here:

    “H.R. 3962 provides that an individual (or a husband and wife in the case of a joint return) who does not, at any time during the taxable year, maintain acceptable health insurance coverage for himself or herself and each of his or her qualifying children is subject to an additional tax.”

    Note the word ‘acceptable’. This is bound to be a fluid definition, but there is no end to the goodies that can be hung on this tree. Does your plan cover the full range of infertility treatments, even those you find abhorrent? Does your plan cover treatment for substance abuse as generously as it covers treatment for other illnesses? If not, it may not be ‘acceptable’. Nobody knows yet what ‘acceptable’ means, but these mandates have already shown up in Massachusetts and elsewhere.

    I think this needs some more visibility. Many people will think ‘well, I have health insurance, I think it’s foolish not to, so I don’t have a problem with requiring it’. But the word ‘acceptable’ is a loophole that will strangle us, even those of us who now have very good health insurance.

  • Mike,

    I agree that the “acceptible coverage” provisions will be mis-used, in that I strongly believe they’ll become a way for the insurance companies to lobby congress to require people to buy more expensive (more profitable) coverage levels. However, it should be noted at that this point the bill doesn’t just say “acceptable”, it provides a number of definitions of what constitutes “acceptable” coverage having to do with maximum deductibles, maximum out of pocket payments, procedures covered, etc. Changing these would, to my understanding, have to be done by an act passed by congress amending the original bill. This will, I’m sure, happen often, and it will be a bad thing. But it’s not a open-ended regulatory mandate for harassment by enforcers.

Did Health Care Reform Help Massachusetts?

Thursday, November 5, AD 2009

Ezra Klein has a post up trumpeting a new paper from MIT economist Jon Gruber which purports to show that Massachusetts significantly reduced individual health care premiums through its 2006 health care reform bill — which in many ways was similar to the Democratic proposals currently moving forward in congress. (Needless to say, this would be contrary to what most people who have actually experienced health care in Mass., even this liberal speech writer, have experienced.) However, looking at all the findings is key:

In their December 2007 report, AHIP reported that the average single premium at the end of 2006 for a nongroup product in the United States was $2,613. In a report issued just this week, AHIP found that the average single premium in mid-2009 was $2,985, or a 14 percent increase. That same report presents results for the nongroup markets in a set of states. One of those states is Massachusetts, which passed health-care reform similar to the one contemplated at the federal level in mid-2006. The major aspects of this reform took place in 2007, notably the introduction of large subsidies for low-income populations, a merged nongroup and small group insurance market, and a mandate on individuals to purchase health insurance. And the results have been an enormous reduction in the cost of nongroup insurance in the state: The average individual premium in the state fell from $8,537 at the end of 2006 to $5,143 in mid-2009, a 40 percent reduction, while the rest of the nation was seeing a 14 percent increase.

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6 Responses to Did Health Care Reform Help Massachusetts?

  • We can be virtually certain from these results that the cost of medical coverage will go up significantly under the current Democratic proposals, it’s just a question of how much.

    Depends. It’ll go down for the sick. I’ll go up for the healthy. On average, it’ll go up because more sick people than healthy people will buy insurance. But then guaranteed issue will naturally lead to a mandate. So under the current Democratic proposal, it’s virtually certain that in the long term the cost of medical coverage will not be affected.

  • You’re just pointing out the poor results and insane cost because you want sick people to die!


  • RR,

    I’m not sure I follow your logic. Let’s be simple-minded for a moment and assume that health insurance is subject to the law of supply and demand (ridiculous, I know, but bear with me). A mandate means a increase in the demand for health insurance (since people who wouldn’t otherwise have bought insurance are now forced to do so). Shouldn’t we expect this increase in demand to lead to an increase in the price of insurance?

  • Insurance isn’t like a manufactured product or service with finite supply, in a sense. A company can make only so many widgets; lawyers can only provide X amount of hours per day (theoretically). A health insurer can write as many insurance policies as the law will allow. There may be some regulatory issues wrt reserves and financial health, so that may restrict the supplyside somewhat, but if the Govt wants universal coverage, they will have to allow adjustment for it.

    So, with a potentially unlimited (or near unlimited) supply, an increase in demand should not affect price. Change in risk pool, however, would.

    Oh, and for those who think tort reform will help – Texas has had tort reform for 30 years. One of the larger health insurers (Unicare) is now calling it quits in Texas. So much for tort reform.

  • I’m not sure that increasing the demand would increase the cost of health insurance, since it doesn’t seem to me that coverage itself would necessarily be a supply constrained product. (If this resulted in the total consumption of health care services significantly increasing, which is certainly possible, that might result in a temporary cost of care increase as contrained provider supply resulted in higher prices to slow demand and fund building new infrastructure, training new people, etc.)

    More to the point, though, is this: Unlike the proposals that center around high deductible insurance combined with funded health care spending accounts — the proposals being pushed by the Democrats do nothing to increase price competition among medical providers, and nothing to encourage people to avoid unnecessary treatment.

    That said, it’s main effects will be guaranteeing issue to those with medical problems that current have them outside the individual insurance market and forcing into the market those who are currently staying out voluntarily. (Employer insurance generally doesn’t have this problem, so this is really just an issue for about 10% of Americans.) It will probably do a lot more of the former than the latter, because for people who are being kept out of the insurance market by costs, the fine for not getting health insurance will almost always be a lot less than the amount you’d be required to pay out of pocket for getting health insurance (even after government subsidies.) On top of this, the CBO is projecting that the “public option” will actually cost more than the average individual plan currently does.

  • I do know health care has shown remarkable improvement in Ohio. In no small part, thanks to non-profit health management companies that are serving many many people. Here’s just one.

Republicans Should Find an Approach to 'Universal Health Care' They Like

Thursday, October 1, AD 2009

I’m not sure that I like this line of thinking, but I’m starting to think that it’s true, so I’ll put it out there and see what people make of it in debate.

It’s starting to look fairly certain that while a bill called “health care reform” will pass the congress and be signed some time before the 2010 elections (because the administration needs to sign something, even if it’s a fig leaf that does little and doesn’t go into effect until after 2012) what passes will not in any sense be a “comprehensive” health care reform package. Given the people who would be in charge of designing it if it made it through right now, I think that’s probably a pretty good thing.

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16 Responses to Republicans Should Find an Approach to 'Universal Health Care' They Like

  • One thing’s for sure: We don’t want to follow in Canada’s footsteps!

    Escape to Montana: Canadians Seek a Private Option

    A bipartisan majority of the Senate Finance Committee defeated the health-care “public option” yesterday, though in our view Max Baucus’s bill will still reach the same destination, albeit more slowly. With that in mind, we offer as today’s commentary a cautionary tale from the land of the original public option, Canada…

    Whereas U.S. healthcare is predominantly a private system paid for by private insurers, things in Canada tend toward the other end of the spectrum: A universal, government-funded health system is only beginning to flirt with private-sector medicine.

    Hoping to capitalize on patients who might otherwise go to the U.S. for speedier care, a network of technically illegal private clinics and surgical centers has sprung up in British Columbia, echoing a trend in Quebec. In October, the courts will be asked to decide whether the budding system should be sanctioned. More than 70 private health providers in British Columbia now schedule simple surgeries and tests such as MRIs with waits as short as a week or two, compared with the months it takes for a public surgical suite to become available for nonessential operations.

    ‘What we have in Canada is access to a government, state-mandated wait list,’ said Brian Day, a former Canadian Medical Assn. director who runs a private surgical center in Vancouver. ‘You cannot force a citizen in a free and democratic society to simply wait for healthcare, and outlaw their ability to extricate themselves from a wait list.'”

    In other words, while Congress debates whether to set U.S. medicine on the Canadian path, Canadians are desperately seeking their own private option. At least Ms. Woodkey had the safety valve of Montana and private American medicine. Once Congress passes a form of Medicare for all, with its inevitable government price controls and limits on care, Americans might not be so lucky.

    Let’s hope that by then Canada has expanded its own private option, so Americans will one day be able to visit Alberta for faster, better care. Unless Congress bars that too.


  • I agree completely; this is one of those “like it or not” situations. There needs to be a better alternative to single payer that satisfies social justice and puts out the political fire — much like the graduated out-of-pocket/HSA/universal catastrophic insurance system that some have linked to/written about here.

  • Regardless of what we may think about subsidiarity and the importance of non governmental solutions, it has become fairly clear that the majority of the voting population is willing to consider it a major political issue if some people cannot get or cannot afford health care coverage.

    I used to think this was true, but the recent debate has made me skeptical. Support for universal coverage is, well, universal, but it is also superficial. People are for it, but not if it means they’ll pay even a little bit more in taxes, or premiums, or might lose their current plan. That plus the fact that it’s hard to see how you have a “universal” plan without either a public option or some kind of mandate makes me think that adopting some sort of universal plan would be a bad move for Republicans, at least politically.

  • I take that back. You could have some sort of voucher system, which would be universal. But I don’t really see that happening any time soon.

  • I think that if Republicans want to win on this issue and the opportunity is ripe they need to decouple the two problems we are trying to address.

    1. UNINSURED – those that DO NOT have insurance.

    2. UNINSURABLE – those that cannot qualify for insurance.

    The uninsured don’t have insurance for many, many reasons. The only sub-class that may need true assistance is those who CANNOT AFFORD it becuase they are genuinely poor. $80,000 annual income doesn’t count as poor. I am referring to those who are truly poor becuase they have genuine problems of capacity, skill, ability or other such circumstances beyond their control. This is a small minority and I think we can take care of them personally. That failing, states can solve this problem themselves. Worst case, and I HATE this, the federal government can take care of it – it would cost much, much less for us to provide a tax-break, voucher or other form of paying for private insurance for these individuals who truly CANNOT afford medical insurance.

    The unisurable may need some type of program. It would be helpful if each state had a program to aggregate the risk of uninsured and use private insurance to purchase the coverage for the whole group similar to a large employer purchasing guarnateed issue policies for all employees. The total number of uninsurable is probably less than 5,000,000.

    Other than that promote a free market for innovation, competition, lower prices and access for all. Tort reform so actual negligence and crimainal activities are punished but don’t make it a profit center for attorneys.

    These simple points can be reduced to a 60 second commerical by a good marketing company and produced in a 5 page bill that anyone can digest.

  • Well, if Republicans were as mean as their detractors appear to believe then a Make Democrats Pay For It All plan would be swell.

  • My understanding is that the GOP has been proposing alternatives, but are just not getting airtime.

  • One simple fix would be to make medical expenses and health insurance premiums above the line deductions (if not credits).

    In most communities, $80K does not go far for a family of four, with a kid in college and a less than 2000 sq ft home.

  • The GOP has put out the Patient Choice Act which, despite the rather repulsive name (IMHO), has a fairly interesting set of credits and subsidies to help people go out and get their own coverage. And I agree it’s partly a matter of no one paying any attention to their proposals.

    However, it strikes me that GOP proposals have to an extent been too much aimed at the sort of middle to upper middle class professionals who make up the more active part of the base. The problem, to my mind, is that for a lot of people that wide open a choice doesn’t seem like a solution.

    My fear is that the GOP won’t be seen as offering a solution by the general population unless there’s a fairly simple default option (such as: If you don’t have insurance through your employer you do X and get coverage) even if there are then a fair number of flexible options that one _can_ take advantage of if one has the interest.

    Kind of like how a lot of people actually aren’t comfortable with the idea of retirement accounts instead of standard social security.

  • Darwin,

    I agree that simple and clear is preferable. But then the Democrat’s plan isn’t really a model of clarity, is it?

  • Agreed, and I think that’s why they’ll pretty much die on the vine with this one.

  • Not that I think the Republicans shouldn’t have a concrete counter-proposal, but I can’t help but wonder why they should bother. Honestly, why go through the motions when you know nothing you offer has a chance in hell of being adopted?

    It could be argued that the GOP should take the time to present a more viable option for public consumption. Perhaps. But again, how much does the public really care? If they are upset with or simply don’t like the Democrats’ proposal, then does it really matter politically whether or not the GOP offers a substantive health care plan?

    I repeat, these are mainly political points. I do think that minority parties should formulate concrete ideas and not simply say no to everything.

  • Point of clarification: the “they” being upset being the public at large.

  • Not that I think the Republicans shouldn’t have a concrete counter-proposal, but I can’t help but wonder why they should bother.

    One of the reasons why I happen to disagree with DarwinCatholic insofar as Republicans needing to present an alternative proposal is because of the fact that it is the Democrat-ic administration that is proposing a change in the status quo and, therefore, I would think, the burden falls on them.

    While the status quo itself might seem unacceptable, it doesn’t help at all should the change, such as those that the Democrats at the Hill actually advocate, would result in even worse circumstances, as clearly the case has been for our Canadian neighbors as far as a similarly conceived/implemented national healthcare is concerned.

    It may very well be the case that the status quo is far more preferable than any of the proposals currently in play.

    It would be better for folks to first take the time seriously required (be it months or even years) to formulate something that would be far more superior than those we have now as opposed to having any such plan, regardless of the consequences, put in place simply for the sake of expediency as well as appeasing certain parties.

  • I don’t think there’s any point in putting another proposal forward now, actually. More like the GOP should plan on having a fairly clear proposal to run on in 2010 with the claim, “Democrats said they were going to give us health care reform, but instead they gave us an incredibly expensive boondogle that hardly helps anyone, makes things more complicated and doesn’t even go into effect until 2013. We have a simple, cost effective plan now.”

    Or, indeed, some presidential candidate could make that the theme in 2012, the interest still seemed to be there.

    I don’t think the GOP has to push something now, because it would vanish down a political black hole. It’s more that I think if the GOP is successful in staving off the Dems this time, they need to bring a very solid proposal to the table next time they do end up with a majority (or are trying to get a majority) and get something real done. Otherwise, we’ll end up running this same farce again in 10-12 years just as we did in 93 and 09.

  • Agreed. The GOP can actually out-healthcare the Dems by proposing a market-driven alternative of their own. They have tort reform on their side. Most Republicans already support guaranteed issue. You don’t need a mandate during this round of reform because guaranteed issue will eventually lead to a mandate.

5 Responses to Why Health Care Reform Is Getting Conservative

  • Karlson is right. It is precisely that type of ineffective leftist agit-prop pushing a policy that the majority of Americans do not want that is causing the socialist aspects of ObamaCare to fall by the wayside. Dems who are not lucky enough to run in states or districts where Lenin or Stalin could win if they had a D after their names are beginning to realize they are facing electoral disaster next year. For example incumbent senator Blanche Lincoln of Arkansas is running behind all four of her prospective Republican challengers.

    ObamaCare is about fork ready. On behalf of my fellow Republicans everywhere, I do thank the Obama administration and the Democrats in Congress for pushing this ill-conceived plan that has managed to awake most Americans to the dangers of one party rule in Washington. I have often said that Jimmy Carter created more Republicans than Ronald Reagan ever did, and I do appreciate the efforts of Obama, Pelosi and Reid to outdo Carter’s heroic efforts for the GOP.

  • I’m happy to see the public option getting the treatment it deserves, but it would be nice if conservatives came up with a coherent, alternative plan that addresses the uninsured population (or, at least the segment of it deserving of subsidy/aid).

  • Here is what the Republicans have proposed:

  • j. christian,

    Make sure you do NOT confuse uninsured with uninsurable.

    Uninsured are people who do not have but may access insurance. Some may not be able to afford it; however, that is very few judging by the fact that ‘poor’ in America own a TV, DVD, game console, car, live in a home better than 90% of the planet, etc. Others don’t want insurance becuase they don’t see the benefit, and some other reasons.

    Uninsurable are people with existing health problems that CANNOT get individual medical insurance. That is less than 5 million people. You cannot expect an insurance company to offer coverage for someone who they know WILL make a large claim. That would defy the defenition of insurance, medical or otherwise. Additionally, this is not fair to the insurable in those risk pools.

    I am confident that if we increase American aggregate wealth with lower taxes, less redundant regulation, rational tort reform and eliminate other illicit government intervention, we, as a country can more than afford to provide care for the uninsurable.

    Our responsibility to the less fortunte, in this case, people with health problems, is to choose to take care of them in Charity, Love. Government is force, it cannot be charitable it can only redistribute by force and distort the natural price system in the process, which creates a whole host of other evils.

    Access to health care has nothing to do with medical insurance. Medical insurance is a risk management tool like any other insurance. Health care is not a right either; however, since we have been blessed with a free market (sort of) that has advanced health care so dramatically, we should provide access to everyone — that is done through lower prices, more choices and increased wealth which can be used for charitable purposes. The free market is the best mechanism we know to do that.

    Those are all overwhelmingly genuine conservative values – note, coservative doesn’t mean Republican.

Medical Bankruptcy in Canada

Wednesday, September 16, AD 2009

There’s been a lot of talk about how lack of sufficient health care is a major cause of bankruptcy in the US. Some of this is based on a couple of very bad studies, which essentially assumed that anyone who declared bankruptcy who had any outstanding medical bills at all must have done so because of medical costs, regardless of the relative size of their medical and other debts. But there’s also a legitimate aspect to this, though it doesn’t have to do with medical costs. Bankruptcy is often the result of some sort of unexpected circumstances (lost job, divorce, medical problems) which drastically increases expenses or lowers earnings. Obviously, if you come down with major medical problems, you may well end up earning less regardless of your medical bills, and this can cause bankruptcy.

Illustrating this is a recent study commissioned by the Canadian government investigating the high prevalence of bankrupty among older Canadians. (via Megan McArdle) The finding: medical problems is the number two cause of bankruptcy among Canadians aged 55-65, the group with the greatest propensity to declare bankruptcy. (see pages 18-19)

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2 Responses to Medical Bankruptcy in Canada

  • I have done hundreds of bankruptcies. Most of them had some medical debts on them, but usually they were a small portion of the total debt, the majority of which consisted of credit card debt. I’d say that in only about 3 percent of the cases I’ve handled was medical debt a major factor in the decision to declare bankruptcy.

  • Not knowing many people myself who declared bankruptcy, in the cases in which friends have, it was mostly to lines of credit and credit card debt.

    Not one was due to medical bills.

    Though this is an unscientific poll to say the least.

How To Solve Health Care

Monday, September 14, AD 2009

Pro-life liberal Catholic writer Michael Sean Winters of the National Catholic Reporter argues that because Catholic conservatives find themselves opposed not only to a universal health care bill that funds abortion, but also to the idea of centralized health care in general, they are in fact playing into the hands of the pro-abortion lobby.

It is strange indeed to see conservative Catholics unwittingly aiding and abetting the agenda of the pro-abortion organizations they oppose. And stranger still that conservatives who spent the last election cycle saying that no political issue mattered as much as abortion are suddenly putting their idolatry of the market before adopting a sound strategy for keeping abortion coverage out of the health care reform effort. They have provided ample reason for the administration and Congress to ignore their pleas on abortion. The may see themselves as the “loyal opposition” but they are not being loyal to the pro-life cause they espouse. They are undermining it.

Natlamp73His argument is basically that since health care reform is currently on the table, if conservative pro-lifers do not promise to support it if it doesn’t fund abortion, then they are therefore helping those who want it to fund abortion. I can’t help like feeling that this is a bit like the old National Lampoon cover: “If you don’t buy this magazine, we’ll kill this dog.”

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10 Responses to How To Solve Health Care

  • If I’m not mistaken, I believe we saw the exact same argument (or one fairly close to it) in a comment that was part of the most infamous thread in this blog’s history:

    I’m thinking Mr. Winters and Tony A are sharing notes.

  • I believe I originated the argument. Certainly a person can oppose something for whatever reason they choose. When they claim to be advocates for the unborn or claim abortion is the most important issue, one is compelled to think they are lying when they refuse to participate in a moderate reform effort. It isn’t like we are talking NHS or single payer. Instead of risking a pooch’s life, they are risking the lives of the unborn for a national clearing house and a public provider in inefficient markets; limitations on the ability to use rescission; and prohibiting rating on pre-existing conditions. And this wouldn’t be so bad if at the end of the day they said they couldn’t support a given bill. The big problem is that they have declared that they don’t want to be a part of the negotiations, because they have no intention of supporting any bill. That’s just imprudent, unnecessary, and in the end, stupid.

  • MZ,

    I could see the point if ObamaCare actually contained some sort of positive offer for pro-lifers. For instance, if Obama announced a compromise in which there would be guaranteed issue, subsidies, a mandate, and exchange and a public option — but also threw in a total ban on abortion after 10 weeks, or even a ban on any insurance funding abortion, plus a large tax on abortions — I would feel pretty compelled by the argument that if pro-lifers were serious they had better sign on the line that is dotted. If that offer is put on the table, I’ll almost certainly grit my teeth and support the bill.

    However, in this case, if ObamaCare doesn’t pass, we find ourselves no worse than we are now in regards to abortion. The only “incentive” being offered is that if we play along, maybe, possibly the Democratic majority will agree not to subsidize abortion in a way that it never has been before.

    In that sense, I think the gun to the pooch’s head is pretty accurate. “Help us pass our bill which you don’t like regardless, or else we’ll do something you’ll really hate.” For Winters’ argument to hold any water, there would have to be something positive for pro-life conservatives in the bill.

    As for sitting the whole thing out — I’d be happy to be a very active partisan for a bill that bore some resemblance to one of the suggests I listed above, or something else I haven’t thought of if I didn’t think (as I do of the current effort) that it will achieve almost nothing (or perhaps actual detriment) at great cost.

  • I guess Democrats ought to just include a provision in every bill providing tax funding for abortion. Then pro-lifers would always be obligated to support the bill in question so long as the funding provision is taken out.

  • I realize health care coverage isn’t considered by you to be a positive. Our bishops happen to think differently.

  • I never claimed pro-lifers were obligated to support any bill. I claimed they were imprudent for abstaining from the debate process.

  • I realize health care coverage isn’t considered by you to be a positive. Our bishops happen to think differently.

    Actually, I do consider it to be a positive — it’s just that I don’t think the major Democratic bills currently on offer would provide much of it. I’d be very strongly in favor of any one of the approaches I listed above to health care coverage.

    I never claimed pro-lifers were obligated to support any bill. I claimed they were imprudent for abstaining from the debate process.

    See, I don’t get the impression that the majority is interested in much actual debate from their conservative opponents. They’d like to guilt-trip conservatives into signing on to the bill basically as-is, with perhaps a very few changes. But when it comes to actual debate on how its best for our health care system to work, there’s little up for negotiation.

    In this sense, I think that defeating the current set of bills would actually be a pretty good start to getting some real debate going. And since the current plans are designed not to help anyone till after the 2012 election, we appear to have plenty of time to discuss things without causing additional harm.

  • Exactly, Darwin. The Democrats could have at least tried to make this a truly bipartisan effort at compromise by including some things the other side could hang their hats on. The inclusion of Hyde Amendment language and major, far-reaching medical malpractice tort reform would have gone a long way toward moving the health care agenda forward.

    The Democrats are the majority party, however, and if they feel that they can get the bill passed without an olive branch or two to the other side, that’s their perogative. But I don’t think I’m obligated, then, to sign on in the faint hope that I might be able to maintain the status quo on federal funding for abortion.

  • I have quit listening to Winters advice on this since he proclaimed as long as their is no abortion in it the bill is fine because it redistrubtes wealth. Which I am not sure is the whole purpose of reforming Health Care

  • I enjoy reading MZ’s arguments.

    It makes me feel better about myself and my sanity.

    Anytime I poke my eye with a pencil or dislodge my left knee I just have to read his posts and suddenly I have this feeling of calmness and serenity.

    Knowing that my problems pale in comparison to those with poor logic and reasoning.

    This makes me put things in perspective that yes, this to shall pass, but MZ’s analysis will always be there for comfort.

    Life is good.

Health Care Now

Thursday, September 10, AD 2009

Blackadder pointed out elsewhere that for all of the insistence that people cannot wait and absolutely need reform right now in order to alleviate the suffering of the uninsured, the health care bills currently under consideration are designed not to begin to go into effect until 2013, conveniently after the next presidential election. It is, I’m sure, a matter of opinion whether this is a cynical political attempt to avoid the consequences of people actually experiencing one’s health care reforms, or if its the necessary time to enact all 1100+ pages of regulations in the current plan. Either way, perhaps there’s a better way if people are really serious about helping people quickly and avoiding partisanship.

By most counts, there are actually around 12-15 million Americans who are uninsured for more than a few months, do not have the financial ability to buy their own insurance (make less than 75k), are legal residents, etc. This 12-15 million includes some people who are simply poor and can’t afford insurance (perhaps it’s not provided by their employers, or perhaps they’re unemployed) and others who are middle class (but without employer coverage) and have medical conditions which make it impossible to get individual health care insurance.

Let’s assume it’s 15 million. If we also assume that they’re fairly expensive to insure ($5000/person/year) the cost of simply paying to buy them all private insurance would be $75 billion per year, or $750B over ten years — actually less than the estimated cost of the current health care reform bill. (Heck, you could pay for the first 4-5 years by canceling all stimulus spending which is not scheduled to happen until after 1-1-2010.)

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13 Responses to Health Care Now

  • 12-15 million is the conservative estimate put out by the Republican Policy Committee. The real number could be as high as 30 million (the number that Obama is using to come to his $900 billion estimate). BTW, it says something about Republicans when they count ALL non-citizens are ineligible, not just illegal immigrants.

  • But Obama’s 30 million number includes a large number of people who either already qualify for government health care but haven’t applied for it, and also a large number who can clearly afford health care but have not chosne to purchase it.

  • Great point Darwin

    I have been thinking the same thin. I am baffles why we have to redo the entire system

  • Now Obama says 30 million. Wasn’t he stating the number was 47 million a few months ago? What happened to those 17 million?

  • Donna,

    The 30 million number is for citizens. 47 million includes illegal immigrants and other non-citizen residents.

  • I may have been off in that, in that I hadn’t realized that the bridge down to ~15M involved excluding legal non-citizen residents, which seems a fairly unjust move.

    Still, the point is not so much that I think we should do what’s described above (which is intentionally overly simplistic) but that the claim that we absolutely can’t possibly no matter what we do provide anything to anyone in less than four years is ludicrous on the face of it. (For instance, England’s transition to the fully government run NHS took only two years 46-48.) If one does, as many advocates claim to, really believe that it’s an absolute humanitarian necessity to have “health care now” then Obama’s plan of not even starting to implement his solution until 2013 should seem totally unacceptable. Such an approach may maximize Obama’s time in office, but it cannot possibly be seen as an approach designed to maximize help to those without insurance.

    If advocates are comfortable admitting that “solving” health care is not all that urgent to them, while getting the government camel’s nose into the tent of a major industry (and having the political stick of “they’re going to take your health care away” to wave at their opponents for the next fifty years) is, then at least we could go on to have an honest debate without all this “there is not time for debate” nonsense.

  • I may have been off in that, in that I hadn’t realized that the bridge down to ~15M involved excluding legal non-citizen residents,

    I don’t think there are 15 million uninsured legal non-citizens. I don’t even know that there are 15 million legal non-citizens in the US.

    Whatever the numbers, your point stands. The calls for immediate action NOW OR ELSE don’t square with reality.

  • Conservative numbers put it at roughly 12 million.

    Some are backing off that number now that it does influence the numbers one reports for the Health Care debate.

    Some have put the number as high as 25 million.

    Hard to quantify a group exactly that may not want to report itself given that they are here against current laws.

  • Oops, read that wrong. The number I put up was for illegal immigration.

  • I don’t think there are 15 million uninsured legal non-citizens. I don’t even know that there are 15 million legal non-citizens in the US.

    I think the case of legal non-citizens is difficult because many of them are sponsored. Their sponsor is financially responsible for them, and would (at least in theory) have to pay their medical bills if they do not secure insurance and cannot pay. As one of those non-citizens, I think it’s perfectly reasonable that the nation should expect us to be financially responsible for ourselves.

  • Here’s an article from Hot Air that digs into the numbers.

    Here’s the key graph as relates to the last few comments:

    Of particular interest is the citizenship/resident category. Foreign-born residents comprise 12.3 million of the uninsured, with only 2.8 million of those naturalized citizens. That leaves 9.5 million non-citizens in the count. The Census Bureau refuses to categorize on their legal residency status, which means that legal and illegal immigrants get counted in this total. Last year, estimates put the number of illegal aliens in this category as 5.6 million out of a total of 9.7 million. Even if we attribute the entire 200K reduction in this category to illegal immigrants leaving the US (as opposed to legal immigrants leaving or illegal immigrants getting insured), it still leaves 5.4 million illegals as part of the overall uninsured number.

  • Well, we’ve gone several hundred years without universal coverage, why is it necessary for us to have it right now with no serious examination?

  • I think the case of legal non-citizens is difficult because many of them are sponsored. Their sponsor is financially responsible for them, and would (at least in theory) have to pay their medical bills if they do not secure insurance and cannot pay. As one of those non-citizens, I think it’s perfectly reasonable that the nation should expect us to be financially responsible for ourselves.

    And many, if not most, of the legal non-citizens who are sponsored do have insurance. But millions do not. They pay all the taxes that citizens pay and should receive all the benefits. The Constitution requires it. 14th Amendment’s Equal Protection applies to all persons, regardless of alienage (see Graham v. Richardson).

    Obama’s 30 million probably excludes illegal immigrants and I don’t know who else. It’s a mystery.

Bad Luck vs. Bad Design

Tuesday, September 8, AD 2009

In a post on the topic of health care rationing (responding to a progressive post which argued that denying care to people unlikely to see much return was one of the benefits of a centralized health system) Megan McArdle of The Atlantic makes the following observation:

There’s another intuition that at least libertarians have, which is that it is not as bad to have undesirable things result from an impersonal process than from an active decision. It is bad if someone’s house burns down and they couldn’t afford insurance. It’s worse if someone’s house burns down, and they were in the class of people deemed unworthy by a bureaucrat of having their house rebuilt.

I think almost all progressives have the opposite intuition. They think it’s better to try to produce an optimal result, even if that results in individual injustices (which it will–government rules are very broad brush, and will always involve error at the margins). I’m not sure how to bridge that intuitive gap.

It strikes me this is indeed one of the determining differences between those skeptical of and those confident in the ability of a centralized beaurocracy to actually improve the administration of health care (as opposed to its availability, which obviously could be improved simply by throwing enough money around.)

Given the range of viewpoints found around here, I’m curious what others think of this. Is this indeed one of the major dividing lines between progressive and libertarian/conservative viewpoints?

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8 Responses to Bad Luck vs. Bad Design

  • I think you (and Ms. McArdle) are on to something here. This is a cultural issue of a completely different kind than the culture wars. The political scientist Daniel Elazer ( has argued there are three political cultures in the US: traditionalist, moralistic, and individualistic. Although they intermingle throughout the country, the first is predominately in the South, the second in New England and the Upper Midwest, and the third in the West, the Heartland (MO through OH), and Mid-Atlantic (although it also finds plenty of adherence in the South and elsewhere. The moralistic political culture sees politics as a (the?) proper arena for addressing the common good and good governance issues are very important to it. People from this political culture are more likely to see the problems that arise from government actions as temporary and fixable (rather than inherent bugs in the system), and thus less problematic.

  • Those who adopt this libertarian positions are simply ideologues. Government is bad so it can’t do any good, case closed. I prefer to let the evidence speak. And the evidence tells me that single-payer healthcare gets you the best all round result of universal coverage and efficiency (health outcomes by cost). Given the record of the so-called communist countries in the 20th century, I’m also fully aware of the evidence that suggests that governments do an appalling job running many businesses. So instead of screaming “socialism” like an ideologue, it would be better to actually peruse the evidence.

  • Huh?

    MM, did you even read the piece, or did you paste in some boilerplate? Topic is not whether single payer is better or not, but rather whether it is a greater injustice if someone doesn’t have the ability to pay for something they want, versus they are actively denied something they want because it has been determined that it doesn’t fit cost benefit analysis.

    Nor is McArdle making the question up — the question arises based on her ongoing debates with several thoughtful progressive bloggers who are themselves in favor of health care reform. If you’d like to follow that laudable example by engaging in rational discussion, do feel free.

  • If you want to get pissy, Darwin, that’s your prerogative. But you should recall that McArdle is a libertarian, which means she holds (as a matter of ideology) positions about the relative roles of the free market and the government that do not gel with Catholic social teaching. Engage her all you wish, but let’s not beat around the bush here.

    She talks about a government bureacracy making a healthcare decision to deny treatment. She fails to note that this is what the current US private system does as a matter of course (especially those who are not protected by the meager protections of the employer insurance system). It’s the ideology, stupid.

  • It would be nice, MM, if you gave Ms. McArdle and/or Darwin the courtesy of reading the post before saying stuff like “X is a libertarian, and libertarians are idealogues who reject Catholic Social Teaching; ergo, I don’t need to respond to anything they write.”

    If, as your rantings writings suggest, you cannot appreciate the idea that people have good faith differences of opinion about how to best achieve the common good – and that these differences of opinion can be based on legitimate moral intuitions – then there is little reason to take your arguments from ignorance seriously. Thus far, you haven’t even commented on the subject of the post, or even written anything that suggests an awareness of what the post was about.

    I have little sympathy for libertarians in general, but I think the post raises an interesting question, even if I would frame it differently. I think it’s more accurate to describe the first system as a situation in which the people and their elected representatives have decided that the state will not intervene to help people, and the result will be that the poor are systematically disadvantaged. I think that may be acceptable for home insurance, where risks are relatively low, but unacceptable for a basic right like health care. In the second situation, the people and their elective representatives have evaluated the relevant trade-offs and have made some attempt to prevent the burden from falling simply on those who are already less fortunate. Both are deliberate decisions about the role of the state; neither is purely impersonal. I favor the second situation over the first, simply because I think it better reflects the preferential option for the poor. I don’t deny, though, that there are good reasons to be skeptical of the model of the benevolent bureaucrat; there are trade-offs here as in every contested area of public policy (that’s why they are contested).

  • …I can think of only one response to MM:
    Chewbacca lives on Endor!

    (to my horror, neither “Chewbacca” nor “Endor” were in my spell-check….)

  • While I’m not sure if there’s any point in attempting to spoon feed debate to someone, I’m mildly curious as to the result:


    Would you see any difference in morality and/or justice between these two situations:

    1) I am unable to afford medical coverage which would have provided unlimited chemo treatments in the event of pancreatic cancer, and so when I come down with it, I get several of the standard treatments that often work (but don’t in my case) but am not able to get a very expensive, experimental treatment which had a 5% chance of helping me.

    2) A centralized government authority in a single payer country determines that cancer treatments with less than a 5% chance of success should never be funded period.

    My guess is that you’d see no difference between these two situations, since I’d guess you’d take an “outcome based morality” approach to the situation and say that it really doesn’t matter why someone was denied, they result is the same.

    However, I think for many people there would be a significant perceived difference between the two situations (though this might not be the case if the person had not realized that their insurance didn’t cover certain types of very expensive care — thus giving them a similar sense to the government situation.)

  • Why bother, Darwin? It’s like trying to point out the forest through the trees. There was nothing ambiguous about the subject or purpose of the post. My guess is that if someone who didn’t identify themselves with a suspect school of thought offered the same observation it would have been welcomed and proudly accepted by MM. He’s made it clear that he’s okay with the rationing of care, he just think it’s the role of the government to do it, rather than your pocketbook. It’s a fair question to ask, I just don’t think the former method is baptized in CST, as some would have us believe. Still waiting for a just and sensible third way to be offered…