rationing

The healthcare bill is on the verge of passing the Senate, despite the fact that it has received a failing grade from healthcare experts like the Dean of Harvard Medical School, and the fact that it will increase taxes, deficits, and medical costs, while reducing lifesaving medical innovations.

In a 60-to-39 vote, Senators voted to quash a Republican filibuster, moving it closer to a final vote where it will need the votes of only 51 of the Senate’s 60 Democrats to pass it (60 votes are needed to stop a filibuster). The vote was along strict party lines: all 60 Democrats voted to advance the bill.

Senate Majority Leader Harry Reid (D-Nev.) lined up the 60 votes through payoffs to wavering Senators and left-wing unions (some mismanaged unions will receive a taxpayer bailout of their health plans, to the tune of up to $10 billion).

The Dean of Harvard Medical School recently gave Obama’s healthcare plan a “failing grade,” saying it will harm America’s health and finances, and hamper medical innovations needed to save patients’ lives.  Dean Jeffrey S. Flier wrote in the Wall Street Journal that along “with dozens of health-care leaders and economists,” he had concluded that the bill “will markedly accelerate national health-care spending,” would harm care “by overregulating the health-care system in the service of special interests such as insurance companies,” and would reduce “our capacity to innovate and develop new therapies” that save lives.

Other experts agree.  The health-care “reform” bill backed by President Obama “would reduce senior care,” increase “medical costs,”  and “could jeopardize access to care for millions,” report health care experts at the federal Centers for Medicare and Medicaid Services.   It is one of the most expensive bills of all time.  The House recently passed a similar bill by the razor-thin margin of 220 to 215.

The bill will raise taxes on the middle class.  It will increase taxes on individuals, employers, and hospitals, impose new taxes on medical devices and cosmetic surgery, and levy a 40% tax on health-care plans above $8,500.  It will increase the deficit, and cost taxpayers at least twice as much as predicted.

It contains special-interest pork, such as payoffs for trial lawyers, and racial preferences that drew criticism from the U.S. Commission on Civil Rights. The bill restricts national competition in health insurance, which is permitted in countries with cheaper health care.

ObamaCare spends money on frills like “cultural competency,” while cutting spending on crucial things like anesthesia.

“ObamaCare is all about rationing,” and tax increases, says one of Obama’s own economic advisers, Martin Feldstein.

Fact-checkers say Obama is lying about health care. Obama often contradicts himself. In the very same speech, Obama claimed that Medicare is “unsustainable” and “running out of money,” then contradicted himself by claiming that “Medicare is a government program that works really well,” making it a model for national health care.

CNN noted that Obama’s plan would take away “5 freedoms,” contradicting Obama’s claim that the bill will leave you free to choose your doctor and keep your healthcare plan without government interference.

The bill does nothing to curb massive waste and fraud in existing government healthcare systems like Medicare and Medicaid, even though it proposes to make massive cuts in Medicare (cuts so painful that most of them will never happen: year after year, Congress waives “the annual cut in fees paid by Medicare to physicians” mandated by an earlier law.  The cuts were added to the bill only to reduce its apparent cost.  As economist and former Congressional Budget Office director Douglas Holtz-Eakin notes in the Wall Street Journal, the promised cuts to pay for ObamaCare will not happen: “Senate Democrats chose to ignore this reality and rely on the promise of a cut to make their bill add up. Taking note of this fact . . . destroys any pretense of budget balance.”)

Backers of ObamaCare have refused to cut medical costs through malpractice reform, with Senate Majority Leader Harry Reid saying that such reforms would save “only” $54 billion.  The Pacific Research Institute estimates that just one type of cost that could be reduced through malpractice-lawsuit reform — defensive medicine — costs around $200 billion annually (which is almost as much as France spends annually on healthcare for all of its citizens; like most countries, France has no punitive damages, and fewer lawsuits against doctors).

One reform opposed by the Democrats — setting up specialized health tribunals to hear malpractice cases — would be particularly helpful. Replacing uninformed juries with specialized health courts would provide more consistent rulings from case to case, eliminate meritless cases, reduce defensive medicine, and more speedily compensate injured people who truly are victimized by doctors’ carelessness. Such tribunals already exist in countries like “Sweden, Denmark, Finland, Iceland and New Zealand.”

Martin Feldstein, one of Obama’s own advisors, has said that Obama’s health-care plan would explode the federal budget deficit and lead to “crippling deficits,” as well as “higher taxes, debt payments, and interest rates” that would cut America’s standard of living. Feldstein also noted that Obama’s health-care plan would harm people with insurance, and predicted that it would lead to massive tax increases. Other analysts have predicted that it will drive up medical costs and inflation.

Obama is relying on $2 trillion in imaginary savings to pay for his health care plan. He is also relying on tax increases, which breaks Obama’s campaign promise not to raise taxes on the middle class.  Obama’s support for the bill, which will massively increase the deficit in the future, also breaks his promise not to sign a healthcare bill that adds even “one dime” to the deficit, now or in the future.

The healthcare “reform” bill backed by Obama “would reduce senior care,” and “could jeopardize access to care for millions,” report healthcare experts at the federal Centers for Medicare and Medicaid Services. The bill also “increases medical costs” through inflation, increasing health-care costs to 21.1 percent of GDP by 2019.

The House of Representatives recently passed the bill by a vote of 220 to 215.

According to the federal experts, the bill would likely either cost much more than projected, or result in some “hospitals and nursing homes” deciding to ”stop taking Medicare altogether,” notes the Washington Post.

The bill will increase taxes to “European levels of taxation,” while failing to provide European-style universal coverage.  It will vastly increase the costs of our health care system, rather than reducing it to European levels.   It reinforces foolish restrictions on national competition in health insurance, which do not exist in Europe.

Doctors afraid of being wrongly sued for malpractice despite providing good quality care order unnecessary tests (or defensive medicine), which wastes at least $200 billion annually. That’s nearly as much money as France spends on health-care for all its citizens.  The bill does nothing to reduce such costs, ignoring lessons from Europe.  (Many European countries have specialized health courts, rather than American-style jury trials, to cut lawyers’ bills, speedily compensate the injured, and prevent American-style baseless lawsuits against doctors.)

In European countries like France, doctors don’t need to be paid as much, because competing professions, like lawyers, are paid less.  European law is generally much more conservative than American law when it comes to lawsuits, including lawsuits against doctors.  Punitive damages are generally forbidden, and lawsuits are discouraged by making unsuccessful plaintiffs pay the other side’s legal bills.

The health-care bills backed by Obama also contain lots of waste and subsidies for politically-correct things like “cultural competency,” while cutting spending on crucial things like anesthesia.

Obama’s proposals contain provisions that he falsely claims will cut costs, but which actually exploded costs when tried by state governments.

Some of the consequences of increasing government’s role in health care are easy to predict. One is that cutting costs requires cutting the amount of care. That means rationing. People judged not deserving of care would be denied it.

Another is that if government uses its increased bargaining power to lower drug prices, there will be less money for R&D. That means less innovation. That could well mean the end of increasing life expectancies.

Some people see these consequences and oppose more government in health care (I refuse to call President Obama and Congress’ proposal a reform; that word implies improvement). Others see those same consequences as reasons for supporting proposed legislation.

Today’s issue of OpinionJournal’s Political Diary (requires paid subscription) shows that Robert Reich, who supports government-run health care, realizes its effects on rationing and innovation, supports it anyway, and said so in a public speech at UC Berkeley in 2007.

Mr. Reich told the Berkeley youngsters: “You — particularly you young people, particularly you young healthy people — you’re going to have to pay more. And by the way, if you’re very old, we’re not going to give you all that technology and all those drugs for the last couple of years of your life to keep you maybe going for another couple of months. It’s too expensive . . . so we’re going to let you die’”

Reich goes on:

“I’m going to use the bargaining leverage of the federal government in terms of Medicare, Medicaid — we already have a lot of bargaining leverage — to force drug companies and insurance companies and medical suppliers to reduce their costs. What that means, less innovation and that means less new products and less new drugs on the market which means you are probably not going to live much longer than your parents.”

Whether you support more government in health care or not is up to you. But it is not disputable that those consequences exist. They should be factored into your opinion. Supporters of proposed legislation should acknowledge the effects of their ideas. Instead, they usually run away from them.

Kudos to Robert Reich for the intellectual honesty he displayed in his speech. More, please.

ObamaCare is all about rationing,” says one of Obama’s own advisers, Martin Feldstein. Feldstein earlier noted that Obama’s health-care plan would harm people with insurance, and massively raise taxes.

Civil-libertarian and former ACLU board member Nat Hentoff says that after reading Obama’s health-care plan, he was more scared of the Obama Administration than any other Administration he’s lived under. (In 1995, Hentoff received the National Press Foundation’s Award for lifetime distinguished contributions to journalism).

Legal experts and the U.S. Commission on Civil Rights have questioned the constitutionality of major provisions of ObamaCare.

Fact-checkers say Obama is lying about health-care. The Washington Post recently debunked his claim that you can keep your doctor and health-care plan if you want to under ObamaCare.

Feldstein, a Harvard professor, warns that “For the 85 percent of Americans who already have health insurance, the Obama health plan is bad news. It means higher taxes, less health care and no protection if they lose their current insurance because of unemployment or early retirement.” Obama’s plan would “cost more than $1 trillion,” and raise the top federal “income-tax rate from 35 percent today to more than 45 percent,” he notes.

Obama is ignoring lessons from overseas on how to make health care cheaper.

As CNN earlier noted, Obama’s plan would take away “5 freedoms,” including the freedom to choose your doctors, the freedom to choose what’s in your plan, the freedom to keep your existing plan, the freedom to be rewarded for healthy living, and the freedom to choose high-deductible coverage.

Earlier, we described how Obama’s health-care plan would destroy many affordable health-care plans, raise taxes on the middle class, and break Obama’s campaign promises, as well as his recent pledge that “if you like your health care plan, you can keep it.”

House Speaker Nancy Pelosi wants to rush the health-care bill through Congress before most people can even figure out what’s in the bill. That’s how she pushed through Congress the $800 billion stimulus package, which contained hidden provisions that ended welfare reform, and which is now projected to cut the size of the economy “in the long run.” (The stimulus package was supposed to deliver a short-run “jolt” that would quickly lift the economy, but unemployment rose rapidly after its passage, and the package has actually destroyed thousands of jobs in America’s export sector, as well as subsidizing welfare and waste.)

Obama’s planned tax-increases on some health-insurance plans, and abandonment of his campaign pledges about health-care, are part of a long line of broken promises by Obama, such as his pledge to enact a “net spending cut,” which he broke in a big way with proposed budgets that will explode the national debt through $9.3 trillion in massively increased deficit spending.

Health-care experts and critics of the Administration say that Obama’s top health care adviser and his first nominee to head the Department of Health and Human Services have advocated denying medical care to certain elderly and disabled people.

Today, Reps. Henry Waxman (D-CA) and Ed Markey (D-MA) released a new 932-page version of their cap-and-trade bill and a summary explaining how emission allowances will be allocated.

President Obama had campaigned on a cap-and-trade plan in which 100% of the emission allowances would be auctioned. His FY 2010 Budget also calls for a 100% auction system (pp. 21 and 100), generating anywhere from $646 billion to nearly $2 trillion in revenues over ten years.

Of course, the last thing companies subject to emission caps want to do is pay $646 billion or more for the right to produce or use energy. So U.S. CAP, the main corporate lobby for cap-and-trade, lobbied for a system with mostly free rationing coupons, and that’s what they got.

Under the revised Waxman-Markey bill, from 2012 through 2025, the electricity sector will receive 35% of the allowances gratis and natural gas distribution companies will receive 9%, with free distributions phasing out from 2026 through 2030. In all, 85% of the rationing coupons are allocated free-of-charge to industry and other interests.

The bill instructs gas and electric utilities to use the free allocations to “protect consumers” from ”price increases.” This is odd. The whole point of cap-and-trade is to raise energy prices. As candidate Obama said in a moment of candor, electricity prices will “necessarily skyrocket.” That’s how cap-and-trade discourages consumption, which reduces emissions. It’s also how cap-and-trade rigs the market in favor of non-carbon energy, which also supposedly reduces emissions.

Perhaps what Waxman and Markey mean is that U.S. utilities will not be allowed to double-dip as European utilities did in Europe’s Emission Trading System (ETS). European utilities got emission allowances for free but claimed them as an expense and then passed the imaginary costs on to customers by raising electric rates (see pages 43-46 of Open Europe’s report on the ETS).

Does this mean Waxman-Markey would not have severe economic impacts of the sort the Heritage Foundation projects in its May 13, 2009 study? No!

The Heritage study estimates that by 2035, the Waxman-Markey cap-and-trade plan will:

  • Reduce aggregate gross domestic product (GDP) by $7.4 trillion,
  • Destroy 844,000 jobs on average, with peak years seeing unemployment rise by over 1,900,000 jobs,
  • Raise electricity rates 90 percent after adjusting for inflation,
  • Raise inflation-adjusted gasoline prices by 74 percent,
  • Raise residential natural gas prices by 55 percent,
  • Raise an average family’s annual energy bill by $1,500, and
  • Increase inflation-adjusted federal debt by 29 percent, or $33,400 additional federal debt per person, again after adjusting for inflation.

The Heritage folks are undoubtedly going to re-crunch the numbers in light of changes made to the bill.

However, the big picture should not change just because Waxman and Markey have decided to distribute 85% of the ration coupons free-of-charge. What chiefly determines any cap-and-trade scheme’s macro-economic and energy price impacts are the stringency of the caps, not how allowances are distributed under the caps.

As the caps tighten, the number of ration coupons declines, and so does the supply of carbon-based energy. As the supply falls relative to demand, energy prices increase, which then reduces economic output and employment.

So don’t be fooled! Electricity and fuel prices will reflect allowance prices, which will be determined by supply and demand, not by whether the allowance was initially auctioned or handed out for free. Think of it this way. The price at which a scalper can sell Super Bowl tickets outside the stadium is the same whether he buys the tickets himself or finds them on the ground.

It is therefore noteworthy that although the caps are identical in both versions of the bill from 2030 through 2050, the caps are generally less restrictive in the revised bill from 2012 through 2029. For example, the original version caps 2020 emissions at 4,873 million metric tons, the revised version at 5,056 mmt. 

I’m counting on our friends at Heritage to explain what these changes mean in terms of jobs, energy prices, and GDP. Once thing is certain. The bill is still a de facto energy tax; and if enacted, it will still be the biggest tax hike in American history.