November 8, 2009

An Even Bigger Bomb

Justin Katz

As much as it's more pleasant to spend Sunday morning talking about our near neighbors' building bombs, moral obligation requires us to note that, by a margin of five votes (out of 435), the House of Representatives passed an even larger bomb, in the night, one that is certain to destroy our nation:

In a victory for President Barack Obama, the Democratic-controlled House narrowly passed landmark health care legislation Saturday night to expand coverage to tens of millions who lack it and place tough new restrictions on the insurance industry. Republican opposition was nearly unanimous.

The 220-215 vote cleared the way for the Senate to begin debate on the issue that has come to overshadow all others in Congress.

A triumphant Speaker Nancy Pelosi likened the legislation to the passage of Social Security in 1935 and Medicare 30 years later. ...

The legislation would require most Americans to carry insurance and provide federal subsidies to those who otherwise could not afford it. Large companies would have to offer coverage to their employees. Both consumers and companies would be slapped with penalties if they defied the government's mandates.

There is no way that would-be nanny state totalitarians will be able to resist the temptation that this represents, or that our economy will survive it. It's times like this that I'm grateful that life forced me to learn a practical, hands-on trade.

We can only hope the behemoth collapses in the Senate.

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Don't worry. That profile in (lack of) courage Harry Reid will make sure it dies.

Posted by: rhody at November 8, 2009 10:52 AM

"So this is how liberty dies... with thunderous applause." - Star Wars Episode III

Posted by: Dan at November 8, 2009 11:13 AM

Did anyone see patches at Pelosi's press conference after the vote? Not only did he look like he just bumped some lines of oxy in the bathroom but he was humiliated by offering some guy a handshake only to get ignored. It was pretty funny watching it live. Patches always is ready and willing to show himself for the joke he is

Posted by: steadman at November 8, 2009 11:46 AM

I think it is time to ask ourselves a serious question, "how much are we prepared to tax unborn generations to prolong our own lives"?

If the answer is in the affirmative I would ask how much you would tax for an additional day, week, 30 days, 6 months?

I have known people to refuse additional care so as not to drain the resources of their progeny. Is this rational and thoughtful?

I think this is a question such as treatment of illegal immigrants, more easily thought of at some remove. What would you think of a cousin who squatted in your living room with his family and then demanded to be fed and clothed, in exchange for which he would mow the lawn? I suppose that question is somewhat dependent on the size of your lawn.

Posted by: Warrington Faust at November 8, 2009 12:08 PM


Don't you think this sentence is a bit much: "the House of Representatives passed an even larger bomb, in the night, one that is certain to destroy our nation"

Last time I checked, publicly provided healthcare - whether in the form of basic coverage with an add on private option, or full coverage -- hasn't destroyed the UK, nor Australia, nor Canada. Nor do you hear many complaints about today's VA, nor about Kaiser -- U.S. models that the national health plans in the 3 aforementioned nations have extensively benchmarked and copied.

I don't think you'd find many U.S. CEOs and CFOs who won't cheer some relief from the incessant, much higher than inflation, increases in employee healthcare costs, and a change in focus to preserving wellness rather than simply racking up fees for ordering up lots of tests once someone becomes sick.

And if the existence of a public option brings to an end the reduction in labor mobility and entrepreneurship caused by the abject fear of losing one's job and health coverage, or coming down with a "pre-existing condition", then I cannot help but believe that the impact on US productivity growth -- the key to growing out of our larger national debt load -- will only be positive.

In sum, step back from your ideological blinders on this one, and consider the practical benefits of (finally) making a significant change to a U.S. healthcare system that has clearly delivered worse performance than those in many other developed countries.

Posted by: John at November 8, 2009 4:31 PM

The State of Hawaii is the only state allowed to opt out of H.R. 3962, the Affordable Health Care for America Act.

That is because the state enacted a strict healthcare reform act of its own many years ago requiring business to provide healthcare insurance to anyone working 20 hour or more a week.

The state is the closest to providing universal healthcare to the total state population and is the only state where about 96% of total population is covered by healthcare insurance.

Getting medical services, seeing doctors and dentist in Hawaii is very easy and not costly and there are plenty of preventative medicine checkups.

Posted by: Ken at November 8, 2009 4:42 PM


So the VA is an adequate model to predict the outcome of nationalizing all healthcare in the United States? Even international examples don't suffice, not the least because there will no longer be a U.S. giant out there doing things differently. And that's even before we bring up social workers' apparent right, in the UK, to take away parents' newborn babies because mom and dad are overweight.

Look, reform is clearly needed, especially reform that separates healthcare from the workplace, but this version goes in wholly the wrong direction. The only way the Democrats' plan will lower the cost of healthcare for employers is if the employers push all of their employees onto the government plan, which the government will have to fund through taxes of one form or another.

There won't be entrepreneurship if the burden of funding government programs makes restricted profits not worth the extra work and risk involved.

Change for change's sake is not necessarily a positive development. A sick man can take a turn for the worse as well as for the better. If the exchange were freedom for security then it might be defensible, but my suspicion is that, in making the deal, we'll end up with neither.

I do hope I'm wrong, but if this beast of a government program, which will fundamentally change the relationship of Americans to their government to an extent never before achieved, passes on the basis of wishful thinking and a desire for something else... anything else... I fully expect the American experiment to move rapidly toward failure.

Posted by: Justin Katz at November 8, 2009 4:57 PM

Be at the Providence Marriott Monday at 8:00am to let Senator Whitehouse know that we oppose government takeover of 1/6th of our economy. Go to work an hour late. Time to step it up.

Posted by: MadMom at November 8, 2009 5:01 PM

Let's talk about the VA. It has been some years since any close association and I don't wish to be thought of as speaking poorly of injured veterans.

For many years the VA couldn't attract really qualified doctors because the pay was miserably low (is this a precursor of the future?). Maintenance was abyssmally poor and the staffs would organize rat patrols (the same was true of Boston City Hospital, now taken over by a university and renamed). Most of the staff saw themselves as caregivers to homeless alcoholics. Veterans who had health insurance went elsewhere.

VA also had an "opt out" plan. If a patient required treatment that they couldn't provide, the patient woould be sent to a private hospital.

Admittedly, my "experience" comes from dating a few of the female docs there, but there it is.

I have been in government operated nursing homes, they stink of urine and the patients have bed sores the size of pancakes. Please, let me go in my sleep.

Posted by: Warrington Faust at November 8, 2009 5:27 PM

Warrington-let me correct your impression.
Even though I have insurance as a federal retiree(I mainly carry it for my wife)I only use it for eye care because I've had the same eye doctor for 14 years and I'm diabetic so continuity is good and he is very knowledgeable about treating diabetics.
The VA is the best medical care I have ever gotten.The doctors are top notch-the Providence VAMC is a teaching hospital for Brown Med school and the specialists are all clinical professors there.The residents,interns,and students are uniformly high quality people.The para professional staff,and even the admin staff are all excellent.They have nothing to be ashamed of.Quite the opposite.My primary care doctor is from Brown's first med school class.
I have never encountered any but the most caring attitude and the cleanliness is outstanding.
Since I am disabled to a certain level all my care and drugs are cost free.It deoesn't matter if it's service connected or not.They do bill my private carrier for non-service connected care,but I have no copay.
When I needed arterial stents(service connected)they sent me to West Roxbury VA Hospital-guess what-they are a teaching hospital for Harvard Med school and are in partnership with Deaconess-Beth Israel.Not too shabby.
The cancer surgeon who has operated 4 times on me since 2007 is,according to a doctor acquaintance of mine,the best surgeon for what I have in RI.He has privileges at 5 hospitals!Second rate doctors?maybe a long time back,but not now.
Just updating you on the situation.
BTW the VA was widely blamed for the abominable situation at Walter Reed-they have NOTHING to so with that place.It is a DOD hospital.
Ken-are people more healthy in Hawaii in general because of the climate and vast opportunities for outdoor exercise year round?I've never been there,so i have no clue.

Posted by: joe bernstein at November 8, 2009 6:36 PM

Joe Bernstein,

Hawaii has one of the oldest and longest living state populations and is a major retirement destination for military and federal government employees because their retirement incomes are exempted from state income tax. There is no property tax on cars, boats or motorcycles and seniors (55 and up) get $40K to $120K discount off for property tax evaluation.

All uniformed services have major installations with medical and R&R centers. Air Force has Bellows Beach AFS with vacation cottages right on be beach so does the Army and Navy plus the major Hale Koa military resort/hotel is right on Waikiki Beach.

I live on the dry non-humid side of Oahu so I get about 355 days of sun light. The other sides might loose a week of sun light and are a little more humid (5%-10% more) due to more rain showers. What I am trying to present here is if it is raining on your side of the island you go to the other side for sun. Sun provides vitamin D.

Just about everyone walks in the cities/towns/neighborhoods and with free city parks, night-lighted sports complexes, community swimming pools, street bicycle lanes, free beaches and 36 golf courses on this island everyone stays active. There is private ice ring for skaters and you can fly to the Big Island of Hawaii for snow skiing or snowboarding Nov through Mar besides surfing, boogie boarding or body surfing in 80 degree water.

Yes Joe there are a lot opportunities in Hawaii to live a healthier more active low stress life style eating fresh organic grown local farm produce, local grass pasture raised animal protein and fresh caught fish and shell fish plus there is a hard shell Maine Lobster Hotel in the islands so we can have Maine lobster almost daily.

Hawaii as a state has been ranked #1 in nation for wellness, low stress living and greatest amount of normal sleeping hours.

Due to current recession, airline and hotel deals are at 1970 pricing levels with indication hotels will lower room rates more next year. Of all US destinations Hawaii has had the highest occupancy rate of 71% and it is beginning to climb again.

To get a sense of Hawaii think of Nha Trang beach walk and the lush tropics of Da Lat but all the trees have flowers perfuming the air, everyone speaks English and smiles all the time.

Posted by: Ken at November 8, 2009 8:09 PM

Joe, I was most familiar with the West Roxbury, VA. That was about 15 years ago (I have lost my appeal to doctors since then). I dated a pathologist there in the 80's, she was making about 35,000 and was out of there as quick as she could find another spot. She was succeeded in my affections by an associate at a moderate size law firm. For comparison, she was making the starting salary of $57,000. Of course she worked a lot more hours than a pathologist.

I note that all of the VA hospitals you mention are now affiliated with medical schools, that was not the case at the time. Or at least not at West Roxbury.

Posted by: Warrington Faust at November 8, 2009 9:53 PM

A pathologist?
My doctor told me this joke:Internists know everything and do nothing;surgeons know nothing and do everything;pathologists know everything and do everything-too late.

Posted by: joe bernstein at November 9, 2009 5:49 AM
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