When I was 17, I read a quote that went something like:
“If you live each day as if it was your last, someday you’ll most certainly be right.”
It made an impression on me, and since then, for the past 33 years,
I have looked in the mirror every morning and asked myself:
“If today were the last day of my life, would I want to do what I am about to do today?”
And whenever the answer has been “No” for too many days in a row,
I know I need to change something.
Remembering that I’ll be dead soon is the most important tool I’ve ever encountered
to help me make the big choices in life.
Because almost everything — all external expectations, all pride, all fear of embarrassment or failure
— these things just fall away in the face of death,
leaving only what is truly important.
Remembering that you are going to die
is the best way I know to avoid the trap of thinking you have something to lose.
You are already naked.
There is no reason not to follow your heart.
Steve Jobs
Sunday Talk Soup: 7/01/12 FTN Continued
Why am I still ranting on this first Face the Nation after the SCOTUS decision on ObamaCare after my first commentary almost a week ago? (1) the first commentary was parsing part of the transcript, the lead segment on Speaker Boehner; (2) there were other topics I wanted to discuss more generally: the slanted coverage, other comments made by other politicians (Schumer on polling, O'Malley regarding the mandate, the entire discussion of Romney, the individual mandate and RomneyCare, etc.)
First, I did not care for Norah O'Donnell's moderation of the entire show. In my judgment, it was blatantly one-sided. Let's be clear here: the cold hard fact is the interview itself: Norah O'Donnell didn't ask the Democrats any challenging questions at all. For example, you can argue that a split-decision SCOTUS win for ObamaCare is a win, but it did not have the moral authority of the full Court behind it: 4 justices said that the entire law should be scrapped, and the ruling only carried because Chief Justice made a dubious decision that the penalty was a tax and hence given broad discretion. There was no discussion that the Medicaid "poison pill" (accept new, higher enrollment criteria or lose all EXISTING federal Medicaid funding) was struck down by SCOTUS, which is HIGHLY significant. It was a narrow decision involving 17% of the economy. O'Donnell failed to point out even after the decision, the sentiment is AGAINST the new law, not for it: RCP shows net disapproval of ObamaCare above statistical significance over the past month (including the latest NYT poll released this week showing a net disapproval of 14 points) and, separately, repeal of ObamaCare favored in every recent poll. KEEP IN MIND THAT ANY APPROVAL OF OBAMACARE IS BIASED UPWARD: most Americans aren't vested in ObamaCare: 85% are covered by existing insurance. All they are being told is popular benefits like people with preexisting conditions, filled prescription coverage "holes", or keeping an adult kid on the policy: NOT how much those costs are going add to their own premiums.
There was little or no discussion of how Congress is going to fund subsidies and what happens if and companies decide that it's a lot cheaper to pay the ObamaCare tax than to continue paying escalating costs. Not to mention that the mandate may lead up to $12B in extra costs as "there are an estimated 10-12 million individuals who qualify for Medicaid benefits [existing vs. ObamaCare increased] but aren't enrolled." Add any state matches, made optional by the ObamaCare ruling (again, which O'Donnell and the other progressives never mentioned), and cash-strapped states like Texas may face up to $27B in new spending over the coming decade. We don't even know the full implications of the 2700-page law (because the Congress unwisely gave the HHS Secretary broad discretion on many items and there is a newly empowered health board spewing out new, unknowable regulations/costs).
There was absolutely no questioning of the Democrats over decades of massive medical fraud in government health programs, price lists in Medicare and Medicaid funding below market price, up to 20% or more, and regular "doc fixes" to credit back automatic pay cuts to providers. And other than Romney's obvious political problems with RomneyCare, where progressives think they have Romney boxed in, absolutely none of them raised known issues with RomneyCare (underfunded from day 1). Let's go to the reality of RomneyCare:
Critics argue that savings from overuse of emergency care could not possibly offset the spending increases that patients with lavish coverage and no incentive for prudence would trigger. So far, the evidence has been on the critics’ side. Indeed, a 2010 study by Stanford University’s John Cogan and others in the Forum for Health Economics & Policy found that in the first two years after Romneycare, premiums in Massachusetts in nearly every category shot up above the national average.
RomneyCare busted the state budget in its first full year with cost overruns of 48 percent, In 2009, Gov. Deval Patrick [remember? The original "don't tell me words don't matter"] blessed an effort to nix coverage for 37,400 legal immigrants, but the courts outlawed the move as discriminatory last month. The courts also barred Patrick from imposing a uniform rate cap on insurers in 2010.How does a liberal Democrat promote "universal coverage" by discriminating against immigrants? In 2010 the legislature enacted a reform that seemed to bring down premiums--but it turns out the comparison is apples and oranges:
In 2010—the biggest premium drop—the Bay State passed a law requiring insurers to offer cheaper, tiered-network plans that compel patients to get care from community hospitals and cheap providers unless they cough up more for better ones.In other words, a variation of rationing care. But there are other federal health care issues as well, which the moderate, Democrats, and panelists all conveniently ignored:
Only 31 percent of Texas doctors said they were accepting new patients who rely on Medicaid, the health insurance program for the poor and disabled, in the survey provided to The Associated Press on Sunday. In 2010, the last time the survey was taken, 42 percent of doctors accepted new Medicaid patients. In 2000, that number was 67 percent. Doctors complain that the Texas Medicaid program pays only half of the actual cost of most services.
More than 54 percent of doctors said they are not accepting patients in the Children's Health Insurance Program, a state-run program for poor children.
The number of doctors accepting new patients who rely solely on Medicare dropped from 66 percent in 2010 to 58 percent in 2012. More than 78 percent of doctors in 2000 said they would accept new Medicare patients. (The federally managed Medicare program pays better than state-controlled Medicaid.)Oh, and the Medicaid expansion made optional by SCOTUS? Already 5 states (Texas, Louisiana, South Carolina, Mississippi, and Florida) have opted out; others are leaning against (New Jersey, Nevada, Missouri, Iowa, and Nebraska). Not to mention that states can opt out of ObamaCare exchanges (to which subsidies are applicable); the federal government can create an alternative, but many believe that the law does not provide for subsidies in any related federal alternative.
I've made the point repeatedly: government is part of the problem, not the solution. We free marketers have been preaching for some time: you have been exacerbating things by manipulating medical service demands with benefit mandates, paperwork, implicit tax subsidies for coverage obtained at work, etc.
As I mentioned in yesterday's commentary on bank regulation, regulation in the long run tends to act as a barrier of entry to competition as it results in an oligarchy where ongoing regulation serves as a poor contrived substitute to real market forces. What the government has done here is to pervert the concept of insurance; it's become a form of bundled health services where consumers tend to use excessively because the benefits are seen as "free" (or nominal in price).
So where was O'Donnell challenging the empty Dem suits like Schumer and O'Malley, e.g., given a limited pipeline of doctors, which has remained fairly flat over the past 3 decades, and aging population requiring more expensive health care: given limited federal and state coffers, where are they going to find the money to pay for all this? What about the states opting out? What about the medical costs of those whom opt out for a small tax or those not eligible for subsidies in states opting out of Medicaid expansion or state exchanges? What about the RomneyCare cost overruns? Won't ObamaCare overrun its costs, too?
Instead, you have progressives playing games with polls on ObamaCare, trying to declare the fight over because of a narrow victory in SCOTUS and score points on Romney (whom they think they've boxed in because there is only so many free market principles you can implement with a legislature 85% Democrat; they aren't talking about his 8 vetoes, his wanting to allow bonds in lieu of a mandate, etc.).
It's clear that I don't believe that O'Donnell did due diligence on substantive issues, confusing Obama's marketing hype with serious public policy, she did duly memorize the Administration's talking points, just like any dutiful mainstream White House correspondent. And she was repetitious: she made multiple references to the House voting on ObamaCare "more than 30 times": I discussed this issue with respect to a recent Doren video in Monday's post. The whole bill came up for repeal or defunding less than a handful of times.
Let me take on the Romney, RomneyCare, and the individual mandate issue: although, in my opinion, O'Donnell doesn't do due diligence on the details of public policy, she tried to put the GOP legislators on the spot with Romney, noting the unpopular mandate and the fact that the penalty is actually higher in Massachusetts.
First, let us point out certain regulatory policies that essentially destroyed the concept of insurance as insurance. My argument with Romney is that he would have been better served to repeal regulations. Massachusetts basically forced their higher costs on other insured FROM DAY ONE.:
Massachusetts also had a dysfunctional individual market. In 1996, the state had instituted rules requiring community rating (premiums could only vary by a certain amount based on age, geography and occupation) and guaranteed issue (no discrimination based on preexisting conditions), says MIT economist Jonathan Gruber, who advised both Romney and the Legislature in creating the health care law and is still on the board of the Health Connector, the state’s version of an exchange. Those regulations “destroyed the market,” he says. “You can’t institute those reforms without a mandate,” requiring individuals to have coverage.Let's point out here: insurance is just like any other item covered by the law of supply and demand: as price increases, you sell fewer widgets, policies, etc. Lower-cost (say, healthy young people) policyholders found themselves paying more than their fair share of premiums.
There are ways to deal with high-cost individuals, e.g., a subsidized high risk/higher premium pool, where, say, the subsidies are funded through some health premium/transaction tax.
Now, and this was a particularly annoying point to me, O'Donnell kept alleging the status quo "discriminates" against people with preexisting conditions. What exactly does that mean: "discriminate"? The fact that people with more serious health conditions have to pay higher premiums? That's not "discrimination"; it's the valuation of risk. Younger drivers pay more for auto insurance based on their group statistics; people who live on a floodplain also need to purchase flood insurance. Big or tall people often have to pay more for their clothes; this is not discriminatory: it has to deal with economies of scale and how many big or tall people there are.
Now there's the point that Romney has repeatedly made: Massachusetts was a special case, because it had one of the highest insured rates in the country: the costs to close the gap were much lower than the country as a whole, and now our country can't really handle those extra costs:
The National Health Insurance Survey found that 14.8 percent of persons nationwide lacked insurance at the time of the interview in 2006. Massachusetts’ rate was 7.7 percent, the lowest state rate in the country. Seventy percent of employers offered insurance in the state the year before the law was passed, compared with 60 percent nationally.Let us recall what motivated RomneyCare: Massachusetts was threatened by the Bush Administration with losing $385M in Medicaid money
Is RomneyCare the same as ObamaCare? Of course not. Mona Charen gives a succinct summary:
The Massachusetts law contained an individual mandate, which states -- unlike the federal government -- are allowed to impose. But it did not consist of 2,700 pages of new regulations; 159 new boards and commissions; and more than $500 billion in new taxes (and counting); the Independent Payment Advisory Board, a rationing board whose decisions are unreviewable by the courts and practically untouchable by Congress itself; restrictions on religious liberty; Medicare cuts; affirmative action mandates for medical and dental schools; huge new authority over one-seventh of the U.S. economy for the Secretary of Health and Human Services; and open-ended regulations of the way doctors and others perform their jobs.I don't accept Charen's view on the health insurance mandate, even in a state context. I do agree that traditional regulation of health comes under the police powers of the state (the Tenth Amendement). I don't think the federal government has that enumerated power, period, beyond interstate matters. This is different than, e.g., drivers license because it is possible for any driver to damage property or people with one's vehicle. Auto insurance, however, is not intended to cover ordinary expenses. (A good explanation of the difference between auto and health insurance mandates is here.)
I certainly agree that I should be responsible for my own health expenses, and I do believe there's an argument to be made about people sharing the risk for certain catastrophic care/events through a fair distribution of costs through the economy (e.g., through a small transaction tax). (A 1986 law mandating emergency health treatment regardless of ability to pay confounds this, of course.)
But as to Junior Legal Plunderer Martin O'Malley or Senator Schumer talking (along with Romney) about freeloaders? I understand Romney's point that 40% of the uninsured in Massachusetts were people whom could afford to buy health insurance but they didn't. I need to hear more of this freeloader concept: most people are healthy. I honestly don't recall having a personal doctor for most of the 1980's and 1990's (and my first 4 years after moving to Maryland). I had insurance through work but I don't recall using it. I may be an exception. I would expect if you can afford to pay for a $15K policy but haven't, you should be billed for unpaid charges you incur at a hospital. Granted, insurance makes that process easier, but health insurance really didn't exist for most people for much of American history.
I see a freeloader not as someone whom doesn't pay for some mandated gold-plated coverage--covering some other person's sex-change operation, in vitro fertilization procedure or some woman's birth control expense, but as someone whom is socializing his own expenses. The real freeloaders are the crony interests behind benefit mandates.
Can I PLEASE get some sympathy for having to live in the same state as that piece of work Martin O'Malley? So help me when I heard that demagogue talk about the "failure" of the free market in the insurance market. This weenie pretends that the perverse self-propagating process of health "insurance" with ludicrous government policies (like guaranteed issue or community rating) constitutes the "free market"? This guy would fail any freshman economics course. Intellectually challenged leaders like O'Malley have the audacity to blame the free market because of the failure of corrupt government and incompetent regulators? GIVE ME A BREAK!
Federal Agriculture Reform and Risk Management Act:
Thumbs DOWN!
From the Citizens Against Government Waste (my edits):
[Despite record farm income and prices], the FARRM Bill would cost nearly $1 trillion over 10 years -- 60 percent more than the 2008 Farm Bill and billions of dollars more than the Farm Bill passed by the Senate earlier this summer! Depression-era, command-and-control programs for commodities like dairy, sugar, peanuts, and cotton remain untouched.
The sugar program benefits the wealthiest 1 percent of sugar farmers, at a cost to Americans of $1.9 billion annually; some 75,000 workers who have lost their jobs in industries such as candy, cereal, and baked goods manufacturing. The cotton program violates international trade rules, leaving us keep paying Brazilian cotton farmers $145 million each year in compensation! The FARRM Bill also leaves intact the Market Access Program and the Rural Utilities Service Broadband Access Program, littered with corporate welfare, waste and /or mismanagement.
Nearly $100B a year to the benefit of Big Agriculture as the US government violates free market principles in manipulating commodity markets artificially propping up prices AGAINST the benefit of American consumers and taxpayers? Why? Is central planning of farm any more meritorious than central planning of health care? I urge my American readers to go to the online petition of the CAGW home page (see the relevant link on the right side of the webpage).
Musical Interlude: My Favorite Groups
The Babys, "Every Time I Think of You". One of my favorite songs of the 70's, but my inner record producer wants to tinker with the masterpiece. (For some odd reason, when I sing the manic repeating ending verse (I love a manic tempo in rock, e.g., Paul McCartney's "Getting Closer"), I find myself interpolating "every time I see your face". I would like to hear more use of the violin in the melody, more prominent drumming, a grittier vocal from Waite and more of a duet chorus (in place of the female solo). And thus turn a #13 hit into a #991 hit...
