Sunday, November 07, 2010

How to kill Obamacare, even without a majority.

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Lots of folks have been fussing about the lack of a majority to kill this nightmare. As it turns out, it's not all that difficult to accomplish.

Here's the path to an Obamacare-free world. Yet another major HT to http://directorblue.blogspot.com/2010/11/new-england-journal-of-medicine.html.

New England Journal of Medicine Inadvertently Hands House GOP the Game Plan for Starving ObamaCare

On Wednesday talk show host and constitutional attorney Mark Levin pointed his Facebook followers to a curious article published in the October 28th edition of The New England Journal of Medicine (PDF).

In short, Dr. Henry J. Aaron -- an apparent fan of the Affordable Care Act (ACA) -- inadvertently handed the House Republicans a fiscal blueprint for crushing the wildly unpopular health care takeover.

The outcome of the 2010 congressional elections may well determine whether this landmark legislation succeeds or fails.

Put another way: the outcome of the 2010 elections reflects the electorate's desire to have the landmark legislation fail.

The evidence of party polarization is overwhelming (see table). A majority of both parties ended up voting for the original Social Security Act, although Republicans had campaigned actively against it. Many members of both parties voted for the legislation that created Medicare and Medicaid, that revamped welfare, and that created Medicare drug coverage (Part D). Not so in 2010.

Gee, you think that had anything to do with being completely shut out of the process? Or, as MSNBC put it, "House and Senate Democrats intend to bypass traditional procedures when they negotiate a final compromise on health care legislation, officials said Monday, a move that will exclude Republican lawmakers... in both houses."

The ACA is nothing if not ambitious. It proposes to enroll tens of millions of people in private health insurance plans through yet-to-be-created health insurance exchanges. It will provide millions of Americans with subsidies tied to income and health insurance costs. It will greatly expand Medicaid. It will set and enforce standards for private insurance... It will create a new commission to oversee Medicare... [and this] is but a partial listing of the provisions of the 906-page bill. If permitted to run its course, the ACA promises to transform the U.S. health care system...

But successful implementation poses remarkable challenges and will require adequate funding, enormous ingenuity, and goodwill from federal and state officials, as well as cooperation from private insurers, businesses and private citizens.

That would be the same private citizens that kicked record numbers of Democrats out of office for passing this Soviet-style plan.

A more serious possibility [than repeal] is that ACA opponents could deliver on another pledge: to cut off funding for implementation. Here is how such a process could work...

The ACA contains 64 specific authorizations to spend up to $105.6 billion and 51 general authorizations to spend “such sums as are necessary” over the period between 2010 and 2019. None of these funds will flow, however, unless Congress enacts specific appropriation bills. In addition, section 1005 of the ACA appropriated $1 billion to support the cost of implementation in the Department of Health and Human Services (DHHS).... [and the] ACA appropriated nothing for the Internal Revenue Service, which must collect the information needed to compute subsidies and pay them. The ACA also provides unlimited funding for grants to states to support the creation of health insurance exchanges (section 1311). But states will also incur substantially increased administrative costs to enroll millions of newly eligible Medicaid beneficiaries...

Without large additional appropriations, implementation will be crippled.

Sweeter words I don't think I've ever heard.

Since most major provisions of the ACA do not take effect until January 1, 2014, [these] delaying tactics might eventually enable repeal...

Perhaps the more likely — and in some ways more troubling — possibility is that the effort to repeal the bill will not succeed, but the tactic of crippling implementation will. The nation would then be left with zombie legislation, a program that lives on but works badly, consisting of poorly funded and understaffed state health exchanges that cannot bring needed improvements to the individual and small-group insurance markets, clumsily administered subsidies that lead to needless resentment and confusion, and mandates that are capriciously enforced.

Zombie legislation. Perfect. After all, this bill was the result of an historic Democrat overreach. And everyone knows that the Democrat Party routinely employs zombies (along with felons and illegal aliens) in its election wins.

Thanks, Dr. Aaron. We appreciate your instructions for starving this vampire entitlement of the taxpayers' blood it requires.


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6 comments:

  1. Unfortunately, what most people don't understand is that Medicaid is not free to those who use it. The payback comes at the end of the person's life when any assets that they may have accumulated...the house they live in, the car they drive, insurance policies, anything that might have any kind of monetary value is taken by the Medicaid Asset Recovery department. Medicaid steals your children's inheritance on any level that there might be one and that is a terrible thing to have happen to a family.

    There is no free lunch people...it just might take a little longer for payback to happen than you might notice. Your family left behind are the ones who are left struggling with the state over assets and that is a wonderful thing for a grieving family to have to do, isn't it?

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  2. As everyone here knows, I do NOT support the current insurance-based plan BUT I am a proponent of socialized healthcare. If the debate here is only against ANY kind of socialized healthcare then I can't participate.

    p.s. For the record, I am vehemently anti-Marxist, but Marxism and strategic socialism are not at all the same thing.

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  3. There are at least two reasons why socialized health care will not work... and, for that matter, has never worked: Costs and the inequity of providing it.

    I would, for example, venture to say that those who are "well off" will not have to concern themselves with the constraints of Obamacare generally or socialized medicine specifically.

    You, for example, would likely not have to swim through the oceans of bureaucracy that, say, I would, to get a kidney transplant.

    You would just write a check, which, FWIW, I do not begrudge you in the least.

    And, of course, the other problem is that there is no way I would ever receive the quality of medical care of Obama or any member of Congress.

    It's kinda like at the local level on the I-5 Bridge replacement. Did you ever notice that the vast majority of those screaming the loudest to replace the I-5 bridge will be the ones least likely to have to pay the tolls to go to work? How very easy it is to task others with paying major money to get a project that YOU (The rhetorical you) want, but won't have to pay for and won't allow those who WILL have to pay for it a say in whether it's built or not.

    I believe I have the closest thing available to socialized medicine run by the government today, I believe: VA care.

    I likely have viral bronchitis or pneumonia as I write this. But I cannot will myself to drive over to the VA in Portland, wait 5 hours or more to be seen, and then 3 hours or more for any prescriptions (Which will cost me more than they would at Fred Meyers) presuming they even write me any.

    I have to pay $50 to be seen by a human. I have to go to an emergency room, otherwise, I would have to wait days for an appointment. And then, I have to pay around 3 times as much for my VA prescription as you do at Fred Meyers, WalMart, Costco, Rite Aid or any of the pother places you could get drugs.

    This benefit, promised to me FOR FREE FOR LIFE when I signed on the dotted line during that little tiff in SE Asia, costs me as much as a thousand a year... a thousand increasingly difficult to put together in this economy.

    And, as I'm standing/sitting there, waiting to be seen, I ask myself: would any politician or high visibility proponent of socialized health care have to put up with this?

    Do I even need to ask?

    I'm well aware of the differences of which you write. But human nature rears its ugly head and pollutes the nobility of the effort to which you speak. But the only way socialized health care could or would work, finances aside (which is where most of the break down takes place) is if everyone gets treated exactly the same.

    And that ain't happening, under Obamacare or under any plan.

    I might believe that it will the moment that Obama reassigns the Doctor/Admiral who accompanies him everywhere he goes.

    But I ain't holding my breath.

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  4. When the debate is "What kind of socialized healthcare do we want?" then I have plenty of interest, commitment, and knowledge to participate.

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  5. Looking forward to it.

    But the fundamental issues of cost and fairness of a socialized system can likely never be adequately addressed.

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  6. "Fairness" is just "envy" said backwards.

    As an engineer, manager, and attorney - I'd get the rest done - just give me the chance.

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Enjoy!