Paranormal Health Care Legislation Passes

The U.S. House of Representatives today passed the most radical piece of legislation since the New Deal, a piece of legislation opposed by a majority of the American people. That takes guts, and I for one admire the Democrats on that score. How much courage it took is indicated by the close vote 220-215. One Republican voted for it, and 39 Democrats voted no. That 39 is close to the number Ms. Pelosi could afford to lose, which means that a big argument behind the scenes was who got the privilege of voting against the bill.

One might argue that popular resistance is based on ignorance, as most people have no clear idea what is in the bill. That would be true since no one has any idea what is in the bill. This is so not so much because of the gargantuan size of the legislation but because no one can know in advance how unelected bureaucrats will use the vast powers that the bill grants them.

Betsy McCaughey writing at the Wall Street Journal Online has a nice summary of some of the most interesting features of the bill. Consider this one:

Sec. 224 (p. 118) provides that 18 months after the bill becomes law, the Secretary of Health and Human Services will decide what a "qualified plan" covers and how much you'll be legally required to pay for it. That's like a banker telling you to sign the loan agreement now, then filling in the interest rate and repayment terms 18 months later.

So no one knows what a "qualified plan" will be, but if this legislation or something rather like it becomes law, we are all about to buy one.

Worries about whether you can keep your existing health insurance would be beside the point under this legislation. Likewise the notion that competition can control prices, something Democrats and the President and particular like to say, is rendered moot by the House bill.

• Sec. 303 (pp. 167-168) makes it clear that, although the "qualified plan" is not yet designed, it will be of the "one size fits all" variety. The bill claims to offer choice—basic, enhanced and premium levels—but the benefits are the same. Only the co-pays and deductibles differ. You will have to enroll in the same plan, whether the government is paying for it or you and your employer are footing the bill.

Exactly who will provide you with health insurance, your employer, a private insurance company, the government, remains to be seen. Whoever it is, the package will be the same. Nor will you have the option of opting out. Anyone who does not buy insurance, or employers who do not offer it, will be penalized. There is virtually no choice or competition remaining in this plan.

This is the "government takeover of the healthcare system" that critics have warned about. Government will determine benefits and government will determine what everyone has to pay for them. Maybe that will be palatable when we finally see what it costs each family.

The House bill will also add more than a trillion dollars to the cost of government over ten years. Even if all that cost is paid for by taxes or cuts in existing outlays, it is still a cost that the economy must bear. At a time when the public and private debt are putting big strains on job creation, that might matter.

Opposition to healthcare reform and the recent revival of the Republican Party are motivated by a distrust of the growth of government and an alarm at ballooning deficits. The Democrats had better hope that those concerns are a passing fancy.

Comments

[lexrex]

un - believe - able!

[Tom]

I would strongly disagree with two points in your first senatance, that this legislation is radical and the idea that a majority of the public don't want this reform. Polls have shown that a big majority supports all the provisions in this bill, including the public option. The only polls that show negative numbers is when they're asked if they support the legislation currently in Congress. I think that has more to do with people's frustration with how Congress was dealing with everything.

[William]

Tom,

I firmly believe most Americans DO want reform of both health care delivery and health insurance. Affordability, portability, access to our chosen health care providers, choice in our health care decisions, choice in the type of coverage we can purchase are concerns I think most Americans share, regardless of political leanings. That said, 85% of Americans are satisfied with their current health care provider and their insurance coverage.

This monstrosity passed by the house will not only fail to address their concerns but will aggravate them. This is not reform but a tipping point to a national takeover of of the health care industry.

I firmly believe that once the details of the legislation just passed in the House are realized, that Americans will firmly reject both the provisions in the bill and it's supporters.

[A.I.]

This brings me back to my "little me" argument as I choose between which entity I will be at the mercy of: big government or big business. Both have unelected bureaucrats. In the case of government, those bureaucrats derive authority directly from elected officials elected by citizens desiring the best possible care for the least possible cost. In the case of business, the bureaucrats derive authority from unelected executives desiring the greatest possible profit from the least possible care. I think I'll go with the former.

[William]

Government is not susceptible to market forces but subject to political ends.

I choose the marketplace as the option that offers freedom and choice.

That's certainly not to dispute that "Big Business" and "Big Government" are not necessarily "in cahoots" at the expense of the public, but at least Big Business cannot impose it's will by the force of law.

[A.I.]

Insurance companies have imposed their will by force of law William, by bending congress to their will. For example, Mccarran/Ferguson excludes them from anti-trust laws. That leaves them free to collude and decide in which states they will offer policies at what prices. There is no real competition, not because policies cannot be sold by a given company in all states, but because it's more profitable to split up the pie and avoid all that messy competition stuff.

[William]

Big Business & Big Government both need reforms, but turning health care over to Big Government exclusively is not the answer. Reforms that provide "all that messy competition stuff" is what is needed.

[Larry]

Given your interest, you might want to check out the http://www.lastingliberty.com/ piece on the healthcare debate : Bigger Than Healthcare

[William]

Larry,

Yes, certainly bigger than health care.

AI,

FWIW, I don't trust either "Big Government" OR "Big Business". They're both equals in the "one stop shopping" in corruption we have when too much power is centralized in one place.

http://www.downsizedc.org/page/about
"We believe the federal government has grown too centralized, too intrusive, and too expensive. We believe in constitutional limits, smaller government, civil liberties, federalism, and low taxes. We want to end laws and programs that don't work, cause harm, and violate the Constitution. We want to restore the full force of the 9th and 10th amendments, which reserve most social functions to the people and the states"

[A.I.]

Here's the thing with the "little me" theme William and Larry, I am virtually powerless against both big government and big business, but both are facts of life that serve a purpose. Neither can be wished or voted away without negative consequences.

You both seem quite intent on limiting the power of government while ignoring that of business while what is necessary is for each to act as a counterbalance to the other. In the case of health care reform, establishing balance is what is being proposed--not a government takeover. Repealing Maccarran-Ferguson would be a step toward forcing companies to compete with each other. Establishing a public option would set minimum standards of coverage that all companies would have to match. But, neither amount to a takeover of health care; they simply give little me some protection against predatory companies and offer me more options in choosing a provider.

[William]

AI,

You're assuming that it takes a large central government to provide necessary oversight to "big business". I disagree, corruption is inevitable when power is concentrated in the hands of the few.

If the existing power of the Federal Government were returned to the states, I believe it would also decentralize the corruption / cronyism we face today.

[Larry]

William and AI, Hayek had something to say about competition, big business, and the free market.See http://www.lastingliberty.com/principles/2009/11/5/hayek-and-the-meaning-of-free-market.html

[William]

AI, another link I recommend
The Health-Insurance Market Is Not Free
http://mises.org/story/3727

[KB]

Great Comments. Tom: "all the provisions in this bill" are part of "the legislation currently in Congress." Solid and persistent majorities are opposed to the latter.

A.I.: I understand you that dislike "big business." Now, imagine your least favorite big business. Then imagine that it could decide what all its competitors would offer, and how much they would get to charge. Imagine it could require all Americans to buy its product, fine them if the don't, and throw them in the slammer if they don't pay the fine. You have better hope that government is a lot more attractive than that.

You are right that the insurance industry is not as competitive as it might be. But there are choices out there. There will be virtually no choices left under the House bill. Nor has Congress been the least bit interested in doing the sorts of things that might encourage competition, like freeing up the interstate market for insurance.

Moreover, Congress will continue to protect its favorite constituencies, like Unions and Tort Lawyers, so private interests are hardly going to be purged. The only reason to like this bill is the expansion of government power it contains.

[A.I.]

I did not say I did not like big business KB. I said it was a necessary fact of life meaning there are things only large concerns can accomplish. But in this case, size does matter. And with no counterbalance, big business is prone to euphemistically do to us the act size mattering is so often associated with.

I agree the same is true of big government. Thus, I advocate balance between business and government power--balance currently lacking in the health care industry.

"Government is too big" may be an effective talking point, but it is not necessarily true. Government needs to be big enough to deal with private entities in meaningful ways.

[William]

AI,

At what point does government become "big enough" to dictate to private entities rather than "deal" with them? At what point do "big government" and "big business" blur into an oligarchy of the privileged few?

Stronger state governments with a less centralized federal power could eliminate some of the high level, one stop shopping of corruption and cronyism.

Yes, it would be "sloppier" and somewhat "messy" but that's not necessarily a bad thing.

[KB]

A.I.: we are once again alarmingly close to agreement, at least in the abstract. There needs to be balance between government and private power. There is no such balance in the House bill. Health and Human Services will control the American healthcare system. Welcome to my nightmare.