The National Federation of Independent Business (NFIB) stole a march on the Obama Administration this morning by filing a petition with the U.S. Supreme Court appealing the 11th Circuit’s Obamacare decision.
The Department of Justice (DOJ) had announced on Monday that it was not going to ask all 11 judges of the 11th Circuit Court of Appeals to review en banc the August 12 decision of a three-judge panel of the 11th Circuit that found the individual mandate unconstitutional. This opened up a path to an appeal by DOJ to the Supremes.
Dan Mitchell gives 12 reasons Obamacare will fail.
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However, with this petition, the NFIB jumped ahead of Eric Holder’s slow-moving DOJ (which until Monday had done everything it could to slow-walk this case filed by 26 states and the NFIB). The NFIB is obviously not appealing the three-judge panel’s opinion about the unconstitutionality of the individual mandate. But the NFIB is appealing the portion of the panel’s decision that held that the unconstitutional individual mandate could be severed from the Obamacare legislation.
The NFIB is asking the Court to overrule this holding, since “Congress itself deemed [the mandate] ‘essential’ to the Act’s new insurance regulations.” Given that the 11th and 6th Circuits have issued “directly conflicting final judgments about the facial constitutionality of [Obamacare’s] mandate,” the case is one that the Court should obviously take up given its interest in eliminating conflicting opinions in the courts of appeal.
What also differentiates this particular case from the many other lawsuits that have been filed against Obamacare is the “all star” lineup of Supreme Court litigators that the NFIB and the 26 states have lined up to argue their case before the Supreme Court. It includes Michael Carvin, a former DOJ official who has argued (and won) numerous cases before the Court; Gregory Katsas, a former DOJ official who was a clerk to Justice Clarence Thomas; Kevin Marshal, another former DOJ official and Thomas clerk; Hashim Mooppan, a former Justice Antonin Scalia clerk; and Randy Barnett, a nationally recognized constitutional scholar and professor at Georgetown.
The lawyers for the states include Paul Clement, former Bush Administration Solicitor General; Lee Casey, another former DOJ official who clerked for Alex Kozinski, who is now the Chief Judge of the Ninth Circuit; and David Rivkin, another Supreme Court litigator with wide experience in the government, including in the White House and the DOJ.
The government lawyers in the DOJ’s Office of the Solicitor General who will be arguing the constitutionality of Obamacare will have their work cut out for them.
Michael Tanner is a senior fellow at the Cato Institute, a libertarian think tank, and the co-author of Healthy Competition: What’s Holding Back Health Care and How to Free It.
Added to cato.org on October 18, 2011
This article appeared in USA Today on October 18, 2011.
Similarly, when Canadian Human Resources Minister Belinda Stronach needed treatment for breast cancer, she had it done at a California hospital. And, when then-Newfoundland Premier Danny Williams needed to have a leaky heart valve repaired, he had it done at the Mount Sinai Medical Center in Florida.
These high-profile patients were following in the footsteps of tens of thousands of patients from around the world who come to the United States for treatment every year.
We aren’t perfect, but if you’re sick, the United States is still the place you want to be.
They come here because they know that despite its flaws, the U.S. health care system still provides the highest quality care in the world. Whether the disease is cancer, pneumonia, heart disease or AIDS, the chances of a patient surviving are far higher in the U.S. than in other countries.
According to a study published in the British medical journal The Lancet, the U.S. is at the top of the charts when it comes to surviving cancer. For example, more than two-thirds of women diagnosed with cancer will survive for at least five years in the U.S. That’s 6 percentage points better than the next best country, Sweden.
Moreover, the U.S. drives much of the innovation and research on health care worldwide. Eighteen of the last 25 winners of the Nobel Prize in medicine are either U.S. citizens or work here. U.S. companies have developed more than half of all new major medicines introduced worldwide over the past 20 years. And Americans played a key role in 80% of the most important non-pharmaceutical medical advances of the past 40 years.
Does U.S. health care cost too much? Sure. But on a year-to-year basis, the cost in other countries is rising about as fast. Do we need to expand coverage? Certainly. But at least we’ve avoided the government-imposed rationing that afflicts so many countries. We aren’t perfect, but if you’re sick, the United States is still the place you want to be.
When then-Massachusetts governor Mitt Romney signed into law the nation’s most far-reaching state health care reform proposal, it was widely expected to be a centerpiece of his presidential campaign. In fact Governor Romney bragged that he would “steal” the traditionally Democratic issue of health care. “Issues which have long been the province of the Democratic Party to claim as their own will increasingly move to the Republican side of the aisle,” he told Bloomberg News Service shortly after signing the bill. He told other reporters that the biggest difference between his health care plan and Hillary Clinton’s was “mine got passed and hers didn’t.”
Outside observers on both the Right and Left praised the program. Edmund Haislmaier of the Heritage Foundation hailed it as “one of the most promising strategies out there.” And Hillary Clinton adviser Stuart Altman said, ‘‘The Massachusetts plan could become a catalyst and a galvanizing event at the national level, and a catalyst for other states.”
Today, however, Romney seldom mentions his plan on the campaign trail. If pressed he maintains that he is “proud” of what he accomplished, while criticizing how the Democratic administration that succeeded him has implemented the program. Nevertheless, he now focuses on changing federal tax law in order to empower individuals to buy health insurance outside their employer, and on incentives for states to deregulate their insurance industry. He would also use block grants for both Medicaid and federal uncompensated care funds to encourage greater state innovation. He encourages states to experiment, but does not offer his own state as a model.
A Double Failure
There’s good reason for his change of position. The Massachusetts plan was supposed to accomplish two things-achieve universal health insurance coverage while controlling costs. As Romney wrote in the Wall Street Journal, “Every uninsured citizen in Massachusetts will soon have affordable health insurance and the costs of health care will be reduced.” In reality, the plan has done neither.
Perhaps the most publicized aspect of the Massachusetts reform is its mandate that every resident have health insurance, whether provided by an employer or the government or purchased individually. “I like mandates,” Romney said during a debate in New Hampshire. “The mandate works.” But did it?
Technically the last day to sign up for insurance in compliance with that mandate was November 15, though as a practical measure Massachusetts residents actually had until January 1, 2008. Those without insurance as of that date will lose their personal exemption for the state income tax when they file this spring. In 2009, the penalty will increase to 50 percent of the cost of a standard insurance policy.
Such a mandate was, of course, a significant infringement on individual choice and liberty. As the Congressional Budget Office noted, the mandate was “unprecedented,” and represented the first time that a state has required that an individual, simply because they live in a state and for no other reason, must purchase a specific government- designated product.
It was also a failure.
When the bill was signed, Governor Romney, the media, state lawmakers, and health care reform advocates hailed the mandate as achieving universal coverage. “All Massachusetts citizens will have health insurance. It’s a goal Democrats and Republicans share, and it has been achieved by a bipartisan effort,” Romney wrote.
Before RomneyCare was enacted, estimates of the number of uninsured in Massachusetts ranged from 372,000 to 618,000. Under the new program, about 219,000 previously uninsured residents have signed up for insurance. Of these, 133,000 are receiving subsidized coverage, proving once again that people are all too happy to accept something “for free,” and let others pay the bill. That is in addition to 56,000 people who have been signed up for Medicaid. The bigger the subsidy, the faster people are signing up. Of the 133,000 people who have signed up for insurance since the plan was implemented, slightly more than half have received totally free coverage.
It’s important to note that the subsidies in Massachusetts are extensive and reach well into the middle class-available on a sliding scale to those with incomes up to 300 percent of the federal poverty level. That means subsidies would be available for those with incomes ranging from $30,480 for a single individual to as much as $130,389 for a married couple with seven children. A typical married couple with two children would qualify for a subsidy if their income were below $63,000.
What we don’t know is how many of those receiving subsidized insurance were truly uninsured and how many had insurance that either they or their employer was paying for. Studies indicate that substitution of taxpayer-financed for privately funded insurance is a common occurrence with other government programs such as Medicaid and the State Children’s Health Insurance Program (S-CHIP). Massachusetts has attempted to limit this “crowdout” effect by requiring that individuals be uninsured for at least six months before qualifying for subsidies. Still some substitution is likely to have occurred.
The subsidies may have increased the number of Massachusetts citizens with insurance, but as many as 400,000 Massachusetts residents by some estimates have failed to buy the required insurance. That includes the overwhelming majority of those with incomes too high to qualify for state subsidies. Fewer than 30,000 unsubsidized residents have signed up as a result of the mandate. And that is on top of the 60,000 of the state’s uninsured who were exempted from the mandate because buying insurance would be too much of a financial burden.
Billion-Dollar Overrun
According to insurance industry insiders, the plans are too costly for the target market, and the potential customers- largely younger, healthy men-have resisted buying them. Those who have signed up have been disproportionately older and less healthy. This should come as no surprise since Massachusetts maintains a modified form of community rating, which forces younger and healthier individuals to pay higher premiums in order to subsidize premiums for the old and sick.
Thus, between half and two-thirds of those uninsured before the plan was implemented remain so. That’s a far cry from universal coverage. In fact, whatever progress has been made toward reducing the ranks of the uninsured appears to be almost solely the result of the subsidies. The much ballyhooed mandate itself appears to have had almost no impact.
The Massachusetts plan might not have achieved universal coverage, but it has cost taxpayers a great deal of money. Originally, the plan was projected to cost $1.8 billion this year. Now it is expected to exceed those estimates by $150 million. Over the next 10 years, projections suggest that Romney- Care will cost about $2 billion more than was budgeted. And the cost to Massachusetts taxpayers could be even higher because new federal rules could deprive the state of $100 million per year in Medicaid money that the state planned to use to help finance the program.
Given that the state is already facing a projected budget deficit this year, the pressure to raise taxes, cut reimbursements to health care providers, or cap insurance premiums will likely be intense. Romney likes to brag that he accomplished his health care plan “without raising taxes.” Unless something turns around, that is not likely to be the case much longer.
Moreover, the cost of the plan is also likely to continue rising, because the Massachusetts reform has failed to hold down the cost of health care. When Romney signed his plan he claimed “a key objective is to lower the cost of health insurance for all our citizens and allow our citizens to buy the insurance plan that fits their needs.” In actuality, insurance premiums in the state are expected to rise 10–12 percent next year, double the national average.
The Bureaucratic Connector
Although there are undoubtedly many factors behind the cost increase, one reason is that the new bureaucracy that the legislation created-the “Connector”-has not been allowing Massachusetts citizens to buy insurance that “fits their needs.”
Although it has received less media attention than other aspects of the bill, one of the most significant features of the legislation is the creation of the Massachusetts Health Care Connector to combine the current small-group and individual markets under a single unified set of regulations. Supporters such as Robert E. Moffit and Nina Owcharenko of the Heritage Foundation consider the Connector to be the single most important change made by the legislation, calling it “the cornerstone of the new plan” and “a major innovation and a model for other states.”
The Connector is not actually an insurer. Rather, it is designed to allow individuals and workers in small companies to take advantage of the economies of scale, both in terms of administration and risk pooling, which are currently enjoyed by large employers. Multiple employers are able to pay into the Connector on behalf of a single employee. And, most importantly, the Connector would allow workers to use pretax dollars to purchase individual insurance. That would make insurance personal and portable, rather than tied to an employer-all very desirable things.
However, many people were concerned that the Connector was being granted too much regulatory authority. It was given the power to decide what products it would offer and to designate which types of insurance offered “high quality and good value.” This phrase in particular worried many observers because it is the same language frequently included in legislation mandating insurance benefits.
At the time the legislation passed, Ed Haislmaier of the Heritage Foundation reassured critics that “the Connector will neither design the insurance products being offered nor regulate the insurers offering the plans.” In reality, however, the Connector’s board has seen itself as a combination of the state legislature and the insurance commissioner, adding a host of new regulations and mandates.
For example, the Connector’s governing board has decreed that by January 2009, no one in the state will be allowed to have insurance with more than a $2,000 deductible or total out-of-pocket costs of more than $5,000. In addition, every policy in the state will be required to phase in coverage of prescription drugs, a move that could add 5–15 percent to the cost of insurance plans. A move to require dental coverage barely failed to pass the board, and the dentists-along with several other provider groups-have not given up the effort to force their inclusion. This comes on top of the 40 mandated benefits that the state had previously required, ranging from in vitro fertilization to chiropractic services.
Thus, it appears that the Connector offers quite a bit of pain for relatively little gain. Although the ability to use pretax dollars to purchase personal and portable insurance should be appealing in theory, only about 7,500 nonsubsidized workers have purchased insurance through the Connector so far. On the other hand, rather than insurance that “fits their needs,” Massachusetts residents find themselves forced to buy expensive “Cadillac” policies that offer many benefits that they may not want.
Governor Romney now says that he cannot be held responsible for the actions of the Connector board, because it’s “an independent body separate from the governor’s office.” However, many critics of the Massachusetts plan warned him precisely against the dangers of giving regulatory authority to a bureaucracy that would last long beyond his administration.
ClintonRomneyEdwardsCare
Despite the problems being encountered in Massachusetts, the Romney plan continues to receive a surprising amount of support as a model for reform. The health care plans advocated by all three of the leading Democratic presidential candidates- Hillary Clinton, John Edwards, and Barack Obama-are all substantially the same as Romney’s. They are all variations of a concept called “managed competition,” which leaves insurance privately owned but forces it to operate in an artificial and highly regulated marketplace similar to a public utility. All of their plans include an individual mandate (only for children in Obama’s case, and for everyone in Clinton’s and Edwards’s plans), increased regulation, a government-designed standard benefits package, and a new pooling mechanism similar to the Connector.
Romney denounces Senator Clinton’s plan as “government run health care,” but there really is very little difference between the Romney and Clinton plans.
In addition, several states have been seeking to use Massachusetts as a model for their own reforms. In California, Gov. Arnold Schwarzenegger added an employer mandate to a plan that otherwise looked very much like the Massachusetts plan. Other states considering similar proposals include Alaska, Kansas, Louisiana, Maryland, Michigan, New York, Oregon, and Washington, as well as the District of Columbia. Although none of these proposals has made it into law, several remain under active consideration.
No one can deny that the U.S. health care system needs reform. Too many Americans lack health insurance and/or are unable to afford the best care. More must be done to lower health care costs and increase access to care. Both patients and providers need better and more useful information. The system is riddled with waste, and quality of care is uneven. Government health care programs like Medicare and Medicaid threaten future generations with an enormous burden of debt and taxes. Given these pressures, the temptation for a quick fix is understandable.
But, as Massachusetts has shown us, mandating insurance, restricting individual choice, expanding subsidies, and increasing government control isn’t going to solve those problems. A mandate imposes a substantial cost in terms of individual choice but is almost certainly unenforceable and will not achieve its goal of universal coverage. Subsidies may increase coverage, but will almost always cost more than projected and will impose substantial costs on taxpayers. Increased regulations will drive up costs and limit consumer choice.
The answer to controlling health care costs and increasing access to care lies with giving consumers more control over their health care spending while increasing competition in the health care marketplace- not in mandates, subsidies, and regulation. That is the lesson we should be drawing from the failure of RomneyCare.
This article originally appeared in the January/February 2008 edition of Cato Policy Report.
Doug Bandow is a senior fellow at the Cato Institute. A former special assistant to Ronald Reagan, he is the author of Foreign Follies: America’s New Global Empire (Xulon).
Health care remains one of President Barack Obama’s greatest political weaknesses. The issue remains an equally serious problem for Republican Mitt Romney.
President Obama’s program to centralize medical decision-making in Washington remains as unpopular as ever. Insurers are raising premiums and canceling policies. The president’s promise that Americans can keep their existing coverage has turned out to be void. Health care providers and insurers are cutting back operations and dropping jobs to comply with the new law. Washington has been forced to issue temporary waivers — over 1400, as of mid-June — to moderate the legislation’s impact.
Moreover, ObamaCare has bent the cost curve upward by reinforcing the underlying third party payment problem. The administration even double counted its imagined cost savings, causing Medicare’s chief actuary to warn that the program’s latest estimates were essentially fraudulent. Future Congresses will have to reduce promised benefits or public subsidies, or hike spending.
No GOP presidential contender officially supported the administration legislation. However, Mitt Romney instituted an early variant of the Obama program.
As part of his liberal phase when governor of Massachusetts — political principles have been ever-flexible for Romney — he orchestrated passage of legislation with eerie similarities to ObamaCare. Massachusetts mandates purchase of insurance, decides what benefits must be offered, and maintains a complex system of subsidies and penalties. Declared Boston Globe columnist Adrian Walker, the two programs are “not identical, but they’re certainly close kin.” MIT economist Jonathan Gruber, who advised both Gov. Romney and President Obama on health care, asserted: “Basically, it’s the same thing.”
Out of either policy pride or political calculation, Romney continues to defend his approach as “a model that works.” But he probably could not escape the legacy even if he wanted to. Walker wrote: “Health care was Romney’s greatest achievement by so wide a margin that it’s hard to know what to compare it to.”
However, Romney has grown increasingly desperate to distinguish his legislation from that of Obama. The best the former can say is that his program was constitutional, since states possess the so-called “police power,” allowing them to regulate most anything within their jurisdiction. In contrast, the federal government was created with only limited, enumerated powers. The Founders would never have imagined that Washington could force people to purchase health insurance under the guise of regulating “commerce among the states.” (So far the federal courts have split on the issue.)
Alas, even the former governor’s constitutional scruples are suspect. In 1994 he backed a federal mandate. His concern about the overweening federal government apparently was not so finely developed then.
In any case, the fact that RomneyCare is constitutional does not mean that it is wise. Americans want their president to exercise good judgment and common sense, as well as respect the office’s constitutional limits. RomneyCare fails the first two standards.
Yet so far Romney has gotten off easy in the Republican contest. In the first debate former Minnesota Gov. Tim Pawlenty failed to criticize Romney on the issue of “ObamneyCare,” as Pawlenty termed it, when given the opportunity. Pawlenty’s belated attempt to toughen his message highlighted his political weaknesses, and he soon departed the race. (In fact, Pawlenty as well as former Utah Gov. Jon Huntsman both supported a mandate, though their respective state legislatures eventually passed more limited legislation.)
Texas Gov. Rick Perry’s entry may end Romney’s easy ride. Perry already has gone after Romney, observing: “I think Mitt is finally recognizing that the Massachusetts healthcare plan that he passed is a huge problem for him, and yeah, it was not almost perfect.” This is likely only the first of many hits.
“ObamneyCare” was not a revolutionary attempt to overturn the status quo. Rather, the usual special interests did quite well. The American Prospect’s Robert Kuttner observed: “In Massachusetts, Romney needed and got buy-in from the powerful hospital, insurance, and corporate lobbies. To win that support, he could not fundamentally change the way they did business. Instead, private insurance companies got more customers thanks to the individual mandate, hospitals kept their beds full, and corporations that failed to insure employees paid only a token penalty of $295 per worker.”
Romney’s legislation sought to extend insurance coverage. About 95% to 96% — the state claims 98.1%, but the actual rate appears to be lower — of Massachusetts residents now are insured. That is a genuine achievement but still not universal coverage. Moreover, as Peter Suderman of Reason observed, “the state’s insurance coverage rates were already unusually high to begin with: About 90% of the state’s population had health coverage prior to the law’s passage.” In short, Gov. Romney’s accomplishment actually was rather modest.
Moreover, at what cost? Defenders of RomneyCare argue that its goal was to expand coverage, not to cut expenditures, but Gov. Romney was not alone in promising “affordable” health care. Anyway, the legislation certainly was not supposed to drive costs skyward.
However, paying for more benefits for more people inevitably makes medicine more expensive. Costs for Commonwealth Care, the Massachusetts government’s subsidized insurance program alone are up a fifth over initial projections. Last year State Treasurer Timothy P. Cahill wrote: “The universal insurance coverage we adopted in 2006 was projected to cost taxpayers $88 million a year. However, since this program was adopted in 2006, our health-care costs have in total exceeded $4 billion. The cost of Massachusetts’ plan has blown a hole in the Commonwealth’s budget.”
State finances have not collapsed only because RomneyCare spread the costs widely, forcing virtually everyone in and out of the state to share the pain. Cahill cited federal subsidies as keeping the state afloat financially. Indeed, a June study from the Beacon Hill Institute concluded that “The state has been able to shift the majority of the costs to the federal government.” The Institute pointed to higher costs of $8.6 billion since the law was implemented. Just $414 million was paid by Massachusetts. Medicaid (federal payments) covered $2.4 billion. Medicare took care of $1.4 billion.
But even more costs, $4.3 billion, have been imposed on the private sector — employers, insurers, and residents. This estimate is in line with an earlier study by the Massachusetts Taxpayers Foundation, which figured that 60% of the new costs fell on individuals and businesses.
As expenses have risen, so have premiums. Noted Kuttner, “because serious cost containment was not part of the original package, premium costs in the commonwealth have risen far faster than nationally — by 10.3%, the most recent year available.” Economists John F. Cogan, Glenn Hubbard, and Daniel Kessler figured that RomneyCare inflated premiums by 6% from 2006 to 2008. This at a time where the state-subsidized Commonwealth Care was displacing private insurance for many people, thereby reducing demand, which should have reduced cost pressures.
Unfortunately, noted the Beacon Hill Institute, “private companies have no choice but to pass the higher costs onto the insured. Some of these costs fall in the double-digit range.” That naturally displeased public officials, since it undercut their claim to have solved Massachusetts’ health care problems.
Gov. Deval Patrick responded like King Canute: he insisted that premiums not rise. Predictably, his rejection of proposed rate hikes required insurers to operate at a loss and placed several in financial jeopardy.
Robert Dynan, the career insurance commissioner tasked with maintaining insurer solvency, wrote that the state “implemented artificial price caps on HMO rates. The rates, by design, have no actuarial support.” Last year Sandy Praeger, Kansas’ insurance Commissioner, observed: “Right now, premium increase have never been more political. If there is any way to justify not granting the increase, commissioners are looking for them.”
Thankfully, Gov. Patrick’s price controls did not fare well when challenged in court and his administration eventually negotiated reduced rate hikes. But the governor then came up with a new legislative program to arbitrarily reduce medical costs.
Even weaker restrictions would be counterproductive. The Beacon Hill Institute warned that “Controlling costs will translate into capping services provided by physicians and other caregivers. These are, in effect, price controls that will dampen the incentive to provide services and lead to longer wait times and the rationing of healthcare.”
Even worse, bankrupt insurance carriers would mean either no health care coverage or expensive government bail-outs. Yet John Graham of the Pacific Research Institute detailed shrinking margins and pervasive losses for Massachusetts health insurers. He warned “that if politicians refuse to allow health plans to increase their premiums at a rate commensurate with the increase in medical costs, health plans will plunge into financial crisis within a remarkably short period of time.” Indeed, carriers “will stand at the precipice of insolvency if the political class in Massachusetts insists on continuing to follow the path that it has chosen.”
Unfortunately, worse is likely to come. The Rand Corporation concluded that “in the absence of policy change, health care spending in Massachusetts is projected to nearly double to $123 billion in 2020, increasing 8% faster than the state’s” GDP. Added Rand, continued cost increases of this magnitude “threaten the long-term viability of the initiative.” Nor can the state count on an increasingly strapped federal government to continue its generous subsidies. Moreover, at some point people and businesses will flee the state rather than pay ever more to underwrite the state’s health care program.
Finally, RomneyCare inflated demand for medical services without increasing the corresponding supply. The Beacon Hill Institute concluded: “The vast number of the newly insured residents in Massachusetts is responsible for bottlenecks in the primary care system that forces residents to utilize emergency room care at a significantly higher than expected rate.”
A fifth of adults report difficulty in finding a physician to treat them. Earlier this year the Massachusetts Medical Society discovered “more than half of primary care practices closed to new patients, longer wait times to get appointments with primary and specialty physicians, and significant variations in physician acceptance of government and government-related insurance products.”
New York internist Marc Siegel observed: “The wait time for an appointment is now routinely over a month for primary-care doctors and specialists … . Internists and family practitioners report being so overwhelmed — too many patients, too much time pressure — that more than half are closing their practices to new patients.” You’d think Massachusetts was a province of Canada.
The state’s subsidized programs effectively drive away doctors. Explained Siegel: “More than half of primary-care docs in Massachusetts find themselves unable to work with Medicaid or Commonwealth Care (state-subsidized insurance), which both pay providers poorly.” Acceptance rates are far lower than even for Medicare, and one Massachusetts legislator has proposed making medical licensure contingent upon acceptance of state-subsidized plans.
Although the expansion of insurance was supposed to reduce emergency room use, visits rose 9% from 2004 to 2008. Ironically, noted Grace-Marie Turner of the Galen Institute, “difficulties in getting primary care have led to an increasing number of patients who rely on emergency rooms for basic medical services.” Thus, uncompensated care still costs more than $400 million annually.
The state also encouraged adverse selection, as predicted. Many healthy people chose to remain uninsured and pay the fine (or lie about having purchased coverage). They then bought insurance when sick, and dropped the policy when it was no longer necessary. Massachusetts was forced to institute an open enrollment period, limiting when people could sign up for insurance — an otherwise bizarre restriction when the objective is to increase the number of people insured.
ObamneyCare is bad policy. Gov. Romney’s signature policy achievement, no less than President Obama’s principal legislative victory, is a bust.
At least Mitt Romney did not compound bad policy with unconstitutionality, but his health care failure inevitably taints his presidential bid. He rightly faces an uphill task in convincing Republican primary voters that he is the best choice to be their nominee.
The old political playbook will not work this time around.
Bragging on Obamacare and the first stimulus in Arkansas will not do much for Pryor in 2014. In this clip above Senator Pryor praises Mike, Vic and Marion. (All three of those men bailed out and Marion and Vic were replaced by Republicans and in 2012 an election will determine the replacement for Mike Ross.) Then he goes on to praise President Obama’s leadership.
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Mark Pryor voted for the first stimulus and will not say what he thinks about the second stimulus. I have written about that before and offer the links below to those earlier posts. Also I wanted to pass along this fine article by Red Arkansas Blog.
Imagine the hearty laughter we had yesterday afternoon when we received an email from President Barack Obama’s campaign blaming House Republicans (and exhorting you to spam your local House Republican’s Twitter feed [if you are represented by a Democrat, you end up spamming Speaker John Boehner]) for not passing his second stimulus bill (thanks Debbie for letting us use that term!) while at roughly the same time, Mr. Obama’s chief cheerleader in the Senate, Sen. Harry Reid, blocked an effort to put Stimulus 2: Electric Boogaloo to an up-or-down vote.
Of course, Mr. Reid may have a good reason for relatively delaying the relative “right away” vote on Mr. Obama’s stimulus: he can’t herd his own caucus.
“It seems it’s a lot easier to block a Republican plan than to get the Democrats to rally around President Barack Obama. Even though Senate Majority Leader Harry Reid (D-Nev.) has repeatedly promised to call a vote on the president’s plan, he has slow-walked Obama’s jobs bill amid fractures within his caucus over how to pay for it.”
It also turns out that the Senate Democratic Whip Dick Durbin may also have a bit of a limp whip (isn’t there a pill for that?):
“Senate Majority Whip Dick Durbin (D-Ill.) said, at the moment, Democrats in Congress don’t have the votes to pass President Obama’s jobs bill”
Of course, this brings us to our own Sen. Mark Pryor who, to date, has not expressed a position on Stimulus II, despite voting for Stimulus I in 2009 that hasn’t really done a whole heckuva lot.
Given the Senate Democratic leadership being forced to delay an immediate vote while they scrounge the north side of the Capitol for votes, Mr. Pryor’s position on a bill that would increase taxes on our state’s natural gas industry (isn’t it good for jobs?) becomes very important.
Because of the importance of Mr. Pryor’s stance on Stimulus II, we are forced to wonder why our senior senator is skulking in the shadows and not speaking to it.
Is he worried about angering the increasingly liberal Democratic Party of Arkansas by not publicly supporting President Obama’s plan to raise taxes on job creators? After all, he sponsored that resolution to create National JC Penny White Sale Da… err… National Jobs Day.
PARTING SHOT
Will Sen. Pryor add an unemployed person to his office staff? How about the DPA? Who should we direct resumes to?
It is my view that if the economy keeps stinking that Republicans will have a field day in November of 2012. However, the same principle holds true that challengers to Democrats will be very successful in Democratic primaries. In Arkansas many have longed for another Clinton in the White House. Could it happen? It is my […]
Thanks to the Arkansas Times Blog and to Arkansas Media Watch for pointing out what Senator Pryor said in his recent visit to Rogers, Arkansas: Getting the economy on track will require deep cuts to the federal budget and a fairer tax system, Sen. Mark Pryor, D-Ark., said Tuesday. National defense, Social Security and Medicare […]
Dear Senator Pryor, Why not pass the Balanced Budget amendment? As you know that federal deficit is at all time high (1.6 trillion deficit with revenues of 2.2 trillion and spending at 3.8 trillion). On my blog http://www.HaltingArkansasLiberalswithTruth.com I took you at your word and sent you over 100 emails with specific spending cut ideas. However, […]
Dear Senator Pryor, Why not pass the Balanced Budget Amendment? As you know that federal deficit is at all time high (1.6 trillion deficit with revenues of 2.2 trillion and spending at 3.8 trillion). On my blog http://www.HaltingArkansasLiberalswithTruth.com I took you at your word and sent you over 100 emails with specific spending cut ideas. However, […]
Mark Pryor voted for the Debt Deal on August 2, 2011. He said, “We must continue making tough decisions to reduce our debt. ” However, I don’t think cutting 22 billion out of projected increases in a 3.6 trillion budget is “making the tough decision to reduce our debt.” Aug 01 2011 Statement by Senator Mark […]
Dear Senator Pryor, The President asked us to contact those representing us in Washington and that is exactly what I am doing today. Let make a few points. First, in the past few months I have responded to your request to provide SPECIFIC SPENDING CUT SUGGESTIONS to your office. I have done so over 100 […]
Mark Pryor’s support of the ultra liberal Obama is very clear in the video clip above. He voted for President Obama’s plan to nationalize healthcare and Obama’s stimulus plan that wasted almost a trillion dollars. Now he is following President Obama down the path of raising taxes during the debt ceiling debate. The Arkansas Times Blog […]
The National Federation of Independent Business (NFIB) stole a march on the Obama Administration this morning by filing a petition with the U.S. Supreme Court appealing the 11th Circuit’s Obamacare decision.
The Department of Justice (DOJ) had announced on Monday that it was not going to ask all 11 judges of the 11th Circuit Court of Appeals to review en banc the August 12 decision of a three-judge panel of the 11th Circuit that found the individual mandate unconstitutional. This opened up a path to an appeal by DOJ to the Supremes.
Dan Mitchell gives 12 reasons Obamacare will fail.
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However, with this petition, the NFIB jumped ahead of Eric Holder’s slow-moving DOJ (which until Monday had done everything it could to slow-walk this case filed by 26 states and the NFIB). The NFIB is obviously not appealing the three-judge panel’s opinion about the unconstitutionality of the individual mandate. But the NFIB is appealing the portion of the panel’s decision that held that the unconstitutional individual mandate could be severed from the Obamacare legislation.
The NFIB is asking the Court to overrule this holding, since “Congress itself deemed [the mandate] ‘essential’ to the Act’s new insurance regulations.” Given that the 11th and 6th Circuits have issued “directly conflicting final judgments about the facial constitutionality of [Obamacare’s] mandate,” the case is one that the Court should obviously take up given its interest in eliminating conflicting opinions in the courts of appeal.
What also differentiates this particular case from the many other lawsuits that have been filed against Obamacare is the “all star” lineup of Supreme Court litigators that the NFIB and the 26 states have lined up to argue their case before the Supreme Court. It includes Michael Carvin, a former DOJ official who has argued (and won) numerous cases before the Court; Gregory Katsas, a former DOJ official who was a clerk to Justice Clarence Thomas; Kevin Marshal, another former DOJ official and Thomas clerk; Hashim Mooppan, a former Justice Antonin Scalia clerk; and Randy Barnett, a nationally recognized constitutional scholar and professor at Georgetown.
The lawyers for the states include Paul Clement, former Bush Administration Solicitor General; Lee Casey, another former DOJ official who clerked for Alex Kozinski, who is now the Chief Judge of the Ninth Circuit; and David Rivkin, another Supreme Court litigator with wide experience in the government, including in the White House and the DOJ.
The government lawyers in the DOJ’s Office of the Solicitor General who will be arguing the constitutionality of Obamacare will have their work cut out for them.
It is a great day if Obamacare ends up going down through the courts. Is there anyway in the world if the Founding Fathers were on the court that Obamacare would have any chance at all to become law.
Today is a great day for liberty. By striking down the individual mandate, the Eleventh Circuit has reaffirmed that the Constitution places limits on the federal government’s power. Congress can do a great many things under modern constitutional jurisprudence, but, as the court concludes, “what Congress cannot do under the Commerce Clause is mandate that individuals enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die.” Indeed, just because Congress can regulate the health insurance industry does not mean it can also require people to buy that industry’s products.
One of the striking things about today’s ruling is that, for the first time in one of these cases, a Democrat-appointed judge, Frank Hull, has ruled against the government. Just as the Sixth Circuit Judge Jeffrey Sutton made waves by being the first Republican appointee to rule in the government’s favor, today’s 300-page ruling shows that the constitutional issues raised by the healthcare reform—and especially the individual mandate—are complex, serious, and non-ideological.
Supporters of limited constitutional government need to temper their celebrations—just as they wisely tempered their sorrows after the last ruling—because we must all now realize that this will not end until the Supreme Court rules. Nevertheless, today’s decision gives hope to those who believe that there are some things beyond the government’s reach and that the judiciary cannot abdicate its duty to hold Congress’s feet to the constitutional fire.
A single-payer health care system is one in which a single-entity — the government — collects almost all of the revenue for and pays almost all of the bills for the health care system. In most single-payer systems only a small percentage of health care expenses are paid for with private funds. Countries that have a single-payer system include Australia, Canada, Sweden and the United Kingdom.
Single-payer is popular among the political left in the United States. Leftists have emitted tons of propaganda in favor of a single-payer system, much of which has fossilized into myth.
Here are some of the more prominent single-payer myths:
Myth No. 2: Claims of rationing are exaggerated.
Jonathan Cohn, author of Sick, wrote that the “stories about [rationing in] Canada are wildly exaggerated.” Yet advocates of single-payer never say what they mean by “exaggerated.”
The fact is that people often suffering great pain and anxiety while they spend months on a waiting list for surgery. Others spend months waiting for a surgery, only to have it cancelled, after which they will spend even more time waiting for another surgery. Sometimes people even die while on the waiting list.
Media in foreign nations are full of stories about people suffer while on a waiting list. In Canada, Diane Gorsuch twice had heart surgery cancelled; she suffered a fatal heart attack before her third surgery. In Great Britain, Mavis Skeet had her cancer surgery cancelled four times before her cancer was determined to have become inoperable. In Australia, eight-year-old Kyle Inglis has lost 50 percent of his hearing while waiting nearly 11 months for an operation to remove a tumor in his ear. Kyle is one of over 1,000 children waiting over 600 days for ear, nose and throat surgery in Warnbro, a suburb in Western Australia.
These are not mere anecdotes. Much academic literature has examined the impact of waiting lists on health. A study in the Canadian Medical Association Journal found that 50 people died while on a wait list for cardiac catheterization in Ontario. A study of Swedish patients on a wait list for heart surgery found that the “risk of death increases significantly with waiting time.” In a 2000 article in the journal Clinical Oncology, British researchers studying 29 lung cancer patients waiting for treatment further found that about 20 percent “of potentially curable patients became incurable on the waiting list.” [Back to Top]
By moving to a premium-support program, Congress can introduce the powerful
forces of consumer choice and competition into Medicare, forcing health plans
and providers to deliver value for taxpayer and beneficiary dollars. Similar
approaches to health care financing and delivery have been used in Medicare Part
D and the FEHBP, the program that covers Members of Congress. The record shows
that this approach can successfully control and slow the growth of health care
costs while increasing patient satisfaction.
Medicare today is less a traditional social insurance program, in which
beneficiaries pay for their benefits, and is becoming more of an income transfer
program. Today’s enrollees are not, in fact, “paying for” their Medicare
benefits, since it is really a “pay as you go” system with today’s workers
paying for today’s beneficiaries. Even so, payroll taxes pay for just a portion
of one part of Medicare, and the premiums that seniors pay for the other parts
cover less than a quarter of those costs.
Taxpayer subsidies account for 85 percent of total Medicare program costs. If
Medicare is left unreformed, our children and grandchildren will pay those
higher taxes even as they work and save to provide for their own families.
By reducing the level of tax subsidies for seniors with higher incomes, the
Heritage plan reduces both the burden on future taxpayers and dependence on
government. By adding catastrophic protection against serious illness and
targeting funding to those who are most in need, the plan strengthens Medicare
as safety-net insurance for all Americans and guarantees them better health and
economic security. Finally, by reducing the role of bureaucracy and red tape in
the delivery of medical care, the Heritage plan makes the practice of medicine
more attractive, thereby encouraging dedicated and talented individuals to join
the health professions.
The Daily Hatch 