Monday, June 29, 2009

HEALTHCARE, CAP & TRADE

Last week by a thread, President Obama and Speaker Pelosi won their Climate-Change Cap-and-Trade bill, by 2l9 to 212. The bill was designed to decrease Greenhouse gas emissions and promote renewable energy. Eight Republicans voted for it, 44 Democrats voted against it. (All five Connecticut representatives voted for it.) One hundred amendments were submitted, only one was allowed. The bill now goes to the Senate.

Misnamed “American Clean Energy and Security Act,” HR 2454 is about four words, announced Nancy Pelosi celebrating the victory, “Jobs, Jobs, Jobs, Jobs.” But it is not a green jobs bill. Millions of additional jobs will be lost, according to the Heritage Foundation: In an average year, 844,000 jobs will be lost. In a peak year two million jobs will be lost.

Over 1,000 pages long, HR 2454 has another 300 pages in an amendment drafted overnight and submitted Friday morning at 3:09 a.m. Minority Leader John Boehner for an hour read aloud from it on the House floor. To be understood, the amendment’s provisions have to be integrated with the 1,000-paged text which nobody had time or opportunity to do.

Less revolutionary, perhaps nearly as important to Mr. Obama, is the health-care bill. At the health-care gathering at the White House on June 24, expert Gail Wilensky asked the President how he expected to pay for it.

He gave a non-answer. The American people are up to it, he said. There is not a challenge we have not been up to. We will not spend money we do not have, he added. It will be deficit-neutral. Previously he has said he would decrease spending on Medicare (and Medicaid?) by $313 billion (and adding another new $643 billion.) An elderly needing costly surgery might needt to settle for a “painkiller,” he implied.

The easiest way to pay the ballooning cost it is the way Canada and England do it, by rationing. People die or travel to another country rather than waiting for appointments. Commissions take a long time to make decisions. Even in the U.S., appeals to Medicare took 21 months on average in 2003.

If you like your insurance, nobody is going to take it away from you, says Mr. Obama. Several times as a candidate he said that we should have what he as a Senator has. He meant the FEHBP, Federal Employee Health Benefit Program, available to congressmen and present and past federal employees, who can make their choice among 290 separate plans. (Sections 3101 and 277 of Senator Kennedy’s bill, which requires everyone have health-care insurance, offer a wide range of choices, but if you do not enroll, you can be fined.)

But that is not what Mr. Obama means when he says “public option.” He might mean a separate parallel program. The uninstructed public may think that’s a good thing especially if it is public. Our Congressman Christopher Murphy on the floor of the House cited one (flawed) poll indicating that the public prefers public to private.

Unfortunately, a public option will drive out private insurers. Since it can call upon the Congress for more funds and the Treasury for bailouts, it will undercut private insurance. Millions will drop their private policies, which will drive out private insurers.

Supporters of public option make several claims: It will be efficiently administered. Like the post office and the IRS? That it will offer competition, but there are 1,300 private companies offering competition. It does not need to make a profit, but there are non-profit insurers all competing.

Particularly where the public-option company is also the referee, a public option does not level the field. And it leads to single payer. Canada and England, single payers, are widely known (or should be) for unsatisfactory quality and quantity of care.

It is often claimed that single-payers cost less than the U.S. But spending among countries is not comparable that ignores differences in drugs, protocols, and equipment. Our drugs are the newest and finest available; theirs, we will have replaced for our newest. Between 1998 and 2002, twice as many new drugs were created in the U.S. as in Europe.

The Obama Team argues that “expanding health-care will bring down the cost.” How, adding 47 million enrollees will lower cost, is baffling. Peter Oszac says spending can be “moderated” if “diffusion of existing costly services were slowed.” Medicare has already curtailed use of “virtual colonoscopies, certain would-healing devices, and even a branded asthma drug.” The Medical Advisory Council or Federal Health Board, will let them know.

A great deal can be done to lower spending on health-care. A new revolutionary structure is not needed. Its spending will rise, its quality will fall. Finally, one might ask, is it constitutional? Does any of this violate the “life, liberty, and pursuit of happiness” of the Constitution? Do the Leaders care?

While the House will shortly be debating the health-care bill, the Senate will be facing the Cap and Trade-Climate Change-Energy bill. The consensus on global warming is breaking up. Support for Climate Change has stopped in New Zealand and slowed in Australia, Japan, and parts of Europe. In the U.S., an EPA report, hitherto concealed, weakens EPA support. In the Senate, this green energy bill will be a hard sell.

By Natalie Sirkin
c2009
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