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Our Recent Essays Behind the Front Page
Wednesday, August 12. 2009
I actively oppose ObamaCare for its many dangerous details and for its needless excess. At the same time, I regret that the tack taken by President Obama and Congressional Democrats has set back the prospects for constructive, needed reforms. They have bullheadedly and ideologically gone in wrong directions, too far, and inflamed natural and largely justified public doubts and passions.
We face some core problems, such as breakthrough technologies increasing medical costs – and survivals and comforts, about a quarter of the uninsured actually being citizens in need of help, individual insurance sometimes being difficult to get, payment rates tilted to discourage general practice doctors so specialists are overused and paid, inefficient paperwork, tort attorneys seeking largesse – sometimes more than justice – causing undue defensive medicine costs. Almost all agree they exist. Almost all agree they require remedy. And, almost all agree on the general nature of the remedies.
Strict focus upon these, with realistic expectations and clear details of treatment, would likely have led to broad consensus and rapid passage. They could be dealt with specifically, moderately, inclusive of proven ways, and incrementally to make adjustments.
The overreach by the president and Congressional Democrats, however, uses these core legitimate concerns to launch a wholesale reshaping of all of health care. Such overreach is inherently defective simply because it is impossible to run such a large-scale endeavor, in addition to how ill-defined or speculative much of it is. It is recognized as a major grasp for control over our lives by central government, arousing the fears and resentments of most Americans at being controlled by remote bureaucrats. When the enormous direct costs are calculated, and the major disruptions and restrictions imposed on most Americans are individually calculated, there is little payoff either to the economy, improved health care, or most individuals. To add to the debacle, some of the core ills are not even treated.
The lines of debate have been hardened into battle lines due to the sheer lies expressed by the president and leading Congressional Democrats, easily exposed by their own recorded words to the contrary, and the insults hurled by them and their minions against everyday Americans’ right to express their concerns.
Candidate for president Obama usually restrained from these excesses, broadly and amorphously referring to the broad consensus on the core problems, and his electoral supporters restrained their language and true intents in order not to undermine his election. Thus, President Obama began his administration with widespread faith for reasonable hope and change. President Obama and Congressional Democrats, and their ideological allies, have succeeded in near utterly destroying this faith, as demonstrated in the rapid large declines in their and their proposals’ poll ratings.
There are now three possible ways this may play out: The overwhelming Democrat majorities in the Congress may ignore their electoral fate in 2010 by ramming through their discredited and dangerous program. Unlikely. The entire enterprise may be abandoned or voted down. Most likely. Sane heads in
Now, for those who have read this far, what should health care reform look like?
First and foremost, each measure taken should be discretely restricted to a specific core issue. That will aid understanding and informed discussion. In itself, this will go a long way toward reforming the Congressional excess of loading down bills with hidden payoffs and extraneous issues, and contribute toward increased confidence in Congress’ intents and behavior.
Second, it must be recognized and accepted that some core issues may, thus, either be rejected or not go to the lengths that some may desire. Somes’ perception of the perfect should not delay or imperil the adoption of the good. Some reforms may be better than others, and some reform may be better than none. Again, in itself, this self-restraint and respect for a democratic and open process will go a long way toward restoring confidence in the sanity and trustworthiness of various policy proponents.
Third, all details must be widely published, with adequate time to read and discuss them. No more bums rush of the public.
Fourth, all such bills passed should contain a definite sunset provision, of say 5 years, upon which they must end or be readopted, and improved as experience may dictate. This will reduce the realistic fear that what may be bad legislation cannot be stopped and will continue to wreak its havoc.
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Good thoughts, Bruce. And good luck on seeing anything of your thoughts entering the real world.
The most powerful rebuttal/incentive to me... is that Congress and Federal employees live under what ever plan is passed, which they're presently not. Should they pass anything which doesn't include themselves being including with the lowest of the low, then it's bullshit.
There is no sane reason at all for which that should not be the case. Unless one is better than the other. That's anathema to to the American ideal.
So... screw them. And let's vote the bastards out.
Progressives don’t want progress, they seek transformation. Perfecting mankind does not admit half-measures. We must kill the statist zombie and set fire to its corpse, or our children are consigned to the same fight.
A sunset clause is a good idea for every law. Perhaps even requiring a supermajority for the first re-adoption.
I think the entire premise here is flawed. The subject is not the jurisdiction of the federal government.
All of these national government programs seem unconstitutional to me. Why should the federal government collect taxes from individuals and then proceed to distribute money back to the states? (And some states get more than is taken.) What legal basis does the federal government have to cram down socialized medicine?
The Tenth Amendment: The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively or to the people.
I also don't want some phony judge telling me I can't read plain English and this says something else.
What am I missing?
I agree with every word, Bruce.
Re Barrett's comment, "picky picky/"
Maybe. But none of this is the province of government in my mind. I also don't trust sunset provisions.
Just notice the comment at 7:07 and don't know the author. Just curious, is #5 sarcasm or troll?
That smells like troll rather than sarc. To BD and Barrett -- I say "amen" at the top of my lungs. Conceivably state business, clearly not federal business.
I would like to take on one thing in your article (at least for now):
"We face some core problems, such as breakthrough technologies increasing medical costs ..."
In computing, breakthrough technologies continue to advance and decrease in costs. Why is it that "medical breakthroughs" - which are often strongly associated with computer technology "breakthroughs" - continue to increase in costs?
I propose that regulation and subsidies (i.e. - government intervention) limit competition and drive up the costs in the health field, while lack of these manipulations in general computing leaves the door wide open for competition and invention (there's a better word to go here that I just can't think of at the moment). To stay in business under these circumstances you must constantly look for ways to improve service and reduce costs to stay ahead of the other guy without losing money.
I could string this out more, but I like Maggie's Farm writers overall, y'all are thoughtful people, so I'll leave it here and avoid rambling. :o)
If you've ever had an electrocardiogram (and you probably have), it was a trivial procedure on a machine found in nearly all medical offices. When I was a young medic, it was a moderately technical procedure and we had only a couple of machines at the hospital. In 1950ish, the EKG was the CAT scan of the early 80's, experimental and expensive.
New equipment in the medical field often starts out with only a few applications at only a few places, so there's a steep cost for training and deployment. Economies of scale eventually kick in and the procedure may well be over-used after a while. The unit cost goes down sharply but the aggregate cost may rise. The result is usually longer and healthier lives and greater "quality of life".