I wrote last Friday about "3rd rails" in American politics; programs like Social Security and Medicare that, no matter how wasteful, politicians can’t substantially deal with.  The reason is that the government has made promises, people have reordered their lives around those promises, and thus any attempt to change the conditions of those promises is met with vehement opposition.

This, then, is related to the eternal life of government programs.  Part of the reason some of these programs live on is because the promises made and the responsibility to live up to them and honor them.  The problem is, we have to honor them even if doing so bankrupts us (or, more specifically, future generations).  We have to honor them even if the money could be spent more efficiently another way, getting the same job done only with better results.  We are already saddled with debt because of some of these huge programs, but are also saddled with current and future promised payments that we can’t afford now, and thus will have to tell our children to make good on.

Is that moral?

Some have said that it’s immoral not to take care of the elderly and infirmed, but by doing it on the backs of our children and grandchildren, is that really the more moral route?  With the health care reform bill, we are making promises that future generations must pay for.  And we are making promises that they may not be able to afford at all after this generation has already spent their inheritance on previous promises made.

And, as I noted previously, no matter what you hear from any politician on how much this or that program will cost, it will cost more.  History is strewn with so many examples of this that anyone believing these numbers is utterly ignorant, willfully or otherwise. 

Making promises binds us to honor them, which is a good thing.  But making promises with an inefficient bureaucracy binds us to a millstone that will continue to take us down with its unsustainable load, and we can’t afford that.

No government ever voluntarily reduces itself in size. So, governments’ programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this earth. — Ronald Reagan (click here for the audio clip)

I’d say with precious few exceptions, Reagan’s words express a truism for any government instituted by man. 

Given this, it simply doesn’t make sense to make huge changes to our health insurance system, putting so much under the purview of the government, all at once.  Once it’s there, no matter how poorly it work, those who benefit from the programs (or believe they do) will make up such a constituency that no politician will dare cross them.  It’ll become yet another 3rd rail that no one wants to touch.  The only option will be to throw good (borrowed) money after bad.

I can say this with confidence because that tracks with history.  It has happened time and time again, and there’s not one thing to indicate that if this doesn’t do what it claims to do, it’ll be scrapped.  Instead, there’s plenty of evidence to suggest that government, regardless of which party’s in charge, will constantly try to "fix it", usually by giving the federal government more control and taking that control and freedom away from the individual. 

The better way to do this is incrementally, but the same problems can plague even these smaller items unless these items increase public freedoms.  For example, allowing health insurance to be purchased across state line is something that would give individuals more choices and hence drive down costs.  When you can only by apples from one  vendor, he can charge what he likes, and it doesn’t matter how good his apples are; where else are you going to go?  When there are 20 vendors, competition ensues and vendors compete on cost and quality.  Allowing this would have immediate results, and the results could be determined to be good or bad.  Actually, I see no real downside to this particular proposal from the Republicans, but if there were, it’s easier to repeal a small law than a huge, intertwined, governmental system. 

[One might ask, doesn’t the proposed public option increase competition?  Well yes, but by 1 rather than by hundreds.  But the general problem with getting the government into the market is that the government makes the market’s rules as well and can undercut competition because it doesn’t have to pay its costs from charging for the service; it can tax everyone on the side, hiding its true price on your 1040 form.]

A massive overhaul of any industry is not something government should be doing.  That’s another reason why I oppose the Democrat’s health care reform bill.

As events continue to unfold while the health insurance reform bill comes either to a vote or a train wreck (or both), I want to hit on a few main reasons why I’m against the Democrats’ idea of "reform".  Today, it’s the money.

Obama has said that whatever he signs must be either deficit-neutral or indeed reduce it, and the claims are that this bill will do just that.  In fact, it’s one of the reasons Democrats say that using reconciliation — typically used for deficit reduction — is appropriate.  They point to the CBO numbers for the bill as coming in under $1 trillion for the first 10 years, while generating savings that would go beyond that.

But here’s the thing. 

First of all, they’re gaming the CBO system.  By putting off any real serious spending for 4 years or so, while collecting taxes in anticipation of the spending, the real cost of the program is hidden.  To find the real estimates, click here to hear Democratic Senator Max Baucus give a better number for it; $2.5 trillion.  The difference?  In his words; if you start counting from the year 2014.  Knowing that the CBO rules only look 10 years out from bill passage, Democrats have crafted the timetable to favor a low CBO number, and they trumpet this fake number on the talk shows.  At least we have Senate video to show that they do know better, but they’re just hoping their constituents aren’t paying attention (which it looks like they aren’t).

Second of all, government programs virtually always cost more than original estimates, whether this is because the first estimates were faulty or gamed, or whether folks like the giveaways so much they ask for more, or whether politicians buy votes by increasing benefits.  The "experts" who were estimating the cost of Medicare back in 1966 — when it cost $3 billion — said that by 1990 it would cost $12 billion, allowing for inflation.  Instead they were off by almost 9 times; it was $107 billion.  And in 2007, it was costing us $431 billion.  For just 1 year.  Even after cost cutting measure like reducing payments to doctors, which then causes some doctors to leave the Medicare market.  (Follow the link for other medical cost underestimating.)

So in order to get this past the American people, Democrats are massaging the data to fit the narrative, while knowing full well (if they have any knowledge of history at all) that they are low-balling by an order of magnitude or more. 

It’s not just the cost estimates; it’s the disingenuousness and outright lying that is going on that should give any supporter pause as to what it is they’ve bought into.

Should something as huge as the remaking of the healthcare system in America be done in such a "unipartisan" manner?  Ask Barack Obama.  That was then:

And this is now:

White House officials tell ABC News that in his remarks tomorrow President Obama will indicate a willingness to work with Republicans on some issue to get a health care reform bill passed but will suggest that if it is necessary, Democrats will use the controversial "reconciliation" rules requiring only 51 Senate votes to pass the "fix" to the Senate bill, as opposed to the 60 votes to stop a filibuster and proceed to a vote on a bill.

So then, it requires a "sizeable majority" so long as it doesn’t take too long.  Then all bets are off.  Gotcha.

There are those who say that our government is "us", so to speak, and thus if health care reform passes, it’s because we wanted it.  Well, except that a majority of us don’t.  This isn’t representative government.  Yes, the general idea did enamor more folks when it first hit Congress, but the more people know about it, the less they have wanted it.  With one exception, opposition to it has been over 50% since the middle of September, and peaked over 50% often before that. 

Most of us don’t want this monstrosity.  But Obama is more than willing to shove aside his principles of good governance, and do precisely what he accused Bush and Rove of, in order to get his way.  Representative government indeed.

There is currently, as is well known, a debate on health policy. Within this debate it seems to me there is a fundamental misunderstanding between right and left on this matter. I’d like to make as pointed a expression of this misunderstanding in the hopes that those on the left might clarify for my their views on this matter.

The left makes the following claims:

1. Restructuring healthcare is required because of the millions without any health insurance coverage.
2. Controlling the rising costs of healthcare is a major concern as well. Therefore the healthcare bill contains measures to contain and regulate pharmaceutical and insurance firm profits as well as doctors compensations. 

These items are problematic especially in the light of the three proposals on the table from the left.

Regarding item 1, a plan which would provide a minimal adequate universal catastrophic health care coverage is neither complicated nor cost prohibitive. It does not require a 2.5k page plan, one more of the nature of 40 pages would suffice, i.e., not much larger than the heath care coverage legal statement/booklets which most of of have for our own plans. This is not by any stretch of imagination the healthcare plan on the table. Therefore it cannot be construed that this issue is in fact a real feature/concern of the plan(s) in question.

As to item number 2, the first and more natural explanation for rising costs is due to a relationship between supply and demand. That is rising costs are symptomatic of rising demand in comparison with a supply. The bill(s) in question instead of consisting of a mechanism for increasing supply and/or attempting to ameliorate expectations or demand is instead more of the nature of a price control and regulatory scheme. In the real world, price controls of commodity items lead to lowered supply and scarcity … not increased production. That is price controls are in reality very good ways to choke off and decrease the supply of a thing. Furthermore the profit margins of insurance companies and “big pharma” are not out of line when compared to comparable industries. Expectations of large cost savings by regulation are not warranted, and this is in addition to the above noted deleterious effects of cost controls.

Putting these two remarks and their objections together alongside the much touted (by the left) reminder that those on the left are so very much smarter than we knuckle-dragging dim-witted conservatives that the left is aware of this disconnect between their policy proposals and the expected effects of their proposal. Thus those clever fellows on the left realising that a universal reasonable catastrophic insurance coverage plan is 40 pages and that cost controls do lead to shortages. 

Now one might propose that the Democratic politicians and pundits are aware that their proposals and justifications for the same have little if anything to do with each other and that instead that they prefer these proposals for very different reasons than those stated. For example, these proposals may ease the passing of any number of other social measures which the increase in social control and power these bills might afford. That, while dishonest at best, is at least understandable after all they see this measure to be one which is to their personal advantage. The problem is the rank and file member of the left. Why do they support a bill which so badly fits the stated aims? This, for me, a mystery.

Otherwise known as the Health Care Summit.

Bruce McQuain at Q&O has a good round-up of the day’s talkfest. 

I’ve been watching and/or listening to the health care summit today and it became fairly obvious from the opening bell that there wasn’t going to be much of anything worthwhile or substantive accomplished – not that I’m surprised.   5 hours into it, it has been mostly the exchange of talking points.

Did anybody really think this was anything more than a very long press conference?  Or perhaps a fig leaf of "transparency" for a bill that has been worked out almost entirely in back rooms.

One thing I thought was interesting was that tort reform, often handwaved away as not really saving much, was shown to be something that, if Democrats are serious about controlling costs and not beholden to the trial lawyers, should be in any reform bill.

Republicans have argued for tort reform for medical malpractice. Democrats (Dick Durbin in particular) have argued against it. McCain used the Texas model to make the point for tort reform. Texas, which has instituted tort reform has seen malpractice premiums reduced by 27% and has had a net gain of 18,000 doctors – extrapolated nationally using direct savings (malpractice insurance premium cost) and indirect savings (reduction of the “defensive medicine” practiced by doctors) the amount saved could be in the $150 billion range.

Certainly worth putting in if the Democrats are serious.  We’ll see.

In going through anecdote after anecdote trying to prove their points, it seems one Democrat got the wrong moral of the story.

Chris Dodd is now telling a story about a guy who privately put together a small business health care association in CT. Of course the point lost on him as he argues for the government to act is it was done privately and perhaps the government’s role ought to be enabling that. Rep. Joe Barton is now making that point.

Local solutions to local problems, not one-size-fits-all square pegs in round holes.  Give the people the freedom to get done what they need to, and whadaya’ know; they will!

Bottom line – no bi-partisan attempt on either side to reach a compromise. And again, that’s fine.

Amen to that.

That’s what writer Keith Baldrey is asking.

Is health care becoming the mortal enemy of our country’s education system?

I don’t pose this question facetiously. When we’re discussing public services, it’s important to remember that at the end of the day, everything comes down to money.

And it is obvious that health care is increasingly getting that money at the apparent expense of other public services – most notably education.

In fact, our health-care system’s voracious and unending appetite for tax dollars is crowding out spending in all sorts of other areas.

That’s a fair question.  We don’t yet have a system like Canada’s, for example, but we do have tax dollars that do go into heath care.  But is it really that bad?  Is there really that much of an issue of having to decide either health care or education?

We no, not really.  As James Taranto notes:

If only we had a single-payer system like Canada’s . . . Oh, wait! Baldrey’s article is about Canada’s system. It appears in the Surrey (British Columbia) Now.

And be thankful that it won’t be.

I’m going to form a union (if the “union exemption” for taxes on healthcare gets passed). Some features of my new union:

1. The dues will amount to the price of your employer’s healthcare, which we will pay for on their behalf … but get that nice loophole thing.
2. Management is welcome to join.
3. We will not take up any wage/workplace or other similar issues.
4. We will not collectively bargain with management, our truck is not with them, but with regulatory burdens.
5. Will will take full advantage of government tax shelters and perks for unions.
6. We will dissolve immediately when it is no longer advantageous to exist.

Seems like these simple steps will set the course in motion. Whaddya think? We have Blue Dog dems, RINOs (DINOs?) why not tea party unions.

Are there other perks and benefits to unionising that I don’t know about? I’ve spent so many years despising unions that I hadn’t realized all those reprehensible government perks to buy votes can and should be subverted and used by the rest of us.

Commenter Boonton kindly and helpfully remarked that yesterday’s post was clear as mud. What follows is an attempt to clarify and expand on what I was trying to say.

In the book (Everything Was Forever, Until It Was No More) that I was reading on the recent travels over break, I came across this passage (the first link is an Amazon book link, the second to a chapter provided on-line by the publisher … which you can likely also buy it from, but they won’t put any change in my tip-jar).

One of the central contradictions of socialism is a version of what Claude Lefort called a general paradox within the ideology of modernity: the split between ideological enunciation (which reflects the theoretical ideals of the Enlightenment) and ideological rule (manifest in the practical concerns of the modern state’s political authority). The paradox, that we will call “Lefort’s paradox,” lies in the fact that ideological rule must be “abstracted from any question concerning its origins,” thus remaining outside of ideological enunciation and, as a result, rendering that enunciation deficient. In other words, to fulfill its political function of reproducing power, the ideological discourse must claim to represent an “objective truth” that exists outside of it; however, the external nature of this “objective truth” renders the ideological discourse inherently lacking in the means to describe it in total, which can ultimately undermine this discourse’s legitimacy and the power that it supports.

First, order of business then is to unpack this a little. The Lefort paradox is sort of a political analogue to Gödel’s incompleteness. It is (the author and presumably Mr Lefort) an observed quality common to ideological regimes. What it claims is that there is a operational split between “enunciation” and “rule”. The enunciation comprises the principles and philosophical grounding that forms the basis of the regime. For example, the Soviet regime was based on Marxist principles and dogmas. The rule then is then the implementation. The point is once a regime is established those involved in the regime can no longer actively question and modify the enunciation.  The ancillary point is that as a result of this paradox ideological regimes are fundamentally unstable. They are rigid because of this separation and unable to adapt in a changing world and circumstance. The book noted above makes a direct connection with the instability of the Soviet state with this paradox. It is a feature of ideologically based regimes.

Now, there are those (particularly Marxists and others) who often claim the governing ideology of the Western democracies and specifically the US is an ideology of market capitalism. But the question of whether market capitalism is in fact an ideology or not (and I don’t think that it really is an ideology) is not one which is germane to this point. For I think that the state set up by the founders is non-ideological … or at least it should be but very often isn’t. Market capitalism or consumerism or whatever are not encapsulated and defined by or within the Constitution. The US Constitution and government does not assume or enshrine marketcapitalism or in fact any particular ideology.

What sorts of governments are non-ideological? A government which is defined by structural and/or procedural elements are non-ideologically defined. Many governments of many types in the past were of this sort, being defined by procedural elements and all of these have been far more long enduring that the flash in the pan 19th and 20th century ideological experiments. So, if one measure of a good government is sustainability and durability, then defining ones state procedurally and not ideologically would seem to be a good thing.

The government as Constitutionally set up (and as well by the Declaration that preceded it) is non-ideological and instead is procedural. It provides a framework within which ideologies can co-exist. The Constitution sets up regulations and restrictions on the federal government which are routinely ignored by Congress, the SCOTUS, and the President. But, the point is if they chose not to ignore the Constitution (for example all rights not enumerated in the Constitution are not available to the Federal government) then some states (or small municipalities if given that freedom) could in fact become socialist, technocratic, theocratic or whatever they chose. Marxism for example is on the whole compatible with the US Constitution. Laws and structures could be set up by the state to support the tenets and dogmas of Marxist polity within the framework of the Constitution.

However, given the instability of ideologically based states, it would follow that enshrining and establishing ideological law on a Federal basis should be regarded as problematic and therefore avoided.  For this makes the state susceptible to the Lefort paradox and the accompanying problems. In fact the founders foresaw that and provided us with the 10th Amendment reserving what rights and powers not explicitly granted to the federal government to the States and the people. Alas, the time for the 10th arguably has come and gone, for de facto if not de jure this Constitutional provision has been repealed by rapacious erosion of the federal expansion/explosion in the 20th century.

Now, right and left, especially in the last decades have been becoming more and more ideologically separated and forceful. “Universal” healthcare is just the latest example (from the left) of this trend. Universal healthcare is ideologically motivated. It is part and parcel of a particular ideology.  Installing it on a federal/national level will enshrine ideology nationally. Now this statement will undoubtedly bring up a plethora of examples of federally mandated instantiation and promotion on ideological ideas and dogmas from the right. And yes, that’s right, this notion condemns those as well. And note, as well, an establishment of Universal healthcare violates the 10th Amendment, my right to not purchase healthcare is not one which is enumerated within the Constitution therefore it is reserved to the people.

So, if you’re for universal healthcare and specfically the bill being pushed in Congress now … you should be ashamed of yourself, it’s an un-Constitutional travesty (which is as well infected with the Lefort paradox) and furthermore ultimately it threatens the durability of the nation as constituted by the founders. If your response to that in turn is “so be it” recall that the corollary is “for only a short time.”

In the book (Everything Was Forever, Until It Was No More)I was reading on the recent travels over break, I came across this passage (the first link is an amazon book link, the second to a chapter provided on-line by the publisher … which you can likely also buy it from, but they won’t put any change in my tip-jar). 😀

One of the central contradictions of socialism is a version of what Claude Lefort called a general paradox within the ideology of modernity: the split between ideological enunciation (which reflects the theoretical ideals of the Enlightenment) and ideological rule (manifest in the practical concerns of the modern state’s political authority). The paradox, that we will call “Lefort’s paradox,” lies in the fact that ideological rule must be “abstracted from any question concerning its origins,” thus remaining outside of ideological enunciation and, as a result, rendering that enunciation deficient. In other words, to fulfill its political function of reproducing power, the ideological discourse must claim to represent an “objective truth” that exists outside of it; however, the external nature of this “objective truth” renders the ideological discourse inherently lacking in the means to describe it in total, which can ultimately undermine this discourse’s legitimacy and the power that it supports.

Now, there are intellectual currents that would claim the governing ideology of the Western democracies and specifically the US is market capitalism, which some shoehorn to fit the definition of a ideology. Yet, I think that the state set up by the founders is non-ideological … or at least it should be but very often isn’t.

The government as Constitutionally set up (and as well by the Declaration that preceded it) is, as I see it, non-ideological. It provides a framework within which ideologies can co-exist. The Constitution sets up regulations and restrictions on the federal government which are routinely ignored by Congress, the SCOTUS, and the President. But, the point is if they chose not to ignore the Constitution (for example all rights not enumerated in the Constitution are not available to the Federal government) then some states (or small municipalities if given that freedom) could in fact become socialist, technocratic, theocratic or whatever they chose.

Universal healthcare is an ideological construct. It makes ideological assumptions about choice and freedom and government responsibility which fit within a “ideological enunciation”. It’s implementation will be direct violence to the intent and content of the Constitution. The right for me to choose to have health insurance (or more specifically to not have the same) is not enumerated in the Constitution, therefore by the 10th amendment this is a right not permitted for Congress to abridge.

So, if you’re for universal healthcare and specfically the bill being pushed in Congress now … you should be ashamed of yourself, it’s an un-Constitutional travesty.

Even as the ObamaCare vote is delivered to us on Christmas Eve, HotAir provides a list of the payoffs… payoffs for votes, that is. From Investors.com,

Sen. Mary Landrieu was the new “Louisiana Purchase.” Sen. Ben Nelson got the federal government to pick up his state’s future Medicaid tab. Maybe we should just put Senate votes up on eBay.

Take the time to peruse the entire greedy list.

Understand, though, that this is simply politics as usual, and not the bipartisan change we were promised.

HT: VerumSerum

Dan Perrin at RedState laments the very real possibility that Harry Reid has his 60 votes for health care "reform".

Word is rampant among the Senate leadership, as well as is being reported by the Wall Street Journal, that Senator Reid has got to 60 votes on cloture on the Senate ObamaCare bill.

The question of whether we live in a country ruled by leaders who refuse to listen, but do what they believe is in their own interest, has been answered.

Conservatives hate this bill. Progressives and liberals hate it too. The public is solidly against it.

But it does not matter, apparently. The implications of a country in open revolt against this bill and the elite in the Democratic party giving the public the finger are profound.

The Daily Kos and FireDogLakes of the net could not produce a single Democratic Senator or Independent to vote no. Conservatives could not produce a single Democratic Senate vote against cloture. Neither could the general public. Perhaps the left can still get one of their own to kill this nightmare. Is there not a single Dem Senator who will stand with the public, or is this merely a quaint notion we used to have about our country — that the system responds to the public?

And they have 60 votes for a bill that hasn’t even been CBO-scored yet.  The vote hasn’t come yet, so there’s still time for some reasonable Democrats to become unable to stomach the massive price tag for this.  In the meantime…

The world will understand America has changed. Our country is now run by elites who are printing money, debasing our currency to throw at massive new spending and deficit creating programs — and actually believe they are both moral and politically smart. Just 19% of the public believes this plan will not increase the deficit.

What comes next is very discomforting to think about. But we have now crossed that line from what our country was into something else, and that something else has nothing whatsoever with the country being a Republic. There will be a reckoning for this, and it will not be pleasant — not for anyone.

(Emphasis in original.)  We’ve lost a lot of ground in the slippery slope of elitist rule.

People generally quote the non-partisan CBO score when trying to figure out how much a bill will cost us.  But Michael Cannon of the Cato Institute notes that, since the CBO is quite transparent, showing how it calculates its scores, Congressional Democrats are gaming the system to make the Senate bill look far cheaper than it really would be.

For some time, I’ve suspected the answer is that congressional Democrats have very carefully tailored their individual and employer mandates to avoid CBO’s definition of what shall be counted in the federal budget. Democrats are still smarting over the CBO’s decision in 1994.  By revealing the full cost of the Clinton plan, the CBO helped to kill the bill.

Since then, keeping the cost of their private-sector mandates out of the federal budget has been Job One for Democratic health wonks.  While head of the CBO, Obama’s budget director Peter Orszag altered the CBO’s orientation to make it more open and collaborative.  One of the things about which the CBO has been more open is the criteria it uses to determine whether to include mandated private-sector spending in the federal budget.  The CBO even published a paper on the topic.  Read this profile of Orszag by Ezra Klein, and you’ll see that those criteria were also a likely area of collaboration with lawmakers.

The Medical Loss Ratios memo is the smoking gun.  It shows that indeed, Democrats have been submitting proposals to the CBO behind closed doors and tailoring their private-sector mandates to avoid having those costs appear in the federal budget.  Proposals that would result in a complete cost estimate — such as the proposal by Sen. Rockefeller discussed in the Medical Loss Ratios memo — are dropped.  Because we can’t let the public see how much this thing really costs.

Crafting the private-sector mandates such that they fall just a hair short of CBO’s criteria for inclusion in the federal budget does not reduce their cost, nor does it make those mandates any less binding.  But it dramatically reduces the apparent cost of the legislation.  It is the reason we’re all talking about an $848 billion Reid bill, rather than a $2.1 trillion Reid bill.

All the promises of reducing the total deficit or paying for the bill with Medicare cuts are as much smoke and mirrors (and outright lies) if the base cost of the bill is fudged.  You’re being led down the primrose path by folks who know full well you wouldn’t support it if you knew how much it was really going to cost.