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Posts For: July 26, 2009

Don’t Think About Rationing

The Democrats are plainly nervous about the “R” word. As they have shown more of their health-care plan, it has become increasingly obvious that the only way to make ObamaCare fly is to squeeze costs — and that means regulating and limiting care. Yes, that is rationing.

The Democrats go to great lengths to deny this. Sen. Herb Kohl assures us that all this talk about rationing is a myth:

I want to be clear that lowering costs has nothing to do with limiting access to care, though opponents of health care reform will try to convince America otherwise. The idea of “rationing” is a myth, and anything resembling it will not be a part of health care reform. No American should ever be kept from a treatment they need. But if we can cut back on unnecessary testing and over-treatment, then our health care system — and America’s patients — will be in better shape.

Got that? It is just whatever is deemed “unnecessary” that will be eliminated. And who will decide? Why, the government. Just as they do in Canada and the U.K., where health care is, well, rationed. In their less guarded moments, supporters of government-run medicine concede that in fact care will be limited. That is what all the “comparative effectiveness” research is about.

The reason Obama’s red-pill/blue-pill spiel was ridiculed was because the choice the president posed was silly. Of course if two pills are equally effective, you choose the cheaper one. But pills aren’t all alike. And patients aren’t cogs (at least not yet) to be medicated, tested, and treated identically pursuant to some cookie-cutter protocol set by a board of bureaucrats in Washington D.C. Rep. Paul Ryan spots the handwriting on the wall:

The first step was taken back in February when the Economic Stimulus package’s fine print set up a new agency (the Council for Comparative Effectiveness Research, or CCER) patterned on Britain’s National Institute for Health and Clinical Excellence (NICE). This agency’s stated purpose is to identify medical practices that produce outcomes that work as opposed to those that don’t work. As long as there is a competitive private health care market, CCER’s impact will be limited. But under a national health care insurance plan, providers will not be paid out of the plan for health care which CCER disapproves of. Once competing plans have been driven out, the government’s approval or disapproval will dictate the care providers may offer to beneficiaries, automatically denying treatments for certain categories of patients.

England’s NICE operates as a rationing bureaucracy. NICE decisions for or against new medicines, surgeries, and other treatments are life-and-death matters. They determine whether patients under Britain’s government health program will be allowed or denied access to preferred forms of care. NICE’s determinations are pushed and pulled by two forces: national budgeting calculations and factional political pressures. Under NICE rationing, the government has capped the amount that may be spent on treatments to extend someone’s life by six months. The amount is $22,000, an arbitrary number chosen by government accountants, not medical professionals.

So when Democrats tell us not to think about rationing, it’s time to think about rationing. The cost “savings” they are going to obtain will come from limiting payments to doctors and hospitals (which in turn will restrict care to patients) and by denying tests and treatment that under normal circumstances the patient’s doctor would hardly consider “unnecessary.” Call it whatever you want, but that’s what rationing is.

The Democrats are plainly nervous about the “R” word. As they have shown more of their health-care plan, it has become increasingly obvious that the only way to make ObamaCare fly is to squeeze costs — and that means regulating and limiting care. Yes, that is rationing.

The Democrats go to great lengths to deny this. Sen. Herb Kohl assures us that all this talk about rationing is a myth:

I want to be clear that lowering costs has nothing to do with limiting access to care, though opponents of health care reform will try to convince America otherwise. The idea of “rationing” is a myth, and anything resembling it will not be a part of health care reform. No American should ever be kept from a treatment they need. But if we can cut back on unnecessary testing and over-treatment, then our health care system — and America’s patients — will be in better shape.

Got that? It is just whatever is deemed “unnecessary” that will be eliminated. And who will decide? Why, the government. Just as they do in Canada and the U.K., where health care is, well, rationed. In their less guarded moments, supporters of government-run medicine concede that in fact care will be limited. That is what all the “comparative effectiveness” research is about.

The reason Obama’s red-pill/blue-pill spiel was ridiculed was because the choice the president posed was silly. Of course if two pills are equally effective, you choose the cheaper one. But pills aren’t all alike. And patients aren’t cogs (at least not yet) to be medicated, tested, and treated identically pursuant to some cookie-cutter protocol set by a board of bureaucrats in Washington D.C. Rep. Paul Ryan spots the handwriting on the wall:

The first step was taken back in February when the Economic Stimulus package’s fine print set up a new agency (the Council for Comparative Effectiveness Research, or CCER) patterned on Britain’s National Institute for Health and Clinical Excellence (NICE). This agency’s stated purpose is to identify medical practices that produce outcomes that work as opposed to those that don’t work. As long as there is a competitive private health care market, CCER’s impact will be limited. But under a national health care insurance plan, providers will not be paid out of the plan for health care which CCER disapproves of. Once competing plans have been driven out, the government’s approval or disapproval will dictate the care providers may offer to beneficiaries, automatically denying treatments for certain categories of patients.

England’s NICE operates as a rationing bureaucracy. NICE decisions for or against new medicines, surgeries, and other treatments are life-and-death matters. They determine whether patients under Britain’s government health program will be allowed or denied access to preferred forms of care. NICE’s determinations are pushed and pulled by two forces: national budgeting calculations and factional political pressures. Under NICE rationing, the government has capped the amount that may be spent on treatments to extend someone’s life by six months. The amount is $22,000, an arbitrary number chosen by government accountants, not medical professionals.

So when Democrats tell us not to think about rationing, it’s time to think about rationing. The cost “savings” they are going to obtain will come from limiting payments to doctors and hospitals (which in turn will restrict care to patients) and by denying tests and treatment that under normal circumstances the patient’s doctor would hardly consider “unnecessary.” Call it whatever you want, but that’s what rationing is.

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Raise Taxes in a Recession?

Like the Beltway Democrats, Virginia Democratic gubernatorial candidate Creigh Deeds seems oblivious to the idea that government shouldn’t be raising taxes in a recession. In his first debate with opponent Bob McDonnell, Deeds may have made two costly errors — sounding like he’s winging it and leaving the door open to new taxes. This report explains:

Deeds said he would make transportation a top priority in his first year in office, saying “there’s no quicker way to create jobs and create economic prosperity in every corner of the commonwealth.”

But when McDonnell asked him whether he would increase taxes, Deeds was evasive.

“A lot of options are going to be on the table,” Deeds said. “I’m not going to presume what will or will not pass the General Assembly next year.”

McDonnell hammered on Deeds’ answer, telling the Democrat: “You don’t have a plan. You haven’t suggested one dime.”

Pressed further on the issue by reporters after the debate, Deeds said: “I’m running for governor, I’m not running for dictator.”

“A specific funding source would be a lightning rod,” Deeds said. “I’m not prepared to throw up any lightning rods.”

McDonnell said he would not raise taxes, saying, “I don’t think the people of Virginia could sustain another tax increase.”

I imagine this will make its way into a campaign ad or two. Even the Washington Post, usually a cheerleader for Democrats in Virginia general elections, can’t conceal Deeds’s poor outing:

McDonnell was on the offensive for much of the 80-minute debate, repeatedly pressing Deeds to take positions on federal measures that would limit greenhouse gas emissions and make it easier for unions to organize, both of which McDonnell said would hurt state businesses. McDonnell also knocked Deeds for refusing to propose a specific plan to pay for transportation fixes.

Following his superbly run primary race against better known and funded candidates, Deeds disappeared from public view. One would imagine he was honing his message and developing policies. But judging from his first significant outing since early June, he did not put the time to good use. Is it any wonder state business leaders who backed his Democratic predecessors are sitting on the sidelines? There is plenty of time before Election Day, but Deeds will have to do better than this if he is to break the run of elections dating back to 1977 in which the party that won the White House lost the Virginia gubernatorial race.

Like the Beltway Democrats, Virginia Democratic gubernatorial candidate Creigh Deeds seems oblivious to the idea that government shouldn’t be raising taxes in a recession. In his first debate with opponent Bob McDonnell, Deeds may have made two costly errors — sounding like he’s winging it and leaving the door open to new taxes. This report explains:

Deeds said he would make transportation a top priority in his first year in office, saying “there’s no quicker way to create jobs and create economic prosperity in every corner of the commonwealth.”

But when McDonnell asked him whether he would increase taxes, Deeds was evasive.

“A lot of options are going to be on the table,” Deeds said. “I’m not going to presume what will or will not pass the General Assembly next year.”

McDonnell hammered on Deeds’ answer, telling the Democrat: “You don’t have a plan. You haven’t suggested one dime.”

Pressed further on the issue by reporters after the debate, Deeds said: “I’m running for governor, I’m not running for dictator.”

“A specific funding source would be a lightning rod,” Deeds said. “I’m not prepared to throw up any lightning rods.”

McDonnell said he would not raise taxes, saying, “I don’t think the people of Virginia could sustain another tax increase.”

I imagine this will make its way into a campaign ad or two. Even the Washington Post, usually a cheerleader for Democrats in Virginia general elections, can’t conceal Deeds’s poor outing:

McDonnell was on the offensive for much of the 80-minute debate, repeatedly pressing Deeds to take positions on federal measures that would limit greenhouse gas emissions and make it easier for unions to organize, both of which McDonnell said would hurt state businesses. McDonnell also knocked Deeds for refusing to propose a specific plan to pay for transportation fixes.

Following his superbly run primary race against better known and funded candidates, Deeds disappeared from public view. One would imagine he was honing his message and developing policies. But judging from his first significant outing since early June, he did not put the time to good use. Is it any wonder state business leaders who backed his Democratic predecessors are sitting on the sidelines? There is plenty of time before Election Day, but Deeds will have to do better than this if he is to break the run of elections dating back to 1977 in which the party that won the White House lost the Virginia gubernatorial race.

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Who Paid for Sheila Jackson Lee’s Visit to Michael Jackson’s Funeral?

The most bizarre moment of the Michael Jackson memorial a few weeks ago at the Staples Center in Los Angeles had to be the rambling speech delivered by Sheila Jackson Lee, the joke of a woman who happens to represent part of Houston in the United States Congress. (At the time, Roll Call reported that Jackson Lee “has a history of making cameo appearances at funerals” and that her staff used to “cull the obituaries” to “find funerals” for her to attend.) There, she announced her intention to introduce a resolution on the House floor listing every single one of Jackson’s charitable contributions and lauding him as a “world humanitarian” (his generosity to various teenage boys was presumably excluded). Fortunately, Speaker Nancy Pelosi recognized that even this would be too much for the American people to take and put the kibosh on Jackson Lee’s scheme.

Well, it appears that at least some of Jackson Lee’s constituents are up in arms about her trip, as well as the likelihood that she used taxpayer money to fund it. A local television station put Jackson Lee on the spot about the matter. See if you can make hash out of this:

“Who paid for that trip for you to go to that memorial service?” reporter Joel Eisenbaum asked Jackson Lee when she appeared live on the Sunday morning newscast.

“Well, uh … that umm … those resources are resources that I have and, therefore, they are in a way that does not interfere with anything that has to do with serving the United States Congress,” answered Jackson Lee.

“Understood,” Eisenbaum replied. “So, public funds?”

“Those resources are resources that I have,” said Jackson Lee.

Hard as it is to believe, this episode does not rank at the top of Jackson Lee’s most absurd moments. Several years ago, she complained about the paucity of African-American names given by the National Weather Service to Hurricanes. And in 2002 the Weekly Standard revealed that Jackson Lee was using a government car to drive her the one block from her Capitol Hill apartment to her congressional office.

If she indeed did use government money to pay for her junket to the Jackson send-off, Jackson Lee will have to eventually report it. But given the tolerance of the people of Texas’s 18th Congressional District for this sort of ridiculous behavior, Jackson Lee doesn’t have a thing to worry about.

Update: I’d be remiss not to mention a brief item published not long ago by the The Wall Street Journal’s David Feith, who managed to get Jackson Lee’s accomplice, Congresswoman Diane Watson, on the phone to discuss their since scuttled resolution honoring Jackson. “I just marveled at the fact that he bought the remains of the Elephant Man,” she told him (one suspects that she “marvels” at this information for reasons different than those that you or I do). And then there’s this: “Michael saw the world through his own lenses. He saw no harm, no danger, nothing wrong with romping on the bed with children.” Watson should seek work as a criminal defense lawyer. There’s far more money in that than serving in Congress…

The most bizarre moment of the Michael Jackson memorial a few weeks ago at the Staples Center in Los Angeles had to be the rambling speech delivered by Sheila Jackson Lee, the joke of a woman who happens to represent part of Houston in the United States Congress. (At the time, Roll Call reported that Jackson Lee “has a history of making cameo appearances at funerals” and that her staff used to “cull the obituaries” to “find funerals” for her to attend.) There, she announced her intention to introduce a resolution on the House floor listing every single one of Jackson’s charitable contributions and lauding him as a “world humanitarian” (his generosity to various teenage boys was presumably excluded). Fortunately, Speaker Nancy Pelosi recognized that even this would be too much for the American people to take and put the kibosh on Jackson Lee’s scheme.

Well, it appears that at least some of Jackson Lee’s constituents are up in arms about her trip, as well as the likelihood that she used taxpayer money to fund it. A local television station put Jackson Lee on the spot about the matter. See if you can make hash out of this:

“Who paid for that trip for you to go to that memorial service?” reporter Joel Eisenbaum asked Jackson Lee when she appeared live on the Sunday morning newscast.

“Well, uh … that umm … those resources are resources that I have and, therefore, they are in a way that does not interfere with anything that has to do with serving the United States Congress,” answered Jackson Lee.

“Understood,” Eisenbaum replied. “So, public funds?”

“Those resources are resources that I have,” said Jackson Lee.

Hard as it is to believe, this episode does not rank at the top of Jackson Lee’s most absurd moments. Several years ago, she complained about the paucity of African-American names given by the National Weather Service to Hurricanes. And in 2002 the Weekly Standard revealed that Jackson Lee was using a government car to drive her the one block from her Capitol Hill apartment to her congressional office.

If she indeed did use government money to pay for her junket to the Jackson send-off, Jackson Lee will have to eventually report it. But given the tolerance of the people of Texas’s 18th Congressional District for this sort of ridiculous behavior, Jackson Lee doesn’t have a thing to worry about.

Update: I’d be remiss not to mention a brief item published not long ago by the The Wall Street Journal’s David Feith, who managed to get Jackson Lee’s accomplice, Congresswoman Diane Watson, on the phone to discuss their since scuttled resolution honoring Jackson. “I just marveled at the fact that he bought the remains of the Elephant Man,” she told him (one suspects that she “marvels” at this information for reasons different than those that you or I do). And then there’s this: “Michael saw the world through his own lenses. He saw no harm, no danger, nothing wrong with romping on the bed with children.” Watson should seek work as a criminal defense lawyer. There’s far more money in that than serving in Congress…

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Flotsam and Jetsam

There is political spin and then there are lies. The latter would be declaring that small businesses would benefit from a new health-care regime in which they choose between a mandate to insure all employees or pay an 8 percent surtax.

That might be among the reasons the Chamber of Commerce and numerous business groups and associations wrote a letter decrying the House Democrats’ plan. They explain: “The creation of a new government-run insurance plan is a step in the wrong direction. Employers currently suffer a significant cost-shift from existing public programs, and the program described in House legislation would significantly increase costs for every American who purchases private insurance. . . . We are further concerned with a proposal to mandate that employers either provide health insurance or pay huge fines or payroll taxes. This ‘pay or play’ mandate is especially bad because employers are also required to pay the majority of employee premiums. Even with some exemptions, this provision will kill many jobs.” But Obama knows best — it’s good for them!

CBO strikes again: “For the second time this month, congressional budget analysts have dealt a blow to the Democrat’s health reform efforts, this time by saying a plan touted by the White House as crucial to paying for the bill would actually save almost no money over 10 years.” If there is an award for honesty and courage in government, CBO chief Doug Elmendorf should get it.

OMB Director Peter Orszag is furious. How dare the people at CBO call it like they see it! (Apparently the arm-twisting session at the White House with Elmendorf didn’t work.)

The Washington Post urges Obama to tell Americans about all the pain health-care reform will entail. Well, that’s one way to go about it, I suppose.

Is Obama the Lindsay Lohan of presidents?

Thomas Friedman’s carbon imprint is really, really big. (h/t Glenn Reynolds)

Fred Barnes: “Obamanomics pays lip service to a free market economy. But Obama hasn’t a clue what makes it work.” Maybe if he or someone in his administration ever ran a business, it would help.

Something different: a Navy spokesman accuses a female reporter of sexual harassment.

In a must-read piece, Shelby Steele tells us: “Disparate impact and racial preferences represent the law and policymaking of a guilty America, an America lacking the moral authority to live by the rigors of the Constitution’s ‘equal protection’ — a guarantee that sees victims as individuals and requires hard evidence to prove discrimination.” The real issue, he says in bracing terms, is “under-development”: “Whites are embarrassed to speak forthrightly about black underdevelopment, and blacks are too proud to openly explore it for all to see.”

Sen. Orin Hatch, who has supported many Supreme Court appointments by Democratic presidents, says “no” on Sotomayor.

The off-message machine strikes again. “Just weeks after a summit meeting intended to show a thawing in relations between the United States and Russia, Vice President Joseph R. Biden Jr. made blistering references to Russia’s failing economy, loss of face and a leadership that is ‘clinging to something in the past’ in an interview published on Saturday. . .. Calling the criticism ‘perplexing’ in light of the diplomatic overtures initiated by the United States and described as ‘pressing the reset button,’ the chief foreign policy adviser to President Dmitri A. Medvedev told the Interfax news agency, ‘The question is: who is shaping the U.S. foreign policy, the president or respectable members of his team?’” The only real question is why Obama lets him go out in public alone.

There is political spin and then there are lies. The latter would be declaring that small businesses would benefit from a new health-care regime in which they choose between a mandate to insure all employees or pay an 8 percent surtax.

That might be among the reasons the Chamber of Commerce and numerous business groups and associations wrote a letter decrying the House Democrats’ plan. They explain: “The creation of a new government-run insurance plan is a step in the wrong direction. Employers currently suffer a significant cost-shift from existing public programs, and the program described in House legislation would significantly increase costs for every American who purchases private insurance. . . . We are further concerned with a proposal to mandate that employers either provide health insurance or pay huge fines or payroll taxes. This ‘pay or play’ mandate is especially bad because employers are also required to pay the majority of employee premiums. Even with some exemptions, this provision will kill many jobs.” But Obama knows best — it’s good for them!

CBO strikes again: “For the second time this month, congressional budget analysts have dealt a blow to the Democrat’s health reform efforts, this time by saying a plan touted by the White House as crucial to paying for the bill would actually save almost no money over 10 years.” If there is an award for honesty and courage in government, CBO chief Doug Elmendorf should get it.

OMB Director Peter Orszag is furious. How dare the people at CBO call it like they see it! (Apparently the arm-twisting session at the White House with Elmendorf didn’t work.)

The Washington Post urges Obama to tell Americans about all the pain health-care reform will entail. Well, that’s one way to go about it, I suppose.

Is Obama the Lindsay Lohan of presidents?

Thomas Friedman’s carbon imprint is really, really big. (h/t Glenn Reynolds)

Fred Barnes: “Obamanomics pays lip service to a free market economy. But Obama hasn’t a clue what makes it work.” Maybe if he or someone in his administration ever ran a business, it would help.

Something different: a Navy spokesman accuses a female reporter of sexual harassment.

In a must-read piece, Shelby Steele tells us: “Disparate impact and racial preferences represent the law and policymaking of a guilty America, an America lacking the moral authority to live by the rigors of the Constitution’s ‘equal protection’ — a guarantee that sees victims as individuals and requires hard evidence to prove discrimination.” The real issue, he says in bracing terms, is “under-development”: “Whites are embarrassed to speak forthrightly about black underdevelopment, and blacks are too proud to openly explore it for all to see.”

Sen. Orin Hatch, who has supported many Supreme Court appointments by Democratic presidents, says “no” on Sotomayor.

The off-message machine strikes again. “Just weeks after a summit meeting intended to show a thawing in relations between the United States and Russia, Vice President Joseph R. Biden Jr. made blistering references to Russia’s failing economy, loss of face and a leadership that is ‘clinging to something in the past’ in an interview published on Saturday. . .. Calling the criticism ‘perplexing’ in light of the diplomatic overtures initiated by the United States and described as ‘pressing the reset button,’ the chief foreign policy adviser to President Dmitri A. Medvedev told the Interfax news agency, ‘The question is: who is shaping the U.S. foreign policy, the president or respectable members of his team?’” The only real question is why Obama lets him go out in public alone.

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