Commentary Magazine


Topic: actuary

Flotsam and Jetsam

Ben Smith sounds skeptical about this ad campaign: “If Alexi Giannoulias pulls this one off, it’ll be one for the annals of political history: He’s trying to cast the failure of his family’s bank — which he ran as recently as four years ago and which failed Friday, the latest casualty of the bad loans in the run-up to the financial crisis — as a reason to sympathize with him and vote for him.”

What — you’re skeptical that the SEC can investigate itself ? “The Securities and Exchange Commission’s (SEC) investigative office said Sunday it had begun an investigation into whether charges against Goldman Sachs were politically timed.”

Michael Rubin is skeptical about the Obami spin that we need an ambassador in Damascus because Syria’s ambassador here doesn’t accurately relay information to Bashar Assad. “We have an embassy in Damascus, and we can pass messages anytime we so choose. If the State Department seriously believes the Syrian ambassador in Washington doesn’t report things back to Damascus (too busy, as he is, taking trips to Oklahoma and California), then Secretary Clinton can make clear to Damascus through other means that it’s time Syria sent responsible diplomats. But the fact is that Bashar al-Assad wants an American ambassador because it would symbolize his rehabilitation. The only question that Secretary of State Hillary Clinton and President Barack Obama should answer is whether they think that rehabilitation is warranted at this point in time.”

Americans remain overwhelmingly skeptical about the benefits of ObamaCare: “Support for repeal of the recently-passed national health care plan remains strong as most voters believe the law will increase the cost of care, hurt quality and push the federal budget deficit even higher. The latest Rasmussen Reports national telephone survey finds that 58% of likely voters nationwide favor repeal, while 38% are opposed. … Sixty percent (60%) of voters nationwide believe the new law will increase the federal budget deficit, while just 19% say it will reduce the deficit. Fifty-seven percent (57%) think the law will increase the cost of health care, while 18% believe it will reduce costs.”

James Capretta is skeptical of HHS Secretary Katheleen Sebelius’s spin on ObamaCare: “The chief actuary for Medicare has released a memorandum providing cost estimates for the final health legislation passed by Congress and signed by the president. Amazingly, the HHS secretary tried to suggest that the memo confirms that the legislation will produce the favorable results that the legislation’s backers have touted for months. That’s nothing but spin. In truth, the memo is another devastating indictment of the bill. It contradicts several key assertions by made by the bill’s proponents, including the president. For starters, the actuary says that the legislation will increase health care costs, not reduce them — by about $300 billion over a decade. … The actuary also says that the financial incentives in the bill will lead many employers to stop offering coverage altogether.”

Skeptical of the chances for a “Palestinian nonviolent movement“? You should be: “Proponents hope civil disobedience, part of a strategy they call the White Intifada, also will flummox Israeli authorities in their efforts to crack down on protesters waving banners rather than shooting automatic rifles, and cast Israeli soldiers as oppressors. Unlike Ghandi [sic] or the Rev. Martin Luther King, Jr., however, the Palestinians who support this approach for the most part don’t appear to be embracing nonviolence as a philosophy. Rather they see it as part of a calculated strategy to achieve Palestinian goals.”

The Gallup poll bolsters skeptics (like me) who doubt Obama’s ability to turn out young voters for a midterm election: “Younger voters remain less enthusiastic about voting in this year’s midterm elections than those who are older, underscoring the challenge facing the Democratic Party in its efforts to re-energize these voters, who helped President Obama win the presidency in 2008.”

Mark Hemingway is right to be skeptical that the new head of the Service Employees International Union wants the union to be “less political.”

Ben Smith sounds skeptical about this ad campaign: “If Alexi Giannoulias pulls this one off, it’ll be one for the annals of political history: He’s trying to cast the failure of his family’s bank — which he ran as recently as four years ago and which failed Friday, the latest casualty of the bad loans in the run-up to the financial crisis — as a reason to sympathize with him and vote for him.”

What — you’re skeptical that the SEC can investigate itself ? “The Securities and Exchange Commission’s (SEC) investigative office said Sunday it had begun an investigation into whether charges against Goldman Sachs were politically timed.”

Michael Rubin is skeptical about the Obami spin that we need an ambassador in Damascus because Syria’s ambassador here doesn’t accurately relay information to Bashar Assad. “We have an embassy in Damascus, and we can pass messages anytime we so choose. If the State Department seriously believes the Syrian ambassador in Washington doesn’t report things back to Damascus (too busy, as he is, taking trips to Oklahoma and California), then Secretary Clinton can make clear to Damascus through other means that it’s time Syria sent responsible diplomats. But the fact is that Bashar al-Assad wants an American ambassador because it would symbolize his rehabilitation. The only question that Secretary of State Hillary Clinton and President Barack Obama should answer is whether they think that rehabilitation is warranted at this point in time.”

Americans remain overwhelmingly skeptical about the benefits of ObamaCare: “Support for repeal of the recently-passed national health care plan remains strong as most voters believe the law will increase the cost of care, hurt quality and push the federal budget deficit even higher. The latest Rasmussen Reports national telephone survey finds that 58% of likely voters nationwide favor repeal, while 38% are opposed. … Sixty percent (60%) of voters nationwide believe the new law will increase the federal budget deficit, while just 19% say it will reduce the deficit. Fifty-seven percent (57%) think the law will increase the cost of health care, while 18% believe it will reduce costs.”

James Capretta is skeptical of HHS Secretary Katheleen Sebelius’s spin on ObamaCare: “The chief actuary for Medicare has released a memorandum providing cost estimates for the final health legislation passed by Congress and signed by the president. Amazingly, the HHS secretary tried to suggest that the memo confirms that the legislation will produce the favorable results that the legislation’s backers have touted for months. That’s nothing but spin. In truth, the memo is another devastating indictment of the bill. It contradicts several key assertions by made by the bill’s proponents, including the president. For starters, the actuary says that the legislation will increase health care costs, not reduce them — by about $300 billion over a decade. … The actuary also says that the financial incentives in the bill will lead many employers to stop offering coverage altogether.”

Skeptical of the chances for a “Palestinian nonviolent movement“? You should be: “Proponents hope civil disobedience, part of a strategy they call the White Intifada, also will flummox Israeli authorities in their efforts to crack down on protesters waving banners rather than shooting automatic rifles, and cast Israeli soldiers as oppressors. Unlike Ghandi [sic] or the Rev. Martin Luther King, Jr., however, the Palestinians who support this approach for the most part don’t appear to be embracing nonviolence as a philosophy. Rather they see it as part of a calculated strategy to achieve Palestinian goals.”

The Gallup poll bolsters skeptics (like me) who doubt Obama’s ability to turn out young voters for a midterm election: “Younger voters remain less enthusiastic about voting in this year’s midterm elections than those who are older, underscoring the challenge facing the Democratic Party in its efforts to re-energize these voters, who helped President Obama win the presidency in 2008.”

Mark Hemingway is right to be skeptical that the new head of the Service Employees International Union wants the union to be “less political.”

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Numbers

Steny Hoyer notwithstanding, CBO didn’t actually, finally score the bill. CBO says it “completed a preliminary estimate.” Hoyer, of course, would like to lock down wavering Democrats, but CBO cautions: “Although CBO completed a preliminary review of legislative language prior to its release, the agency has not thoroughly examined the reconciliation proposal to verify its consistency with the previous draft. This estimate is therefore preliminary, pending a review of the language of the reconciliation proposal, as well as further review and refinement of the budgetary projections.” Well, if we aren’t exactly going to vote on the bill, then I guess we don’t exactly need a firm CBO estimate.

But there are some numbers that should alarm the fence-sitters. Rasmussen tells us: “Fifty percent (50%) of U.S. voters say they are less likely to vote for their representative in Congress this November if he or she votes for the health care plan proposed by President Obama and congressional Democrats. … 51% of voters not affiliated with either major party are less likely to support someone who votes for the legislation. Just 32% of unaffiliateds are more likely to vote for someone who supports the bill.”

So you can see why Hoyer is so desperate to grab on to a CBO number, anything, to divert members away from political realities and their own nagging sense that this is all a Ponzi scheme. And if you think there’s any doubt about that, consider this exchange between Obama and Bret Baier, where it becomes obvious what a fiscal flimflam is going on here:

BAIER: The CBO has said specifically that the $500 billion that you say that you’re going to save from Medicare is not being spent in Medicare. That this bill spends it elsewhere outside of Medicare. So you can’t have both.

OBAMA: Right.

BAIER: You either spend it on expenditures or you make Medicare more solvent. So which is it?

OBAMA: Here’s what it does. On the one hand what you’re doing is you’re eliminating insurance subsidies within Medicare that aren’t making anybody healthier but are fattening the profits of insurance companies. Everybody agrees that that is not a wise way to spend money. Now, most of those savings go right back into helping seniors, for example, closing the donut hole.

When the previous Congress passed the prescription drug bill, what they did was they left a situation which after seniors had spent a certain amount of money, suddenly they got no help and they were stuck with the bill. Now that’s a pretty expensive proposition fixing that. It wasn’t paid for at the time that that bill was passed. So that money goes back into Medicare, both to fix the donut hole, lower premiums.

All those things are important, but what’s also happening is each year we’re spending less on Medicare overall and as consequence, that lengthens the trust fund and it’s availability for seniors.

BAIER: Your chief actuary for Medicare said this, that cuts in Medicare: “cannot be simultaneously used to finance other federal outlays and extend the trust fund.” That’s your guy.

OBAMA: No — and what is absolutely true is that this will not solve our whole Medicare problem. We’re still going to have to fix Medicare over the long term.

BAIER: But it’s $38 trillion in the hole.

OBAMA: Absolutely, and that’s the reason that we’re going to have to — that’s the reason I put forward a fiscal commission based on Republicans and Democratic proposals, to make sure that we have a long-term fix for the system. The key is that this proposal doesn’t weaken Medicare, it makes it stronger for seniors currently who are receiving it. It doesn’t solve that big structural problem, Bret. Nobody’s claiming that this piece of legislation is going to solve every problem that’s been there for decades. What it does do is make sure that the trust fund is not going to be going bankrupt in seven years, according to their accounting rules —

BAIER: So you don’t buy —

OBAMA: — and in the meantime —

BAIER: — the CBO or the actuary that you can’t have it both ways?

OBAMA: No —

BAIER: That you can’t spend the money twice?

OBAMA: — no, what is absolutely true and what I do agree with is that you can’t say that you are saving on Medicare and then spend the money twice. What you can say is that we are going to take these savings, put them back to make sure that seniors are getting help on the prescription drug bill instead of that money going to, for example, insurance reform, and —

It’s embarrassing, really. And it’s a reminder of why it’s really hard to get members to vote for something that not even the president can adequately justify as fiscally honest.

Steny Hoyer notwithstanding, CBO didn’t actually, finally score the bill. CBO says it “completed a preliminary estimate.” Hoyer, of course, would like to lock down wavering Democrats, but CBO cautions: “Although CBO completed a preliminary review of legislative language prior to its release, the agency has not thoroughly examined the reconciliation proposal to verify its consistency with the previous draft. This estimate is therefore preliminary, pending a review of the language of the reconciliation proposal, as well as further review and refinement of the budgetary projections.” Well, if we aren’t exactly going to vote on the bill, then I guess we don’t exactly need a firm CBO estimate.

But there are some numbers that should alarm the fence-sitters. Rasmussen tells us: “Fifty percent (50%) of U.S. voters say they are less likely to vote for their representative in Congress this November if he or she votes for the health care plan proposed by President Obama and congressional Democrats. … 51% of voters not affiliated with either major party are less likely to support someone who votes for the legislation. Just 32% of unaffiliateds are more likely to vote for someone who supports the bill.”

So you can see why Hoyer is so desperate to grab on to a CBO number, anything, to divert members away from political realities and their own nagging sense that this is all a Ponzi scheme. And if you think there’s any doubt about that, consider this exchange between Obama and Bret Baier, where it becomes obvious what a fiscal flimflam is going on here:

BAIER: The CBO has said specifically that the $500 billion that you say that you’re going to save from Medicare is not being spent in Medicare. That this bill spends it elsewhere outside of Medicare. So you can’t have both.

OBAMA: Right.

BAIER: You either spend it on expenditures or you make Medicare more solvent. So which is it?

OBAMA: Here’s what it does. On the one hand what you’re doing is you’re eliminating insurance subsidies within Medicare that aren’t making anybody healthier but are fattening the profits of insurance companies. Everybody agrees that that is not a wise way to spend money. Now, most of those savings go right back into helping seniors, for example, closing the donut hole.

When the previous Congress passed the prescription drug bill, what they did was they left a situation which after seniors had spent a certain amount of money, suddenly they got no help and they were stuck with the bill. Now that’s a pretty expensive proposition fixing that. It wasn’t paid for at the time that that bill was passed. So that money goes back into Medicare, both to fix the donut hole, lower premiums.

All those things are important, but what’s also happening is each year we’re spending less on Medicare overall and as consequence, that lengthens the trust fund and it’s availability for seniors.

BAIER: Your chief actuary for Medicare said this, that cuts in Medicare: “cannot be simultaneously used to finance other federal outlays and extend the trust fund.” That’s your guy.

OBAMA: No — and what is absolutely true is that this will not solve our whole Medicare problem. We’re still going to have to fix Medicare over the long term.

BAIER: But it’s $38 trillion in the hole.

OBAMA: Absolutely, and that’s the reason that we’re going to have to — that’s the reason I put forward a fiscal commission based on Republicans and Democratic proposals, to make sure that we have a long-term fix for the system. The key is that this proposal doesn’t weaken Medicare, it makes it stronger for seniors currently who are receiving it. It doesn’t solve that big structural problem, Bret. Nobody’s claiming that this piece of legislation is going to solve every problem that’s been there for decades. What it does do is make sure that the trust fund is not going to be going bankrupt in seven years, according to their accounting rules —

BAIER: So you don’t buy —

OBAMA: — and in the meantime —

BAIER: — the CBO or the actuary that you can’t have it both ways?

OBAMA: No —

BAIER: That you can’t spend the money twice?

OBAMA: — no, what is absolutely true and what I do agree with is that you can’t say that you are saving on Medicare and then spend the money twice. What you can say is that we are going to take these savings, put them back to make sure that seniors are getting help on the prescription drug bill instead of that money going to, for example, insurance reform, and —

It’s embarrassing, really. And it’s a reminder of why it’s really hard to get members to vote for something that not even the president can adequately justify as fiscally honest.

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Health-Care Larceny

In a perfectly crafted paragraph, Michael Gerson sums up where we are on health-care “reform” (more about that later):

The most visible Democratic domestic priority of the past 40 years must be smuggled into law, lest too many Americans notice. Politicians claiming the idealism of saints have adopted the tactics of burglars. Victory, if it comes, will seem less like a parade than a heist.

Why the need for the lawlessness? Because the president has failed to persuade the country of its merits, and he and Nancy Pelosi have their hands full trying to wrestle the final House Democrats to the mat.

The bill is in no meaningful sense “reform,” which was the premise of the entire undertaking. For example, it was going to slow the increase in premiums. But even the AP acknowledges, “Premiums are likely to keep going up even if the health care bill passes, experts say. If cost controls work as advertised, annual increases would level off with time. But don’t look for a rollback. Instead, the main reason premiums would be more affordable is that new government tax credits would help cover the cost for millions of people.” Hmm. This was precisely the point Sen. Lamar Alexander and Rep. Paul Ryan made at the health-care summit.

And what about budget neutrality or entitlement “reform”? Gerson says that’s not happening:

The problem here is not only accounting tricks and the assumption of unprecedented courage on the part of future Congresses when it comes to Medicare cuts — though these are bad enough. The main source of irresponsibility is that the revenue-gaining measures in the health bill — particularly Medicare cuts and taxing “Cadillac” health plans — would be used to create a new entitlement instead of repairing an existing one. …

The unfunded liability of America’s current entitlements is more than $100 trillion. Medicare will eventually require a massive infusion of cash under a congressional entitlement fix. Both the Congressional Budget Office and the Medicare actuary have pressed the point that Medicare savings can be used to pay future Medicare benefits or to finance new spending outside Medicare — not both. When the entitlement crisis arrives, Obama will have already spent much of the resources required to meet it, leaving growth-killing new taxes as the main remaining option.

So you can see why we’re down to parliamentary larceny. It’s probably what we should have expected from a bunch of Chicago pols. But it’s certainly not very hope-n-changey. It’s probably not even constitutional.

In a perfectly crafted paragraph, Michael Gerson sums up where we are on health-care “reform” (more about that later):

The most visible Democratic domestic priority of the past 40 years must be smuggled into law, lest too many Americans notice. Politicians claiming the idealism of saints have adopted the tactics of burglars. Victory, if it comes, will seem less like a parade than a heist.

Why the need for the lawlessness? Because the president has failed to persuade the country of its merits, and he and Nancy Pelosi have their hands full trying to wrestle the final House Democrats to the mat.

The bill is in no meaningful sense “reform,” which was the premise of the entire undertaking. For example, it was going to slow the increase in premiums. But even the AP acknowledges, “Premiums are likely to keep going up even if the health care bill passes, experts say. If cost controls work as advertised, annual increases would level off with time. But don’t look for a rollback. Instead, the main reason premiums would be more affordable is that new government tax credits would help cover the cost for millions of people.” Hmm. This was precisely the point Sen. Lamar Alexander and Rep. Paul Ryan made at the health-care summit.

And what about budget neutrality or entitlement “reform”? Gerson says that’s not happening:

The problem here is not only accounting tricks and the assumption of unprecedented courage on the part of future Congresses when it comes to Medicare cuts — though these are bad enough. The main source of irresponsibility is that the revenue-gaining measures in the health bill — particularly Medicare cuts and taxing “Cadillac” health plans — would be used to create a new entitlement instead of repairing an existing one. …

The unfunded liability of America’s current entitlements is more than $100 trillion. Medicare will eventually require a massive infusion of cash under a congressional entitlement fix. Both the Congressional Budget Office and the Medicare actuary have pressed the point that Medicare savings can be used to pay future Medicare benefits or to finance new spending outside Medicare — not both. When the entitlement crisis arrives, Obama will have already spent much of the resources required to meet it, leaving growth-killing new taxes as the main remaining option.

So you can see why we’re down to parliamentary larceny. It’s probably what we should have expected from a bunch of Chicago pols. But it’s certainly not very hope-n-changey. It’s probably not even constitutional.

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Just a Notch on a Belt

Buried deep inside an angst-filled column complaining that Obama is underappreciated and overly criticized, Richard Cohen concedes what many on both the Right and Left suspect: “He wanted a health-care bill. Why? To cover the uncovered. Maybe. To rein in the insurance companies. Maybe. To lower costs. Maybe. What mattered most was getting a bill, any bill. This is not a cause. It’s a notch on a belt.” We suspect that is true in part because Obama never really told us what he wanted in the bill. He never sent a proposal to Congress. He didn’t spell out specific requirements for his plan in that game-changing (not) speech in September. Each time Congress moved ahead with one version or another, Obama praised the effort without much comment on the content. Some thought it was tactical. But maybe he never really cared what was in it.

That conclusion is reinforced by the bill’s content and timing. As for the content, it doesn’t do what the president in broadest strokes said he wanted to accomplish. James Capretta points out that this isn’t “universal” care:

The House and Senate bills would add 15 million or more people to [Medicaid's] rolls without any guarantee whatsoever that there will be doctors and hospitals that can see them. Ironically, the very Democrats who most frequently tout “universality” as the goal are also the ones who ensure it will never actually come about by insisting that America’s lower-income families enroll in government-run insurance — with no other options. Beyond the Medicaid expansion, Obamacare is really an obligation, not a right. Every citizen would be required to sign up with a government-approved health-insurance plan or pay a tax penalty for going without coverage.

And even its proponents concede there will still be 23 million or so uninsured. Nor does the bill meet the president’s goals of deficit neutrality or cost cutting:

[T]he claim that bill lowers the deficit means that, in addition to cutting Medicare by half a trillion dollars, the Senate would also raise half a trillion in new taxes — during a recession. Only a series of accounting gimmicks — such as implementing benefits beginning in 2014 but raising taxes starting in 2010, and double-counting Medicare savings — allowed Senate majority leader Harry Reid to get a CBO cost estimate that pretends to add “not one dime” to the deficit. Medicare actuary Foster found that the Senate bill would bend the cost curve up, not down, and that the new taxes on drugs, devices, and health-insurance plans would increase prices and health-insurance costs for consumers.

But the telltale sign that Obama doesn’t really much care about the merits of the bill or any of the bill’s promised benefits is the timeline. The Heritage Foundation lays this out in detail:

2010: Physician Medicare payments decrease 21% effective March 1, 2010

2011: “Annual Fee” tax on health insurance, allocated according to share of total premiums. Begins at $2 billion in 2011, then increases to $4 billion in 2012, $7 billion in 2013, $9 billion in the years 2014, 2015, and 2016, and eventually $10 billion for 2017 and every year thereafter. Two insurers in Nebraska and one in Michigan are exempt from this tax.

2012: Medicare payment penalties for hospitals with the highest readmission rates for selected conditions.

2013: Medicare tax increased from 2.9% to 3.8% for incomes over $250,000 (joint filers) or $200,000 (all others). (This is stated as an increase of 0.9 percentage points, to only the employee’s share of the FICA tax.)

2014: Individual mandate begins: Tax penalties for not having insurance begin at $95 or 0.5% of income, whichever is higher, rising to $495 or 1% of income in 2015 and $750 or 2% of income thereafter (indexed for inflation after 2016). These penalties are per adult, half that amount per child, to a maximum of three times the per-adult amount per family. The penalty is capped at the national average premium for the “bronze” plan.

2015: Establishment of Independent Medicare Advisory Board (IMAB) to recommend cuts in Medicare benefits; these cuts will go into effect automatically unless Congress passes, and the President signs, an override bill.

2016: Individual mandate penalty rises to $750 per adult ($375 per child), maximum $2,250 per family, or 2% of family income, whichever is higher (capped at the national average premium for the “bronze” plan). After 2016, the penalty will be increased each year to adjust for inflation.

2017: Itemized deduction for out-of-pocket medical expenses is limited to expenses over 10% of AGI for those over age 65.

Bottom line: nothing but taxes and Medicare cuts begin before 2014. This is not a serious plan to address a health-care “crisis,” is it? No. It is an effort to throw something up against the wall and clean up the mess later. It won’t be proven “not to work” before Obama’s last election because it isn’t designed to really do anything, other than raise taxes, for the next four years. It is the ultimate placeholder that Obama can check off on his to-do list without the responsibility for actually solving the crisis he told us we had to fix urgently – before Christmas 2009.

It is hard, then, to quibble with Cohen. This isn’t a serious effort to reform health care. It’s lazy governance from a president who couldn’t face failure or craft a coherent bill. He and Democrats in the House and Senate imagine that the voters are too dumb to figure this out. We’ll test that proposition in November.

Buried deep inside an angst-filled column complaining that Obama is underappreciated and overly criticized, Richard Cohen concedes what many on both the Right and Left suspect: “He wanted a health-care bill. Why? To cover the uncovered. Maybe. To rein in the insurance companies. Maybe. To lower costs. Maybe. What mattered most was getting a bill, any bill. This is not a cause. It’s a notch on a belt.” We suspect that is true in part because Obama never really told us what he wanted in the bill. He never sent a proposal to Congress. He didn’t spell out specific requirements for his plan in that game-changing (not) speech in September. Each time Congress moved ahead with one version or another, Obama praised the effort without much comment on the content. Some thought it was tactical. But maybe he never really cared what was in it.

That conclusion is reinforced by the bill’s content and timing. As for the content, it doesn’t do what the president in broadest strokes said he wanted to accomplish. James Capretta points out that this isn’t “universal” care:

The House and Senate bills would add 15 million or more people to [Medicaid's] rolls without any guarantee whatsoever that there will be doctors and hospitals that can see them. Ironically, the very Democrats who most frequently tout “universality” as the goal are also the ones who ensure it will never actually come about by insisting that America’s lower-income families enroll in government-run insurance — with no other options. Beyond the Medicaid expansion, Obamacare is really an obligation, not a right. Every citizen would be required to sign up with a government-approved health-insurance plan or pay a tax penalty for going without coverage.

And even its proponents concede there will still be 23 million or so uninsured. Nor does the bill meet the president’s goals of deficit neutrality or cost cutting:

[T]he claim that bill lowers the deficit means that, in addition to cutting Medicare by half a trillion dollars, the Senate would also raise half a trillion in new taxes — during a recession. Only a series of accounting gimmicks — such as implementing benefits beginning in 2014 but raising taxes starting in 2010, and double-counting Medicare savings — allowed Senate majority leader Harry Reid to get a CBO cost estimate that pretends to add “not one dime” to the deficit. Medicare actuary Foster found that the Senate bill would bend the cost curve up, not down, and that the new taxes on drugs, devices, and health-insurance plans would increase prices and health-insurance costs for consumers.

But the telltale sign that Obama doesn’t really much care about the merits of the bill or any of the bill’s promised benefits is the timeline. The Heritage Foundation lays this out in detail:

2010: Physician Medicare payments decrease 21% effective March 1, 2010

2011: “Annual Fee” tax on health insurance, allocated according to share of total premiums. Begins at $2 billion in 2011, then increases to $4 billion in 2012, $7 billion in 2013, $9 billion in the years 2014, 2015, and 2016, and eventually $10 billion for 2017 and every year thereafter. Two insurers in Nebraska and one in Michigan are exempt from this tax.

2012: Medicare payment penalties for hospitals with the highest readmission rates for selected conditions.

2013: Medicare tax increased from 2.9% to 3.8% for incomes over $250,000 (joint filers) or $200,000 (all others). (This is stated as an increase of 0.9 percentage points, to only the employee’s share of the FICA tax.)

2014: Individual mandate begins: Tax penalties for not having insurance begin at $95 or 0.5% of income, whichever is higher, rising to $495 or 1% of income in 2015 and $750 or 2% of income thereafter (indexed for inflation after 2016). These penalties are per adult, half that amount per child, to a maximum of three times the per-adult amount per family. The penalty is capped at the national average premium for the “bronze” plan.

2015: Establishment of Independent Medicare Advisory Board (IMAB) to recommend cuts in Medicare benefits; these cuts will go into effect automatically unless Congress passes, and the President signs, an override bill.

2016: Individual mandate penalty rises to $750 per adult ($375 per child), maximum $2,250 per family, or 2% of family income, whichever is higher (capped at the national average premium for the “bronze” plan). After 2016, the penalty will be increased each year to adjust for inflation.

2017: Itemized deduction for out-of-pocket medical expenses is limited to expenses over 10% of AGI for those over age 65.

Bottom line: nothing but taxes and Medicare cuts begin before 2014. This is not a serious plan to address a health-care “crisis,” is it? No. It is an effort to throw something up against the wall and clean up the mess later. It won’t be proven “not to work” before Obama’s last election because it isn’t designed to really do anything, other than raise taxes, for the next four years. It is the ultimate placeholder that Obama can check off on his to-do list without the responsibility for actually solving the crisis he told us we had to fix urgently – before Christmas 2009.

It is hard, then, to quibble with Cohen. This isn’t a serious effort to reform health care. It’s lazy governance from a president who couldn’t face failure or craft a coherent bill. He and Democrats in the House and Senate imagine that the voters are too dumb to figure this out. We’ll test that proposition in November.

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Flotsam and Jetsam

Tom Jensen of Public Policy Polling observes that Sen. Michael Bennet is trailing all Republicans in a potential 2010 race, one by as much as nine points. He notes that this “is a reminder that Democratic Governors sure didn’t do their party in the Senate any favors with their appointments last year. The appointments of Michael Bennet in Colorado, Ted Kaufman in Delaware, Roland Burris in Illinois, and Kirsten Gillibrand in New York put all of those seats in play for next year and it really didn’t have to be that way.”

James Capretta and Yuval Levin explain ReidCare: “In other words, rather than build on the failed cost-control model of Medicare, they now want to actually further burden Medicare itself. Why take a roundabout path to failure when a direct one is available? The irrationality of this solution is staggering. But, of course, it’s a solution to Reid’s political problem, not to the nation’s health care financing crisis.”

The New York Times thinks ReidCare is in trouble too: “Democratic leaders hit a rough patch Friday in their push for sweeping health care legislation, as they tried to fend off criticism of their proposals from a top Medicare official, Republicans and even members of their own party. . .Republicans said [the Medicare actuary's] report confirmed what they had been saying for months. ‘It is a remarkable report,’ said Senator Mike Johanns, Republican of Nebraska. ‘It is a roundhouse blow to the Reid plan.’” We’ll see.

Dana Milbank thinks Senate Democrats could find a better leader. He explains that “as his public-option gambit demonstrated, merely dangling proposals, regardless of how meritorious they may be, doesn’t cause them to become law — and it may cause Democrats from more conservative states, such as Lincoln’s Arkansas, to lose their jobs.” And lose his own as well. Millbank thinks his caucus might be happier with Dick Durbin or Chuck Schumer. Well, they might get their wish, given Reid’s polling.

Looking at the dismal polling on ObamaCare and the CBS polling showing Obama leading George W. Bush by only a 50-to-44-percent margin, James Taranto argues that “these results almost surely represent a backlash against Obama and Congress’s Democrats. Their insistence on pushing ahead and forcing on the country a health-care scheme that by now is almost as unpopular as it is monstrous is without a doubt a major factor here.” And it might be that a cold, ultra-liberal president who blames his problems on his predecessor really isn’t what they all had in mind.

An excellent development, and perhaps a sign that the Obami are waking up to the reality of the thugocracy of Iran: “More than $2 billion allegedly held on behalf of Iran in Citigroup Inc. accounts were secretly ordered frozen last year by a federal court in Manhattan, in what appears to be the biggest seizure of Iranian assets abroad since the 1979 Islamic revolution. . .President Barack Obama has pledged to enact new economic sanctions on Iran at year-end if Tehran doesn’t respond to international calls for negotiations over its nuclear-fuel program.”

Obama is still sliding: “The Rasmussen Reports daily Presidential Tracking Poll for Saturday shows that 25% of the nation’s voters Strongly Approve of the way that Barack Obama is performing his role as President. Forty-one percent (41%) Strongly Disapprove giving Obama a Presidential Approval Index rating of -16. That’s the lowest Approval Index rating yet recorded for this President.”

It’s the “international community” after all: “Iranian Prime Minister Mahmoud Ahmadinejad, Venezuelan President Hugo Chavez and Zimbabwean President Robert Mugabe plan to address negotiators at international climate talks in Copenhagen next week.”

Tom Jensen of Public Policy Polling observes that Sen. Michael Bennet is trailing all Republicans in a potential 2010 race, one by as much as nine points. He notes that this “is a reminder that Democratic Governors sure didn’t do their party in the Senate any favors with their appointments last year. The appointments of Michael Bennet in Colorado, Ted Kaufman in Delaware, Roland Burris in Illinois, and Kirsten Gillibrand in New York put all of those seats in play for next year and it really didn’t have to be that way.”

James Capretta and Yuval Levin explain ReidCare: “In other words, rather than build on the failed cost-control model of Medicare, they now want to actually further burden Medicare itself. Why take a roundabout path to failure when a direct one is available? The irrationality of this solution is staggering. But, of course, it’s a solution to Reid’s political problem, not to the nation’s health care financing crisis.”

The New York Times thinks ReidCare is in trouble too: “Democratic leaders hit a rough patch Friday in their push for sweeping health care legislation, as they tried to fend off criticism of their proposals from a top Medicare official, Republicans and even members of their own party. . .Republicans said [the Medicare actuary's] report confirmed what they had been saying for months. ‘It is a remarkable report,’ said Senator Mike Johanns, Republican of Nebraska. ‘It is a roundhouse blow to the Reid plan.’” We’ll see.

Dana Milbank thinks Senate Democrats could find a better leader. He explains that “as his public-option gambit demonstrated, merely dangling proposals, regardless of how meritorious they may be, doesn’t cause them to become law — and it may cause Democrats from more conservative states, such as Lincoln’s Arkansas, to lose their jobs.” And lose his own as well. Millbank thinks his caucus might be happier with Dick Durbin or Chuck Schumer. Well, they might get their wish, given Reid’s polling.

Looking at the dismal polling on ObamaCare and the CBS polling showing Obama leading George W. Bush by only a 50-to-44-percent margin, James Taranto argues that “these results almost surely represent a backlash against Obama and Congress’s Democrats. Their insistence on pushing ahead and forcing on the country a health-care scheme that by now is almost as unpopular as it is monstrous is without a doubt a major factor here.” And it might be that a cold, ultra-liberal president who blames his problems on his predecessor really isn’t what they all had in mind.

An excellent development, and perhaps a sign that the Obami are waking up to the reality of the thugocracy of Iran: “More than $2 billion allegedly held on behalf of Iran in Citigroup Inc. accounts were secretly ordered frozen last year by a federal court in Manhattan, in what appears to be the biggest seizure of Iranian assets abroad since the 1979 Islamic revolution. . .President Barack Obama has pledged to enact new economic sanctions on Iran at year-end if Tehran doesn’t respond to international calls for negotiations over its nuclear-fuel program.”

Obama is still sliding: “The Rasmussen Reports daily Presidential Tracking Poll for Saturday shows that 25% of the nation’s voters Strongly Approve of the way that Barack Obama is performing his role as President. Forty-one percent (41%) Strongly Disapprove giving Obama a Presidential Approval Index rating of -16. That’s the lowest Approval Index rating yet recorded for this President.”

It’s the “international community” after all: “Iranian Prime Minister Mahmoud Ahmadinejad, Venezuelan President Hugo Chavez and Zimbabwean President Robert Mugabe plan to address negotiators at international climate talks in Copenhagen next week.”

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Did Reid Kill ObamaCare?

Sen. Harry Reid threw a long bomb in an act of desperation. Recognizing that there was no deal on the public option, Reid resuscitated an old liberal gambit — expanding Medicare. But the questions and contradictions came flooding forth. How was this be paid for? Wouldn’t the buy-in cost be too expensive? How could we dump millions of older, sicker people into Medicare while slashing hundreds of billions in funding from the program? It frankly makes no sense.

At week’s end, a flurry of objections and criticism — from senators, the Medicare actuary, editorial pages, previously supportive business groups, doctors, and hospitals — together with shockingly negative polling on ObamaCare suggest that we may have finally reached a point when “doing nothing” (at least for a while) makes immense political sense for lawmakers. The public isn’t clamoring for health-care “reform” and they might even be pleased with lawmakers who insisted that their leaders not jam through a partisan, ill-conceived bill.

In a sense, Reid clarified what many suspected was going on. The Democrats had ceased trying to craft a workable bill and had decided to pass something, anything, and fix it later. By choosing an approach so obviously hare-brained, however, Reid deprived his party of the pretense that they were engaged in serious lawmaking. Perhaps Reid can put all the pieces together, respond to the substantive concerns coming from all sides, reassure his members that the polls don’t mean anything, and round up 60 votes before the end of the year. But now that seems a whole lot less likely. And if it all crumbles, conservatives will have Harry Reid to thank.

Sen. Harry Reid threw a long bomb in an act of desperation. Recognizing that there was no deal on the public option, Reid resuscitated an old liberal gambit — expanding Medicare. But the questions and contradictions came flooding forth. How was this be paid for? Wouldn’t the buy-in cost be too expensive? How could we dump millions of older, sicker people into Medicare while slashing hundreds of billions in funding from the program? It frankly makes no sense.

At week’s end, a flurry of objections and criticism — from senators, the Medicare actuary, editorial pages, previously supportive business groups, doctors, and hospitals — together with shockingly negative polling on ObamaCare suggest that we may have finally reached a point when “doing nothing” (at least for a while) makes immense political sense for lawmakers. The public isn’t clamoring for health-care “reform” and they might even be pleased with lawmakers who insisted that their leaders not jam through a partisan, ill-conceived bill.

In a sense, Reid clarified what many suspected was going on. The Democrats had ceased trying to craft a workable bill and had decided to pass something, anything, and fix it later. By choosing an approach so obviously hare-brained, however, Reid deprived his party of the pretense that they were engaged in serious lawmaking. Perhaps Reid can put all the pieces together, respond to the substantive concerns coming from all sides, reassure his members that the polls don’t mean anything, and round up 60 votes before the end of the year. But now that seems a whole lot less likely. And if it all crumbles, conservatives will have Harry Reid to thank.

Read Less




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