President Obama Speaks to Congress Tonight

High [Melo]drama on Capitol Hill

Will Malven
8/09/2009

Tonight President Obama will again address the nation and a joint session of Congress (as though he has something new to say). It is another in a series of speeches he has given in a futile effort to revive the flagging support for his health care plan…and his legacy. To date this strategy has been a net negative for him.

Expect him to once more talk about “myths and lies” being used to fight against his health care reform. He will again promise us that he has no intention of taking away our private health care and replacing it with a public system…although that is precisely what he wishes and the inevitable result of his agenda should it be adopted.

He will speak about the “death panels” dismissively, asking those who mention them to point out where those words appear in any of the proposed bills, knowing that though the specific words do not appear, the need for rationing will dictate their existence.

He will, once more, lie to us. His lies are most often lies of omission; he won’t tell us the entire truth, only enough to convince to join him in his fight against "injustice," most often in the form of those evil insurance companies who, "Gasp!" dare to make a profit.

Expect him to play the aggrieved soul. He will, no doubt, bring up the right’s reaction in anticipation of his speech to students across the nation, saying something to the effect of:

“See, all I wanted to do was to exhort the youth of America to strive towards success and conservatives reacted with claims of indoctrination and propaganda. There was no propaganda, just a positive message.”

Yet we were justified in our mistrust because we know Obama for who he truly is and we have observed those with whom he has surrounded himself (as he instructed us to do in order that we might judge him better). We know the liberal mind as well as we know our own.

We know that those on the left will be crowing about how unreasonable conservatives were to hold their children out of school while Obama was talking to them about continuing with their educations and persevering through adversity to better themselves…all the while knowing that, had those very same conservatives NOT said anything, their dire predictions which forced the President to change his speech would have been proven true.

Can we prove all of this…no, of course not…the speech, having been altered, cannot then be examined as it was originally, but since we know the minds of these liberals and the shameful way in which they play with the truth, we know our original assumptions were justified.

Thus we see the dangerous game conservatives are forced, by this president, to play.
If we anticipate and intercept his moves, then he and his advisors can alter their plans and then point their hypocritical fingers at us playing the injured, misjudged victim, wrongfully accused.

If we fail to intercede, then he succeeds in propagandizing our young people and further indoctrinating them into this culture of entitlement.

Expect him and his Democrat supporters to play Shakespeare’s Shylock to our Portia,

“…If you prick us, do we not bleed? If you tickle us, do we not laugh? If you poison us, do we not die?…”

Expect him to play Tolkien’s Saruman to our Theoden,

”...Despite the injuries that have been done to me, in which [you] alas! have had some part, still I would save you, and deliver you from the ruin that draws nigh inevitable, if you ride upon this road which you have taken...”

Expect more of Gibbs with his “silly season” remark.

Expect that, caught with the canary’s feathers on their collective mouths, these Democrat cats, guilt free and unapologetic, will wipe the condemning evidence from their faces and smile gleefully as we are caught in their trap.

They ridicule our “unreasonableness” and our "paranoia;" they laugh at our caution and predictions…all the while knowing that we were correct.

No matter, we cannot relax our vigil. We must let them mock us, knowing we are right. We must persevere, trusting that the American people, who so clearly saw through the lies about the health care bill and showed up in large numbers, will remain as perceptive and see through Obama’s attempts to paint all of his opponents as “out of the mainstream.”

We were lectured when we complained, that President G.H.W. Bush gave a speech to school children during his term in office, so why are we so upset that President B. Hussein Obama is giving one? After all, isn’t it only fair that this "giant among men," this "messiah of the left" should be allowed to share his vision with those same young people? Isn’t it only reasonable?

What they fail to mention is that, unlike when President Bush 41 gave his speech, this time there will be no congressional committees investigating the president for having given his speech; no GAO estimates as to how much tax payer money President Obama spent in giving this speech. Both men had a Democrat Party in control of Congress, but only President Bush was subjected to scrutiny because of his speech.

So tonight expect the same lies and half-truths; expect an appeal to “reasonableness” and expect another lecture on the importance to America “that we solve this dire crisis facing us all.” President Obama will, no doubt, appeal to our humanity and our sense of fairness and charity to press his agenda, but never forget that his sort of charity comes at the point of an IRS auditor’s pen, not from the heart.

Remember also that the real sense of urgency coming from Obama is derived not from a sense of obligation to the American people, but a sense of his own floundering presidency needing a victory…and he will declare any bill a victory, no matter how far it strays from his original agenda.

Expect also that he will exhort his Democrat colleagues to go it alone if need be…much to his regret, I'm sure.

His message will be that the need for action is so dire that if necessary we Democrats must do for America what Republicans are unwilling to do.

Has there ever been a more cynical President in our 233 year history? I doubt it.

The only need in America the is dire right now is the need to stop President Obama in his drive to destroy our health care system in the same way that he and President Bush destroyed our economy and our automotive industry, through more government intrusion and control.

Long Live Our American Republic!!!!

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"Moderates" Toying With "Back Door" to Socialized Medicine

Will Malven
9/08.2009

Well I told you they wouldn't give up on imposing a single-payer health care plan on us and here is more evidence of their intent.

Obama is giving a speech tomorrow before a joint session of Congress to extol the virtues of healthcare reform and attempt to renew the sense of urgency that has gradually evaporated from the health care reform movement as skeptics have dominated the discourse...or course most of that urgency is about trying to save his administration from being labeled a failure...so once more Obama is going back to the well which served him so well during the 2008 campaign, but seems to have failed him miserably in this health care debate.

Obama Readies (Another) Speech As Health Care Picks Up Steam

By MICHAEL SCHERER AND KAREN TUMULTY - WASHINGTON
TIME
9/08/2009

This is what Barack Obama does. Back him into a corner, get the press in a frenzy, send his polls ratings plummeting, and the aging basketball player responds again and again with the same move: he delivers a major speech. And why not? It keeps working. It's the thing that first introduced him to the nation, at the 2004 Democratic National Convention. It is what extricated him from the Jeremiah Wright mess during the campaign. It has become the central method of his foreign policy push, in Prague, Cairo, Moscow and Accra.

It's also been the method of choice in his push for health-care reform. In just the last two months, he has held six health-care town halls and a prime-time news conference. But public support for his plans has been declining through the summer. So the answer, he believes, is one more speech, Wednesday night in front of a joint session of Congress.

Maybe this technique is failing to rally people to his cause because the voters are far better informed on the proposed health care changes than they were about what a fraud Obama was and because they remain far better informed on the issue of health care reform that either the Democrats in Congress working on the bill or Obama as to what is in the bill.

By the way, only a dedicated liberal news organization, committed to the Democrat Party and the President's health care agenda could claim that in the current climate "Health Care Picks Up Steam."

Folks health care reform is gasping for breath as it struggles to survive in any recognizable form...leave it to liberals to confuse "picking up steam" with "twitching in its death throes."

So as Obama is pimping his next version of "health care reform," look for browbeating and scapegoating of Republicans...again...in spite of the fact that Democrats have sufficient votes in Congress to pass any legislation they wish-without any Republican support as well as exhortations of dire consequences should Congress fail.

All I know is that we are going to be faced with another command performance of the "Empty Suit in Chief...Liar Extraordinaire."

To add insult to injury, some in Congress are attempting to trick the voters by performing a little legislative legerdemain called "the trigger option."

Time/Yahoo are reporting, among other things, that Senators Ben Nelson (D-NE) and Olympia Snowe (RINO-ME) are ready to sign on to a "deal" that would impose a "public option" only if the insurance companies failed to change their way of doing business; the so called "trigger" option.

Continuing from the above article:

Meanwhile, in the Senate, where a compromise has not yet been reached, there are some signs that agreement time might be upon us. On Sunday, in an interview with CNN, Nebraska Democrat Ben Nelson, a longtime opponent of a public-health-insurance option, said he could support a public plan as a "fail-safe" or "backstop" that would be created only if insurance companies did not reform their business practices over the coming years. Republican Senator Olympia Snowe, a key swing vote from Maine, has also spoken favorably about a triggered fail-safe.

This so-called trigger is very dangerous for those who oppose any public option for health care. It is the proverbial stalking horse for the later imposition of a public option by the government bureaucracy.

Who is to say when the insurance companies have failed to "reform their business practices?"

Who is to say when this "trigger" kicks in? Who is to say how the resultant "public heath-insurance option" would kick in and who would determine what provisions would be included?

The "trigger" option is nothing but a cowardly means of letting the gutless "moderates" in Congress vote for the public option without being forced to do so overtly. It is nothing but the "stealth option" for socialized medicine.

There is not person more contemptible in Congress than those who lack the courage of their convictions. What really sad is that these very gutless, indecisive "moderates" are held up as models of restraint and polity when in reality they are simply cowards.

Members of Congress like Snowe, Nelson and Collins, to name a few, lack the intestinal fortitude to face their constituents and say where they stand on the issues. They are indecisive and vacillating because they are dullards and easily swayed by arguments full of emotion and completely lacking of merit.

This "trigger" option is very dangerous exactly because it holds the appeal of doing the unthinkable while providing the cover of plausible deniability. It is the perfect option for those gutless "middle of the road" members of Congress who lack the intellect and integrity to make a real decision.

When Congress says "trigger option" people watch your liberty, because they are preparing to take some of it away...via the back door.

Say what you will about those committed liberals in Congress, at least they are courageous enough to say what they want.

Long Live Our American Republic!!!!

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AARP's Double Talk Exposed: Memo From Pelosi Reveals "Close Coordination"

Will Malven
9/03/2009

Sorry for the late notification, but this just came to my attention. Human Events reveals a "House Democrat leadership memo sent to their membership" which among other things reveals that the House Democrat Party leadership has been coordinating with AARP in their efforts to get the Health Care bill passed.

Funny, but I seem to remember a couple of AARP representatives denying that they were behind any bill. The memo lists a number of Leftist organizations with whom Pelosi and the rest of the Democrat leadership have been coordinating.

From the memo:

The Leadership is working in close coordination with the White House and outside groups (including but not limited to HCAN, Families USA, AFSCME, SEIU, AARP, etc.) to ensure complementary efforts during August. The President, Secretary Sebelius and other principals in the reform debate will be working throughout the month to hold events, promote the message in the press and move the reform effort forward.

We see here a combination of union thugs (SEIU and AFSCME), leftist "Astroturf" organizations (HCAN-Health Care for America Now and Families USA) and of course AARP (who is not supporting any bill...according to them).

It is amazing to me how often and easily those on the Left lie about what they are doing. The AARP sent out their spokespeople to "correct" what the President and Conservative had been saying about AARP being on board with the Health Care bill.

What I find most amusing is that although AARP representative Cheryl Mathias stated in an interview on CBS Evening News, Monday August 17. NewsBusters has a full transcript of the interview, but here is the cogent part:

AARP representative Cheryl Mathias: "AARP has not endorsed any plan at this point."

CBS reporter Sheryl Attkisson: "Yet the AARP's Cheryl Mathias couldn't find anything to quibble with, including the Medicare cuts, which she says will not affect benefits."

A quick visit to AARP's webpage confirms that they are still fighting for the Democrat plan in whichever form it emerges. They continue to tell the lie that a federal health care option won't lead to socialized medicine even though such a claim defies logic.

After all of this information, there should be little doubt remaining that the AARP is in the pocket of the Democrat Party and this President. They should rename themselves the AADP - The American Association of the Democrat Party.

Fortunately the American Seniors Association is growing in size and influence. They remain the most viable, if not the only Conservative alternative to the AARP.

I am not affiliated with the ASA, I don't receive any money or compensation from them, I am just someone who has gotten tired of the double speak coming out of AARP. I am tired of organizations that claim to be "non-partisan" while spending every penny for and fighting every battle on the side of the Democrat Party.

When was the last time the AARP opposed any Democrat Party agenda item? When was the last time they came out against Democrats in Congress?

I say join the ASA and let the AARP become officially what it is de facto another arm of the Democrat Party.

Long Live Our American Republic!!!!

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Thousands Quit AARP Over Health Reform (AARP Doesn't Care)

Will Malven
8/18/2009

According to CBS News, AARP doesn't care that they have lost 60,000 members since July 1:

"AARP says for a group with 40 million members that adds hundreds of thousands each month, losing 60 thousand is just a drop in the bucket."

Now you understand why they were so rude at the Dallas health care forum. Now you can understand why they left the meeting in a huff when their own members began to question them about their support of the Obama/Democrat health care plan.

THEY TAKE THEIR MEMBERS FOR GRANTED!

Because so few know that there is an option outside of the AARP, because most retirement age people assume that the AARP is the only game in town, they don't have to care what their members think...after all, they get "hundreds of thousands" of members each month.

Imagine the arrogance it takes for such an organization to make such a comment. How long do you think a business would keep a CEO that lost them 60,000 customers in one month? How long do you think the stockholders would let someone remain in charge of their business who said "Well 60,000 customers is just a drop in the bucket, we get 100,000 each month?" Imagine the contempt these people have for their own members.

Here's the CBS News story:

Thousands Quit AARP Over Health Reform
Tens of Thousands Don't Like the Health Care Overhaul

CBS) CBS News has learned that up to 60,000 people have cancelled their AARP memberships since July 1, angered over the group's position on health care.

Elaine Guardiani has been with AARP for 14 years, and said, "I'm extremely disappointed in AARP."

Retired nurse Dale Anderson has 12 years with AARP and said, "I don't wanna be connected with AARP."

Many are switching to the American Seniors Association, a group that calls itself the conservative alternative as CBS News Investigative Correspondent Sharyl Attkisson reports.

Maybe it's time for us seniors to start spreading the word that there is a better alternative (the ASA); one that is more attentive to the wishes of their members and less a slave of the Democrat Party leadership; one that believes in traditional American values like private enterprise and the idea that Congress works for us rather than the other way around.

And that is the truth about the AARP...they exist to promote the Democrat Party agenda. They have been slavishly cleaving to the Democrat Leadership for decades, doing their bidding and persuading senior citizens that they were working for them.

Time to destroy the lie. Time for those of us who know to spread the word about the AARP alternative, the American Seniors Association.

Don't let the Obama/Democrat Leadership/AARP cabal run you over or fool you with their lies. Make your voices and your dollars heard. Leave the AARP and join the ASA...there is no stronger statement than that.

There is a better plan for health care reform. The Republicans have it. It is called the Coburn/Ryan Patient's Choice Act. READ IT.

Instead of a plan that will do nothing about the rising cost of health care, why not:

• Allow patients to purchase health insurance from companies outside of their state, we do that with auto insurance, why not with health insurance?
• Allow patients to buy catastrophic health insurance to take care of the really big expenses, and put money aside in a tax-free health savings account for the smaller day to day expenses
• PASS TORT REFORM LEGISLATION. Doctors spend huge amounts of money to pay for their malpractice insurance because of law suit abuse...remember John Edwards became a multi-millionaire on the backs of our doctors. Doctors are forced to order dozens of unnecessary tests just to protect themselves from any potential lawsuit. It is estimated that over $100 Billion is spent in so-called "defensive medicine."
• Force full disclosure of health care costs so that patients can shop for the best policy and the best procedure for the best price.

How about we let the free market that has made America the strongest economy in the world and given Americans the best life style in the world, give us the best health care in the world.

Don't let Congress and the President scare you into a hastily drawn up, poorly written, 1000+ page health care debacle...there is no need to rush. When 80% of Americans are satisfied with their current plan, why screw it all up just to cover the other 20%? Wouldn't it be better just to fix that 20% and leave the rest of us alone?

We need better health care, not faster healthcare.

Long Live Our American Republic!!!!

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Obama unedited still wants to go to "single payer" healthcare

Will Malven
8/04/2009

Well, the Obama White House has already come out lying about what the President said back in 2007 about his goal being a single payer health care plan. The claim being asserted by Linda Douglass, a former ABC News correspondent who is now an official flack for the White House rather than an unofficial one as she used to be when she worked for ABC, in a video being touted by the White House and all sympathetic pundits as a "rebuttal" to the video I posted yesterday with the title "SHOCK UNCOVERED: Obama IN HIS OWN WORDS.

The claim being made by Linda Douglas and the White House damage control team is that the video distorts what the president was actually saying by cutting and piecing together clips and taking them out of context. Interestingly, she never actually addresses what the original video shows, she merely asserts that the President was "taken out of context."

After that she goes on the play two clips that she asserts "you probably haven't heard from those sources," which show Obama in June of this year telling us what he has been saying for the past few months:

"If you like the coverage that you already have, you can keep
it."

This is, of course, a straw man argument, no one has said that the president hasn't been saying that exact thing recently the point of the videos in question is that what he has been saying recently isn't what he truly believes or what he has been saying throughout his political history.

Here's video 1 where Obama back in 2003 talks about a single payer system and that it will take time to achieve that goal.



Ms. Douglas also doesn't respond to the statements of Representatives Barney Franks (D-MA) and Jan Shakowsky (D-IL) which also show the clear intent of the Heath Care Reform bill that Democrats are attempting to push through Congress. Neither of those clips were "taken out of context."

In fact both of those members of Congress are proud of their stance...and for that I honor them. They are unapologetic socialists and wrong to boot, but at least they are honest in their desires and aims. Our President lacks such candor and backbone.

Since Ms. Douglas has made this false assertion, I am posting the original, relevent and uncut portion of Obama's appearance at the Las Vegas SEIU Health Care Forum for the Democrat Presidential Candidates.



The volume is pretty low, unlike the earlier clip; I apologize, but I have no control over what is posted on YouTube.

There can be no doubt that Obama stated that he wanted a system:

...that allows those who can go through their employer to access a federal system or a state pool of some sort , but I don't think we are going to be able to eliminate employer coverage immediately" [Emphasis added]

No if's, no and's, no but's about it. He said it, he meant it, he didn't equivocate or hesitate, he wants to take health care coverage out of the hands of employers and put it in the hands of the government.
Ms. Douglas, you can lie about it, you can avoid answering the issue, you can accuse the blog world of distortion, but you cannot prevent the truth from getting out...


...not even with your little army of informers (neighbor informing on neighbor - now that is scarey, shades of the old East German Stasi or the old Soviet Union).

Isn't that a pleasant thought from the Obama Administration? They are now asking that we become a society of informers...how very Stalinesque of Obama. Here's the money quote from WhiteHouse.gov:

There is a lot of disinformation about health insurance reform out there, spanning from control of personal finances to end of life care. These rumors often travel just below the surface via chain emails or through casual conversation. Since we can’t keep track of all of them here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov. [and we will forward it to the Secret Service? Maybe the FBI or the IRS for a little impromptu auditing?]

Gee! Nothing worrying about that...

Well Linda, the only thing I see that's fishy is occurring in the White House and in Congress within the Democrat Party...should I report that?

Long Live Our American Republic!!!!

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Democrats Block GOP Health Care Mailing

Will Malven
7/23/2009

Once again we see that Democrats in Congress will go to any lengths to prevent the truth from getting out about the Obama-care health care bill now in Congress. Proof once more that Democrats care nothing about the American people or solving their problems, they care only about controlling us.

Roll Call has the low-down on these devils and their efforts to keep the voters out of the loop:

Democrats Block GOP Health Care Mailing

July 23, 2009
By Jackie Kucinich
Roll Call Staff

Democrats are preventing Republican House Members from sending their constituents a mailing that is critical of the majority’s health care reform plan, blocking the mailing by alleging that it is inaccurate.

House Republicans are crying foul and claiming that the Democrats are using their majority to prevent GOP Members from communicating with their constituents.

The dispute centers on a chart (view PDF) created by Rep. Kevin Brady (R-Texas) and Republican staff of the Joint Economic Committee to illustrate the organization of the Democratic health care plan.

Democrats don't want you to see it because it shows just how screwed up the health care plan really is. It is a bureaucratic nightmare of huge proportions.

The flow chart resembles a game board designed up by some crazed, uninformed, Liberal politician (which of course it was) with a maze of arrows and colored blocks, each of which represents some bureaucratic hurdle consumers must overcome before they receive treatment.

I doubt very seriously the famous cartoonist Rube Goldberg could have designed anything more complicated...or ridiculous.

Governmental interference caused the current financial crisis and Democrats are attempting to solve the problem with governmental interference.

Governmental interference caused the health care crisis and true to form, Democrats are hide bound to "solve" it with...you guessed it...more governmental interference.

Here's a clue to you Democrats out there. No matter how much you wish it were so, the federal government has never accomplished anything better, more efficiently, or cheaper than private enterprise...NEVER!!!

Given that undeniable fact; proven over and over again, why on Earth would anyone look to our federal bureaucracy to solve a problem as complex, far reaching, and intrusive on the individual's privacy as health care?

One can only surmise that it derives from profound and over-arching stupidity. Certainly there appears to be enough of it to go around within the Democrat Party; beginning with our current president and the majority leaders in both houses of Congress.

Well, I'm doing my little part to get the message out to Republicans and all American citizens. With the web and all of the alternate news sources it has, Democrats will fail in this effort to censor Republicans in Congress and once more prove that they oppose the free flow of information of value to their own constituents.

Long Live Our American Republic!!!!

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The Massachusetts Mess

By The Honorable Arlene Wohlgemuth

News coming out of the Massachusetts experiment with “socialized medicine lite” – the combination of insurance coverage that is free, subsidized, or mandatory to make it near universal – continues to be distressing for reasons other than the predictable, ever-escalating cost to the state.

First were the reports from across the state of primary care physician shortages. According to a physician workforce study conducted by the Massachusetts Medical Society, half of the internists in Massachusetts stopped accepting new patients, as did 95 percent of general practice physicians in Boston’s top three teaching hospitals.

Waiting times for appointments, for those fortunate enough to get one at all, increased by more than one-third. Need to schedule a physical? How about this time next year?

The latest development is an astounding change in the way patients and doctors have interacted for generations. “Shared medical appointments” are the new wave in Massachusetts physician practices due to the shortages.

Eight or nine patients with the same general complaint are scheduled at the same time and ushered into a room to have their examinations – together. The doctor examines each one and then discusses with them as a group how to manage their health issue. Other, more personal issues can be discussed with the group, or perhaps with the doctor alone afterwards.

This underscores that having insurance means nothing without access to a provider.

Despite significant increases in the number of health professionals since the passage of medical liability reform in 2003, Texas remains in a shortage. The guideline for an appropriate ratio of health professional to general population is considered to be 1-to-1,500. The guideline for being declared a health profession shortage area is when it reaches 1-to-3,500. Texas’ current ratio is 1-to-4,016.

Even worse, demographic trends reveal an undeniable confluence of important factors – a huge increase in the elderly population, a growing general population, and a dramatic decrease in medical students selecting family practice and internal medicine.

In a normal marketplace, supply and demand would dictate a higher price for the item or service in short supply; that would draw more resources to meet the increased demand. Instead of paying more for what is needed, primary care physicians’ average annual earnings have been artificially driven down to about half that of specialty doctors.

The average student loan debt coming out of medical school is about $150,000. Two more years in a specialty residency would increase the doctor’s annual income by roughly that amount. Little wonder that medical students are choosing the specialty route.

Government programs and managed care insurers are much to blame for the market distortions. Reimbursement levels have declined while administrative demands have increased. The result is that family practice physicians spend less time seeing patients and more time filling out the paperwork plus paying a third party to file it all – a recipe for a dissatisfied doctor. Perhaps that is why nearly half of the physicians nationwide plan to reduce the number of patients they see or quit the practice of medicine altogether in the next three years, which will amplify the physician shortage.

Many are looking again to the government for solutions. The late physicist Albert Einstein defined insanity as doing the same thing over and over and expecting a different result. Heavy government involvement in the field of medicine always results in fewer providers and lower quality of care. Government health care programs are responsible for the high cost and malfunctioning marketplace we have today.

Every proposal should be judged by one question: Will this measure result in more government control or more personal control? If the answer is the former, as with the proposed expansion of the Children’s Health Insurance Program soon to come before the new Congress, then the measure is a problem, not a solution. Regardless of where the income limit is set, the people just above the limit will find insurance unaffordable while those within the program find health care inaccessible.

Looking to government to solve our health care problems is, well, insanity. And Massachusetts’ “socialized medicine lite” proves it.

The Honorable Arlene Wohlgemuth is a Visiting Research Fellow at the Texas Public Policy Foundation, a non-profit, free-market research institute based in Austin. She served six terms as a member of the Texas House of Representatives, specializing in health and human services issues.

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TPPF COMMENTARY: Compassion? Not in My Book

States like Texas have drawn criticism for not expanding government health care programs during strong economic times. But now that the national economy has slipped into recession, what has happened to the states that chose the other path? As former state representative and TPPF Visiting Research Fellow Arlene Wohlgemuth points out in this week's commentary, those states (notably California) are facing substantial budget deficits – and one of the first places they're looking for budget cuts is health care.

---

Compassion? Not in My Book
By The Honorable Arlene Wohlgemuth

Bailout requests by numerous states have recently been a top news item, as everyone lines up behind the financial sector with their hands out. Rather than debate the wisdom of these bailouts, it is time to look at the states’ fiscal policies and see whom they hurt.

The recession of the early 2000s saw states scrambling to balance their budgets. Texas’ watershed year was 2003, with a $10 billion budget shortfall for the biennium, but we were not alone. California faced a whopping $38 billion shortfall that same year. The way the two states responded then, set the stage for what is happening today.

Texas reduced spending to cover the deficit that represented about 15 percent of its general revenue. The commitment was made, and kept, that the shortfall would not be resolved by increasing taxes.

Today, Texas has become the nation’s top job producer, hosts more Fortune 500 companies than any other state, and was cited by the Financial Times as the state best able to weather the financial storm. Although the economic downturn will cause short-term problems, especially in retirement system investments, the state will enter the next budget cycle in the black, just as it did in 2005 and 2007.

California, on the other hand, not only raised taxes as part of its deficit plan, but also borrowed $10.7 billion – about 15 percent of its general revenue. The result has been that California has lost both jobs and population. The current budget year has a $26 billion budget gap, representing 25.7 percent of general revenue. Its solution again is to borrow much of the money rather than significantly reducing spending. But this time, there is a steep price to pay.

California now has the lowest bond rating of any state and will pay for that through a high interest rate. Stateline.org reports that the state may be the first to “nose-dive into junk bond territory.” Instead of facing the recession from a position of fiscal strength, the state is incredibly weak.

Next will come the budget cuts, not only in California but in up to 36 other states. Not surprisingly, the two areas of the budget most often cited for targets of cuts are Medicaid and education.

California, in the name of compassion, has expanded its Medicaid rolls to the highest in the nation, with 29 percent of the population enrolled. Provider rate cuts are always first on the chopping block when things get tight, and that is what California has tried to do. Its 10 percent cut to providers in Medi-Cal, the state’s Medicaid plan, was temporarily halted by a federal judge in August, further complicating their budget woes.

California has expanded its Medicaid rolls in the good times, creating a dependency on the program, and now that the economy has gone south, health care for the poor will be the first area to take a hit. Expansion of government-paid health care programs inevitably increases the cost of health care for everyone and contracts the private market, meaning that everyone suffers. If the federal government decides to bail out states like California, it will reward them for poor fiscal management and punish Texas for being responsible.

The Kaiser Family Foundation estimates that for every 1 percent increase in the national unemployment rate, there are one million new enrollees in Medicaid and State Children’s Health Insurance Program (SCHIP), costing $3.43 billion in additional program spending.

At the very time when families will need the safety net of Medicaid and SCHIP the most, states that have not exercised fiscal responsibility, particularly those that have expanded their health care programs beyond sustainability, will not be in a position to help. That is not compassion.

Careless spending hurts those it purports to help.

Arlene Wohlgemuth is a Visiting Research Fellow at the Texas Public Policy Foundation, a non-profit, free-market research institute based in Austin.

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TPPF COMMENTARY: Improving health care without expanding government

As election season winds down and the 81st legislative session draws nearer, the focus now turns to legislative tactics and fulfilling campaign promises. Advocates of Medicaid expansion have already begun their push to extend Medicaid’s eligibility enrollment period, an effort to incrementally increase the number of people receiving subsidized health care.

In contrast, just last month, in an effort to reign in state spending on Medicaid, the federal government announced stricter guidelines on what Medicaid will cover. Texas would be well advised to follow suit and seek ways to cut Medicaid spending by reducing the public’s reliance on the program.

However, talk of extending Medicaid’s eligibility enrollment period from six months to 12 has been in the air in Austin since the legislature pulled a similar move last session that extended the Children’s Health Insurance Program (CHIP) eligibility period. That maneuver, along with other reforms, resulted in a 42 percent growth in CHIP enrollment and a dramatic increase in costs.

The growth of CHIP recipients and the growth in Medicaid recipients that would likely follow an extension of the eligibility period is the result of people remaining enrolled in government programs long after they have exceeded the income limit.

If the goal of extending eligibility periods is to increase individuals’ access to health care, then we can improve that without expanding government programs or spending taxpayer’s dollars.

The way to create more access to health care is to create a more diversified market with more points of access and more provider options.

Today, we funnel people to the highest cost provider – where either the patient pays a nominal fee and the insurance company picks up the rest, or the government pays the entirety of the bill. Why are patients getting eye exams in the hospital or paying more than $100 to be diagnosed with strep throat and prescribed medication?

What if consumers had an alternative to the highest cost provider; the “Wal-Mart” version of health care, if you will? Someone who could make the diagnosis, prescribe the medicine needed, and send you on your way for less than $50 and all in under 30 minutes.

Providers like these exist; they are nurse practitioners and physician’s assistants and many of them work in what people in the medical community call retail clinics. These clinics offer a new model of providing primary care that focuses on providing convenient patient care at low prices.

Often located in retail shopping centers and open late with no need for an appointment, they are directly responding to the demands of their consumers, many of which are the uninsured targeted by government programs.

Forty-three percent of their patients are between the ages of 18 and 24 – the population with the highest uninsured rate – and 33 percent of their patients pay out of pocket for their care, a practice unheard of at a traditional primary care provider’s office.

Unfortunately, Texas is missing out on the rapid growth of this health care option. Laws that limit the scope of practice and require strict oversight for nurse practitioners and physician’s assistants hamper the development of these clinics and limit access to care.

These clinics are a direct response to the needs of patients, but protectionist regulations aimed at ensuring job security and enforced under the guise of consumer safety are limiting Texas’ ability to adequately respond to the needs of its citizens.

These providers could also serve as way to meet the growing demand for health care providers in our state; however, additional requirements that force these providers’ to operate under the watchful eye of physicians make it difficult for these caregivers to provide services in the areas where they are most needed.

Legislators have the opportunity to give Texans the option of affordable, convenient health care by eliminating onerous state regulations. The question is, will they seize the opportunity.

Kalese Hammonds is a health care policy analyst at the Texas Public Policy Foundation, a non-profit, free-market research institute based in Austin.

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TPPF COMMENTARY: More health care requires more choices

More health care requires more choices
By Kalese Hammonds

Texas has the highest ratio of uninsured residents in the country. With nearly one in four Texans uninsured, legislators and other stakeholders tirelessly look for the silver bullet to guarantee that everyone has access to health care. Many have concluded that the answer is lies in getting as many of the uninsured covered as possible.

Strategies for reducing Texas’ five million uninsured have come from a variety of angles, but most involve additional government assistance and impose a greater burden on taxpayers. The more modest proposals expand existing programs and increase outreach to eligible citizens, while the extreme measures would require every individual to buy health insurance and force the government to subsidize those who couldn’t afford it.

Others have proposed a backdoor approach by addressing the cost of health insurance, but such attempts have been just as heavy-handed. Suggestions that the state provide reinsurance for companies that pay out expensive claims would place an unnecessary burden on the state and taxpayers, while imposing requirements that would force insurers to forego risk-adjusted premiums in favor of a community-rated pricing method would make health insurance less expensive for risky individuals but more expensive for everyone else.

Early results from these reforms have been less than stellar. In Massachusetts, the individual mandate and state subsidies have led to massive cost overruns. The newly insured have flooded doctors’ offices, creating a shortage of providers and forcing doctors to either turn down patients or put them on a waiting list.

What Massachusetts has found – and what advocates for the uninsured fail to recognize – is that health insurance does not necessarily mean access to health care. In fact, health insurance is partially responsible for the continuing decay of our health care system. Its desensitization of consumers from the cost of health care has created an environment that encourages overutilization.

As the demand for health care services has risen, so have their prices; proof that the economic principles of supply and demand do, in fact, apply to health care.

For those who question the viability of free markets and competition in health care, they need only look at the field of Lasik eye surgery. Because consumers pay the full cost of their procedures, competition has led to lower prices and an abundance of providers.

Experience teaches us that the best way to lower prices is to pump more products into the market, allowing consumers to decide which of the options gives them the most bang for their buck.

Primary health care services would benefit from a similarly competitive environment where a broader range of providers would afford consumers more choices at varying price levels. Nurse practitioners and retail clinics offer basic health care at lower prices and during more convenient times, giving consumers alternatives to expensive doctor visits and crowded waiting rooms that are only open during work hours.

Unfortunately, Texas laws restrict these alternatives by tying the number of nurse practitioners to the number of physicians, and limiting the services they can provide. Other Texas laws that ban the practice of corporate medicine and place unnecessary regulations on health care facilities make it difficult for Texans to have a wide range of choices for health care. The majority of health care consumers are trapped in a system that gives them few options and even less information about the price they are paying for services.

Just like getting health insurance for everyone will not cure our health care system, providing less expensive alternatives to current health care is not the silver bullet either. But it is a solution that would not place additional burdens on taxpayers, require expansion of government programs, or increase insurance premiums for people who already have it.

Giving consumers more choices would improve access to health care by providing individuals with more choices that would be affordable, regardless of insurance status.

Kalese Hammonds is a health care policy analyst at the Texas Public Policy Foundation, a non-profit, free-market research institute based in Austin.

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TPPF COMMENTARY: Dependency Mindset Limits Health Care Choices

There is no doubt that America’s health care system warrants immediate attention and various culprits have been blamed for the system’s slow disintegration. Much of the anger consumers feel with today’s health care system is directed at rising costs and out-of-pocket expenses.

Surprisingly, their discontent does not lie with the restrictive policies and protectionist-minded policymakers that have created the inflated prices, and their frustration has not been with the exorbitant amount of their tax dollars spent paying for other people’s health care. The overwhelming cry is that the government has not done enough.

A study that revealed stagnant and declining life expectancy rates for various populations in the United States has ignited a firestorm of charges that the government has failed to encourage the public to make healthier lifestyle choices.

A look at recent government campaigns reveals another story. In New York City, a federal judge has approved a city ordinance that would require chain restaurants to post calorie information on menus. Proposed legislation in Mississippi would prohibit restaurants from serving people with a Body Mass Index greater than 30.

Intrusive tactics like these represent a growing trend in government over-reach, while the overwhelming reception of bureaucratic involvement reveals a sense of government reliance never before seen in the United States. There is no greater testament to our society’s embrace of dependency than the battle cry to expand government health programs and extend coverage to higher-income families.

The federal government already spends more than $700 billion a year on health services to millions of low-income households. This money comes straight from the pockets of fellow taxpayers, redistributing the hard-earned money of those earning more and giving it to those earning less.

A number of studies have concluded that as much as 60 percent of the children newly eligible for the State Children’s Health Insurance Program already have private health insurance. Under this new dependency mentality, people are dropping their private coverage for subsidized government programs at an alarming rate. One study found that in several SCHIP programs, at least 28 percent of children enrolled in SCHIP had been enrolled in private coverage during the last six months.

The National Bureau of Economic Research has estimated that between 50 percent and 75 percent of previous increases in Medicaid coverage are associated with a reduction in private insurance coverage. Congressional Budget Office testimony supports this data with reports that states are seeing reductions in the number of privately insured by as much as 50 percent.

The majority of health care proposals – expanding public programs, extending government subsidies, requiring employers to contribute to health care benefits – appeal to this new dependency mentality. These strategies build on the fundamental structure of our already broken system, forcing a select group of individuals to subsidize health care for a growing portion of our population, increasing government dependency and further insulating the majority of consumers from the cost of health care.

As these charitable programs grow, encouraging more government dependency and further isolating consumers from the actuary cost of health care, they eliminate the financial consequences of poor lifestyle choices and open the door to over-reaching government policies. The expansion of public programs creates financial incentives for the government to implement policies that define individual lifestyle choices and manipulate the market place in an effort to constrain health care spending.

Continuing this pattern will inevitably foster the development of regulatory guidelines that dictate our behavior. An effective transformation of American health care will require dismantling the current structure and rebuilding a consumer driven market crafted around personal responsibility and competition.

Allowing the health care system to harnesses market forces would entail limiting government control of health insurance and health care providers. A consumer driven health care market would allow individuals to take control of their health care, driving down costs by encouraging competition and letting individuals decide which health care services are most valuable to them.

By restraining government’s regulatory reach and limiting government health care subsidies, this new approach to health care would lead to lower taxes and encourage individuals to make decisions that are both financially responsible and healthy. A return to competition and personal responsibility will cure America’s health care crisis...if we let it.

Kalese Hammonds is a health care policy analyst at the Texas Public Policy Foundation, a non-profit, free-market research institute based in Austin.

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TPPF COMMENTARY: Mandating Expensive Health Insurance in Texas

Lawmakers across the country apparently believe their idea of necessary health care benefits supersedes that of their constituents. Rather than allowing individuals to make their own decisions, elected officials have dictated the structure and benefits of health insurance policies through legislative “mandates.”

There are many motivations for health insurance mandates; among them, guaranteeing a payment source for providers offering certain treatments and securing coverage for individuals trying to cope with a particular disease or condition.

Unfortunately, these same mandates arbitrarily inflate the cost of health insurance, making even a basic plan too expensive for many consumers and forcing them to rely on the government to provide these benefits or forego coverage altogether.

Of course, a single mandate does not have a crushing impact on the cost of health insurance. However, researchers have found that the combined effect of the mandates drive up the cost of a basic health plan by nearly 50%.

With 55 mandates, Texas ranks among the five most heavily regulated health insurance markets in the country. Recent studies show that one-fourth of uninsured individuals go without coverage because of the increased costs from health insurance mandates. Curtailing such mandates presents an immediate opportunity for lawmakers to lower the cost of insurance plans and help reduce the number of uninsured.

Texas mandates require coverage for services such as in vitro fertilization, marriage and occupational therapists, and drug and alcohol rehabilitation. The latest addition is the “mental health parity” mandate, which alone has been estimated to increase premiums by as much as 10%.

This approach of limiting health insurance to heavily mandated plans that require coverage of “bells and whistles” services is like telling someone in the market for a new car that they can buy the fully-loaded, top-of-the-line Cadillac off the show room floor…or nothing at all.

In today’s health insurance market, people are forced to choose between the Cadillac-style plans, relying on the government to provide insurance through Medicaid and CHIP, or going without coverage at all.

Instead of having legislators determine what services consumers need, insurance products should respond to consumer demands and consumer judgments on value and price.

In today’s customer service driven environment, consumers can engineer a computer built to their specifications, customize their cell phone plans, and even design their own shoes. It only makes sense that an item as personal and critical as health insurance would be adaptable to the specific needs and financial resources of individual consumers.

Eliminating government-enforced mandates so that customizable plans are more accessible would allow consumers to craft inexpensive plans that not only meet their basic requirements but also allow personalization according to an individual’s specific needs.

Fortunately, Texas lawmakers interested in expanding coverage can put health insurance within reach for more Texans by resisting the temptation to regulate the marketplace and by providing consumers with more options.

Several state legislatures have already designed legislation that would allow people in their states to purchase health insurance plans that have been approved for sale in other states. Lifting the barrier to interstate purchase would give individuals the opportunity to buy a more affordable health insurance policy from a state with fewer mandates, while simultaneously encouraging heavily regulated states to deregulate. This competition would curb the impulse of lawmakers to expand the number of mandates each session, and provide an incentive for protecting “mandate lite” health insurance policies the legislature has already approved for sale to certain people.

Minimizing regulations and allowing consumers to choose a health plan tailored to their specific health needs and personal financial capabilities is the first step to making health insurance a real possibility for everyone.

Kalese Hammonds is a health care policy analyst for the Texas Public Policy Foundation, a non-profit, free-market research institute based in Austin.

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TPPF COMMENTARY: In health care, government is the problem

By Mary Katherine Stout

As the presidential candidates discuss their plans for the American health care system, they point their fingers of blame in several directions – toward insurers, toward employers, and even toward over-eaters and non-exercisers. But none of the leading candidates are pointing toward the main culprit – the government.

The federal and state governments have driven up the cost of health insurance and health care with Byzantine regulations, outdated tax policies, and price-setting that distorts the marketplace.

States have piled on health insurance mandates, artificially increasing the cost of insurance and skewing the concept of risk. Texas ranks among the top five most heavily mandated states with 52, requiring insurers to cover everything from alcoholism to in-vitro fertilization, acupuncturists, and marriage therapists. Lower cost coverage sold in another state—perhaps one without all the mandates—is not an option since only policies approved by Texas regulators are available here.

The federal tax code tethers insurance to employers giving favor to employers providing insurance and to individuals with employer-sponsored coverage. The results include needless periods of uninsurance coinciding with unemployment, limited insurance options that reflect the choices of employers instead of employees, and individuals who buy their insurance only after Uncle Sam takes the first bite from their paychecks. Texas even gives employers credit for providing insurance coverage in calculating their tax burden, but individual taxpayers paying for their own care see no such benefit.

Prices for health care services are often based on Medicare rates, which are set by Washington. State and federal governments insulate public beneficiaries from the cost of their care, instead asking taxpayers to pay the full freight even as they work to provide for their own family. Federal laws create perverse incentives allowing people to receive treatment without paying, which stick the tab to federal, state, and local governments; along with those who have insurance.

If health insurance and health care are out of reach for people, it is due to government meddling in the marketplace and stifling competition.

Government regulations have given us this mess, so it is unlikely that government can lead us out. The stories of foreign heads of state coming to the United States for health care services, Canadians waiting in long lines for would-be life saving treatment, and Britain’s willingness to ration care according to age, seemingly fall on deaf ears.

But it is hard to imagine that a government that addresses customer service complaints about long lines at the post office by taking the clocks off the walls, can ever handle the complex and deeply personal health care decisions of more than 300 million people.

The differences between Republican and Democrat presidential candidates’ are not as “sharp” as the editorial board claims. Candidates of both parties may differ on the specifics of their plans, but most envision an increasingly active role for government in regulating health insurance and paying for health care.

Despite historically loud objections to establishing a single payer health care system in the United States, decades of quiet and incremental government expansion have resulted in record levels of government involvement in health care—everything from regulating what providers can do and what they are paid, to actually writing the checks to pay for care.

Today, people are awake to the significant problems in health care, yet most have been duped into believing that the radical departure from the status quo is more government.

Indeed, that may be the real granddaddy of health care myths.

A new direction in health policy would follow the path of competition with the goal of delivering Texans a great deal of choice in insurance and care, with both increasing quality and decreasing cost.

Mary Katherine Stout is Vice President for Policy and Director of the Center for Health Care Policy at the Texas Public Policy Foundation, a non-profit, free-market research institute based in Austin.

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