Don’t count on a death panel for new health legislation

While I was away, the Senate passed a health-care bill; you may have noticed. Ever since, there’s been lots of talk about whether the House and Senate might be unable to reach a compromise combining their respective (and very different) bills; talk about legal challenges to various provisions of the bill; and talk about Republicans running in 2010 and 2012 on a pledge to repeal the legislation.

I’m not getting my hopes up for any of these options. We’re going to be stuck with this monstrosity for a long time — most likely until it sends the federal government into bankruptcy, as this bill, along with the slow-motion fiscal train wrecks of Medicare and Social Security, will inevitably do.

The talk about the House and Senate having difficulty resolving their differences strikes me as political theater. Are there liberal House members who are reluctant to vote for a bill without an explicit public option, which will probably be necessary in any compromise with the Senate? Certainly. Will there be very public pressure from liberal interest groups not to settle for what they perceive to be a watered-down version of reform? Yep.

But most of this liberal outrage will be either manufactured or very easily assuaged. It will be manufactured in an attempt to persuade Americans that this truly is a centrist approach, rather than the first, irreversible step toward a government takeover of health care. And the liberals who are genuinely disappointed with it will be easily assuaged precisely because they know deep down that this is the first, irreversible step toward a government takeover of health care.

Legal challenges don’t offer that much hope, either. A lawsuit about the payoff that Sen. Ben Nelson [name corrected from earlier draft -- KW] got for Nebraska in exchange for his vote, as several state attorneys general reportedly are mulling, will be of little use. The payoff isn’t central to the bill and could be easily excised without affecting its substance. (Nelson has suggested he might be willing to drop the payoff as other senators come to realize they could have gotten billions for their own states.) And, most practically, any such challenge would come before a court well after the votes had been counted in Congress, which was the only reason the payoff was made in the first place.

A challenge to the constitutionality of a mandate for individuals to purchase health insurance might have a somewhat greater chance of success, and would be somewhat more central to the substance of the reform. But this, too, strikes me as ultimately unhelpful. The mandate was included as a practical counterpart to the elimination of pre-existing conditions; without it, people would simply wait until they were sick before purchasing health insurance. While I’m no legal or legislative expert, it seems quite possible that the mandate could be struck down without affecting the pre-existing conditions provision — which only means that premiums would continue to rise for those people who did buy insurance.

Many lawyers will be working on other, potentially more successful angles. And it definitely would be fitting if this bill about health care, a market which has been significantly skewed by an abusive and unrepentant trial bar, were to be held up by lawsuits. But I have yet to see a winning idea.

That leaves a GOP pledge to repeal the bill, which I find the least promising option out there.

For starters, there is virtually nothing the Republicans could do to this bill in 2011-12. Practically speaking, the GOP’s best hope in next year’s election is to win back a very narrow majority in the House and to reduce the Democrats’ majority in the Senate. That is not the stuff of which repeals are made. And even if they somehow could repeal the law, President Obama would still be around to veto the repealing legislation.

There will be too many other subjects in the 2010 election — the economy, chiefly, and perhaps a major national security/foreign policy crisis — for it to be about the single issue of repealing the health reform. By the 2012 presidential election, if not by next November, I would expect too many voters to consider the health reform, even if they dislike it, a closed case that they’d rather not reopen.

So I am pessimistic both about this reform — which will redefine the term “unintended consequences,” given its sweeping nature and the secrecy in which it has been crafted — and about the chances of undoing it. There may be some space for unwinding it a bit, improving it at the margins. But there is a reason why the left has pushed so hard, so long, to take over health care. This is a permanent realignment of government’s relationship with the governed, and I seriously doubt the governed are going to like what we get.

34 comments Add your comment

Road Scholar

December 29th, 2009
11:46 am

And so what ae the conservatives offering in exchange? Nothing! Other than the sky is falling! If they were so intent on balancing the budget, why isn’t there a war tax, or at least adding the cost to the budget during their regime? What about the last medicare bill; passed without a way to pay for it by a repub dominated regime! I watched Mitch McConnell on TV Sunday; what an a$$hole, the “Harry Reid” of the conservatives! He doesn’t like the bill, but had nothing to offer in substitute. I wish the newsmedia would stop throwing softball questions at him and the others. Also if they took the time to explain the bills provisions, it would stop some of the misinfo being floated out there by BOTH sides.

I must admit the special deals and earmarks in this and other legislation is nauseating. What ever happened to the nation first?

Jess

December 29th, 2009
11:53 am

Very good article. Your last sentence has summed up what many have tried to express in an elegant and simple way.

This along with existing unfunded entitlements, will as you say bankrupt the country unless there is a massive restructuring of our tax system. Europe learned a long time ago that a hugh, and hidden revenue source was to be had with a VAT. I expect to see this, along with many other fees and taxes, come to life after the health care bill is passed. Problem is even repubs. will have to ultimately support hugh tax increases because unraveling ourselves from this fiasco will be nearly impossible. Another lesson from Europe.

Kyle Wingfield

December 29th, 2009
12:01 pm

Road Scholar, conservatives have offered plenty of alternatives: tort reform, changing the tax code so that small businesses and individuals get the same breaks that larger companies do, allowing people to buy states offered in other plans (which is a big deal because state regulations inhibit a lot of potential competition), changes in the ways people can form risk pools, and others. Just because you don’t like these alternatives doesn’t mean they haven’t been offered.

And while I do think changes need to be made, I would take nothing over what Congress is offering us right now. A bad bill is worse than no bill, and this is a bad bill.

Kyle Wingfield

December 29th, 2009
12:05 pm

As for what happened to nation first, it does still exist…from Rasmussen Reports:

Just 17% of Nebraska voters approve of the deal their senator made on Medicaid in exchange for his vote in support of the plan.

http://www.rasmussenreports.com/public_content/politics/elections2/election_2012/nebraska/election_2012_nebraska_senate

Chris Broe

December 29th, 2009
12:10 pm

90% of our healthcare dollar is spent in the last 12 weeks of a patient’s life. (NEJM).

The issue can’t be treated satisfactorily from a partisan bent.

Churchill's MOM

December 29th, 2009
12:50 pm

What do you expect? The RINO Party works for the insurance companies and the Democratic party works for the lawyers and doctors. Who works for the taxpayer NONE OF THE ABOVE.. I am back to becoming a Libertarian, our current “2″ party doesn’t work when neither party works for the citizens only special interest.

Churchill's MOM

December 29th, 2009
1:08 pm

Wingboy 12:01 pm…my husband, the doctor, says that tort reform in Georgia has NOT cut their insurance cost becaus the insurance companies have pocketed the sayings not pass them on. You might want to read this in the ABC..

http://atlanta.bizjournals.com/atlanta/stories/2009/12/21/story11.html?b=1261371600^2610851

Churchill's MOM

December 29th, 2009
1:09 pm

SB ABJ not ABC sorry.

Horrible Horrace

December 29th, 2009
1:16 pm

Road Scholar

December 29th, 2009
11:46 am

The only option acceptable to myself, a repulican now leaning more independent, is not trash this entire OboboCare bill.

A War tax…? You must be kidding. Just more tom-foolery launched by the despot dems. My Federal taxes are the War tax. Idiots like yourself are so intent on backing Obobo than your own bankruptcy takes a back seat. Just hope you have a nice nest egg cuz by the time the kenyan finishes you are gonna need it.

OH, PS…I have my nest egg…

MrLiberty

December 29th, 2009
1:21 pm

Never expect any move towards real freedom from the Republican party. They have no principles, just like the Democrats, so all we can expect from both is more big government in bed with more big business.

The best hope we will have will come from our state house where back in september, a group of senators pledged to pass legislation allowing the voters of Georgia to essentially “nullify” the federal legislation. At least 20 other states may be in line to pass similar legislation. Enough rejection by the states and enforcement of the legislation might become unworkable and we might all be free of the burden.

The next on their agenda should be a law to repeal all legislation governing insurance companies in this state. While freedom minded individuals at the Federal level clearly pointed out that the problem of availability and competition is the direct result of state-imposed and created cartels within state boundaries for insurance providers, neither federal representatives nor state officials seem in any hurry to correct the problem. At the state level, dictators like Oxendine enjoy the power such legislation gives them over insurance companies, while state legislatures enjoy the kickbacks and bribes (in the form of perfectly legal campaign contributions you can be sure) they get from lobbyists of every medical practice under the sun to be included in the 48 state mandates on coverage that every insurance company must cover.

Yes, we will be saddled with this unconstitutional piece of garbage legislation, but let us hope that our state elected officials will step up to the plate and say “no more” to a federal government that is out of control. If they are successful in getting this legislation through, the next step should be to pass a resolution of secession and really tell the feds where to go with their policies, their oppression, and their never ending deficit spending.

Hillbilly Deluxe

December 29th, 2009
2:13 pm

We had tort reform in Georgia in 2005 and insurance didn’t go down one bit. They were the ones who pushed for the legislation, not doctors or trial lawyers.

The truth of it is, be they in the House or the Senate, Republican or Democrat, none of them gives a damn about people like us. Re-election is all they really care about.

Road Scholar

December 29th, 2009
3:05 pm

First, sorry about the previous post. If either Bellsouth or the AJC could keep their sites up for a while….

Kyle, all I hear from the Repubs is that they don’t like what the Democrats are proposing. I hear NOTHING about what they are alledgedly proposing in their arguments at the same time they say NO. If I was trying to get something past, I would not only rale against what the other side was propoing and its real impacts (death squads, my ass), but also telling what I was for. I have heard about tort reform…we had that in Georgia…see lack of impacts above. And since most of the legislators are lawyers and doctors, are you suggesting that they would recommend anything that would benefit the public and not line their pockets or reduce their exposure?
Small business tax breaks? I thought all of the business tax breaks passed by the Bush regime was suppose to lead us to the promised land? And where did we go? Down the tubes with the rich getting richer?

It’s not that I wouldn’t like a tax break, but we have to pay for things. Where do we get the money? And don’t tell me businesses are the only way, since most have tax breaks and loopholes galore!

As for insurance across state lines, I agree wholeheartedly. I thought that is why we have the Interstste Commerce Commission.

Horace: Your not so horrible. How do you propose to pay for the war while at the same time giving tax breaks to the wealthy and businesses? The point is, when you start a war or any costly program, how do you pay for it? This wasn’t even in Bush’s/Repub’s budget!

Mr Liberty: “The next on their agenda should be a law to repeal all legislation governing insurance companies in this state.” Without oversight, look what happened with the banks and Wall Street! Granted we alledgedly had oversight, but guess why people like Madow got away with what they did so long? Because they were powerful for “making” so much money! And their profits and bonuses aren’t big enough?

Kyle what I’d like to see is that a few elected officials put together a grass roots program for all to consider w/o special exemptions and bribes. Our healthcare is not the best in the world based on costs, deathrates etc. Or do you disagree? Please check your rising costs and increased conditions, co-pays, restrictions before answering.

Road Scholar

December 29th, 2009
3:53 pm

Kyle, are you still working?

Ragnar Danneskjöld

December 29th, 2009
3:59 pm

Well-argued Kyle; I’m sold. Dear Mom @ 1:08, hope you had a great Christmas. We would agree that the bill that Georgia lawyers labeled “tort reform” did not make any difference. I have a typical jbmlaw solution for you, and that is to amend the tort of malpractice so that it is administered and funded along the same lines as worker’s compensation, with state prescribed benefits, funded by annual assessments. Would be faster and cheaper and fairer than the present legal-lottery system.

Kyle Wingfield

December 29th, 2009
4:01 pm

Yes, Road Scholar…thanks for the concern…

The tax breaks I mentioned, btw, were nothing more than the exemptions granted for corporate health insurance purchases.

Churchill's MOM

December 29th, 2009
4:09 pm

Rag Head.. When does your son go back? We had a nice holiday, my Husband & I are going to my fathers this week end to bird hunt. I am really looking forward to having some time alone with him.

F-105 Thunderchief

December 29th, 2009
6:13 pm

Deregulate health care 100-percent, then prices will be what they are supposed to be.

I Care

December 29th, 2009
6:17 pm

How sad the republicans vote as a block about anything that comes up for a vote in the Obama administration. We have a sad state of affairs with the elected idiots in DC. Yes, I care for the poor. I was brought up to care for those less fortunate that I. I heard a republican (sorry, I just can’t capitalize that word) state, “Let’s stop this bill and we’ll do it right.” Gosh, did you not have eight years to do so. Health care reform has been talked about for over 20 years…at least. This may not be perfect, but it may be a start from which we can build, change, edit and clarify. Finally, I’m just sick of republicans being so @$%@#$%@$ partisan. Work for the good of the people. Trust me, being from Georgia, I did NOT vote for the idiots who are blocking everything Obama tries to do. They are being most unproductive.

I Care

December 29th, 2009
6:21 pm

Re-reading some posts, I just had a thought to share. What’s so funny with the Palin junk about “death squads,” is that their uneducated idiots who attend tea parties and don’t read, actually believe it. So sad. How did America become a country of idiots. Europeans are so much more in tune with what is REALLY happening in the WORLD…not just Alaska or a 20-mile radius from ones’ home. So sad we Americans are.

I Care Too

December 29th, 2009
6:26 pm

I Care……my goodness, but don’t *you* sound like a blindly partisan democrat (can’t bring myself to capitalize that word either). I am sure you supported many of the policies of the Bush administration in your non-partisan manner, huh?

ernisTbass

December 29th, 2009
7:20 pm

What is /was needed were more community health clinics where people without insurance could see a doctor with fees based on income, similar to food stamps. This would address basic health care and empty emergency rooms of people with a fever with no noticable effect on the current system that most people are satisfied with. It should have been phased in over four years and funded with the 400 billion that is(chuckle chuckle) to be saved from Medicare. The only stipulation would be that only funds saved from Medicare could be used to fund the program. That would have forced those politicians that made that claim to put up or shut up. The current claim of budget neutral, money saving, economy saving, job saving, is total BS. If I purchase a rental property for 100,000 and my payments are 1200 a month and I rent it for 1600 a month then it is budget neutral or possibly profitable after related expenses. However if I rent it for 900 a month and then demand that every neighbor pay 50 dollars a month at gunpoint just so I don’t lose money then it isn’t really budget neutral for the rest of the neighborhood, only for my book keeping purposes. Tony Soprano would approve but I don’t expect it to sit very well with the public once they figure out who is a neighbor and who is the renter getting by on someone else’s dime. Also, why is it that unions are getting exempted left and right, or should it be left and farther left, from the “Cadillac policy” tax? Either you get taxed based on price or you don’t, there may be a successful lawsuit there. Finally when the “Bush Tax Cuts” expire and taxes are levied on employer provided healthcare policies that would have a family of four with a 90,000 income see an average tax increase of 6,000-8,000. That would make a certain promise based on 250,000 a tad misleading, it will at the very least validate Joe Wilson. Look on the bright side. You too may have been declared RICH! just compare your tax returns over the next two years and remember the rhetoric about taxing the rich. It’s change you can count on, just don’t count on spending it.

Evil-Doer

December 29th, 2009
8:14 pm

Pro-Death Panel, Old peeps continue to drink from the government teet, it’s time to cut the cord and eliminate waste, keeping old farts around for story-book time reeks of socialism…

John

December 29th, 2009
8:19 pm

The real root of the problem with healthcare is that, over time, our society has created the perception that someone else (the insurance company, your employer, the government, etc.) will pay for your healthcare costs. That’s been driven by: (1) employers’ desire to attract good employees by offering good benefits – eventually it became an entitlement, and (2) the fact that the employer group policy is the most cost efficient method for insurance companies to deliver coverage – like it or not.

As Americans, we have the expectation of having the best of everything available to us – cars, houses, food, medical care, the list goes on. On the whole, we do have the best. But guess what? It’s all expensive. The R&D that went into cancer and AIDS research that has dramatically increased the survivability for patients with these diseases was driven by a capitalist economy. The doctors, and scientists who work on these things are the very best of the best who have expensive educations. Equipment and clinical trials for new drugs cost the pharmaceutical companies lots of money. Guess what else? All of these people and companies have the crazy expectation of being well compensated for their efforts. You don’t like that these people are getting rich? Fine, but just remember that if your prevent that, those resources will leave the market while other resources will have little incentive to replace them (there’s no money in it). Result: The quality of healthcare will stop porgressing, probably decline, and become LESS available (fewer doctors, remember).

What we need is for individuals to take a greater financial stake in their own healthcare. Insurance companies provide a level of coverage that is a true risk. Need surgery? That’s covered, but you’re on your own when you get a cold. Premiums go down, and employers can pass on the savings to their employees in the form of higher wages (don’t think they’ll do it? Remember that they still must compete for employees).

This country is great because it was built on the concept of the free market. Markets will ALWAYS correct for imperfections. If you try to monkey with the market, you will only delay the correction and make it more severe when it does occur.

On a broader scale, the Dems do not care about healthcare. They do not care about global warming (even if it did exist and was man-made). What they do care about is control over your life. These kinds of issues are key to their getting that control.

DannyX

December 29th, 2009
10:44 pm

John, government funding has a lot to do with medical breakthroughs the drug companies produce. Grants and universities provide a tremendous amount of research that go into new drugs. One aids drug, azt, was developed by the government as an anti-cancer agent. It failed as a cancer drug but has accounted for billions of dollars in sales. That patent was GIVEN to a drug company. The US government pours billions into research annually.

Pharmaceutical research and development is far from free market.

Big government is responsible for a lot of big profits.

no credibility

December 30th, 2009
12:29 am

the so-called award winning blogger can’t even get the name of the nebraska senator right. so much for his educated opinions. what does this say about modern day journalism when journal constitution bloggers are not fact checked for accuracy. it’s a sad day for journalism when once respected newspapers around the country have turned their internet content unchecked over to bloggers from both the extreme right and left.

Paulette

December 30th, 2009
7:40 am

This bill is a wedge into control of the economics of America. The nefarious back room dealers connive for outcomes the American people don’t even want to think about. Control needs to stay in the hands of the American electorate not in the pockets of Chicago style sleazy sneaks. No matter what anyone thinks about the bill — at least we can all agree that the Congress is corrupt and should not be give access to power.

Chris Broe

December 30th, 2009
7:45 am

How about a Death Panel for terrorists?

bob

December 30th, 2009
7:58 am

I care, you are upset with partison politics now that repubs are doing it ? Ask dems why they fought bush on reform when it came to Fannie. Freddie and Social Security ?

Kyle Wingfield

December 30th, 2009
9:09 am

Not sure how Bill Nelson got in there instead of Ben Nelson, but it’s fixed now.

Chris Broe

December 30th, 2009
9:11 am

no credibility stumbled across a very important point: As punditry becomes a revenue source for every clown with a website via links to amateur blog sites to google ads to Greater Moronia, our acceptance of tabloid level journalism will grow to where no news report can be trusted until long after the fact when some sort of spun consensus emerges.

When it’s too late to know what really happened, maybe.

Ragnar Danneskjöld

December 30th, 2009
9:23 am

Dear mom @ 4:09 12/29, I returned to the swamp Sunday and my son headed back Monday. Mrs. jbmlaw is now enjoying a little peace and quiet again.

Democrats are Corrupt, Repukes are Lying Scum

December 30th, 2009
9:52 am

I still believe the neocon scum aided and abetted 9/11 to advance their perverted goals in the MiddleEast, not the least of which is an expansion of Israel to include all of Lebanon and much of Syria. This ObamaCare scam is a smoke screen to allow the feds to cut Medicare spending and collect more taxes prior to the 2013 implementation date of this ABORTION. The funds collected under ObamaCare between now and 2013 will be used to offset the loss of the former Social Security Surplus that was used to fund the Federal government, thus allowing a BANKRUPT NATION to continue the illusion of prosperity and wage four wars simultaneously. Social Security will collect less this year, 2009, in taxes than it pays out in benefits. This will make the Federal budget deficit much worse, hence the need for the ObamaCare taxes. I believe Obama has been taken in by the neocon lies, and is expanding the war against Islam to include Yemen and Iran. If I am correct, get ready for a return of the DRAFT, as an AmeriKan war of aggression in four countries cannot be waged with only a volunteer army. Never underestimate the power of the pro israel lobby in WashingAss, the scum own that worthless city and the press. You will never know the truth by reading the main stream american media, or watching the american boob tube, and certainly not by listening to talk radio. Any and all criticism of Israel and neocons will be labeled anti semitism, and discredited and/or deleted. Try reading the comment sections of the Washington Post for a true view of the pro israel lobby, the federal workers in Washington are well aware its control of the Federal government, and their comments reflect their frustration with this one way street of American wealth and military equipment and technology flowing to Israel, with nothing coming back except demands for more. No longer satisfied with vast amounts of American wealth, military equipment, and technology, the pro israel lobby has long wanted American boots on the ground in the Middle East. That goal achieved, they now seek expansion of that war to ALL Arab and Muslim countries in the region, and that demands a return to the draft.

Dearie Smith

December 30th, 2009
10:23 am

Comment to no credibility (12:29 a.m.) Why the name calling? Your choice of “no credibility” as a blogger name assumes you never aspire to be an “….. award winning blogger”.

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