25 September 2009

Nothing up his sleeves...

Magicians are masters at misdirection. You never see the trick, you only see the magic, because that's what they want you to look at - you can't help yourself. I can't decide whether Obama is a master, as well, or whether his approach is simple overload.

We are so caught up in the healthcare debate because the stakes are so high, that we can hardly absorb all the rest:

  • The IG scandal. Remember that? The Walpin lawsuit is still pending, but there were other IGs also fired. Transparency and accountability, in this administration are, well, "just words."
  • Cap and Trade. Sure, it's dead. Right? It isn't dead yet, and try to get the crowds away from the anti-Obamacare rallies to stop it.
  • Afghanistan. It's in the news right now, but not as prominently as it ought to be. There is a reason the McChrystal report was leaked, and it may have been revealed in today's report that the White House pressured his generals to "scrub" their assessments.
  • Nationalization of the banking and auto industries. Does anybody even remember that? It's still a pretty big deal, but it's dwarfed by the Obamacare proposal.
  • The radical Czars. Glenn Beck is a voice in teh wilderness on this one, I'm afraid. Van Jones is gone, and that's good, but he is hardly the only radical appointed extra-constitutionally, and probably not even the worst.
  • The new financial regulations are atrocious.
  • Our Iran policy is not only groveling and weak, but scandalous. Today we learned about another Iranian nuclear facility, but Obama knew about it before he was even sworn in.
  • Missile defense in Europe. Or lack of it. Obama is making the world a much more dangerous place.
I can't even tally it all up, but the cards are in Obama's favor on implementing radical change. We have to stop Obamacare. He doesn't have to pass it to get his brand of "change."

At least, not yet.

19 September 2009

What, exactly, do people dislike about health care today?

During my son's five year battle with cancer, the one constant was nausea. It was a symptom of his cancer, and a side effect of virtually every treatment and every drug he took. His doctors prescribed many anti-nausea medications, from Decadron, to Zofran, to Kytril, to Emend, to Aloxi, to Marinol, to Phenergan - he had them all, and more. Our insurance covered it, but they were very specific about when you could get a refill. If we needed to change the dose before a refill, and ran out before they thought we should, it was tough to get it refilled; a call to the doctor, a call to the insurance, another day for the pharmacy. If this happened on a Saturday night, the delay was longer.

On more than one occasion, we simply could not wait. We could not cure his cancer, but for a thousand dollars or so, we could ease his nausea for a couple of days. For people without the same means as we had, their kids would just have to live with the nausea.

Bear in mind, nobody ever denied coverage - every pill was covered by insurance. No doctor ever told us it was unnecessary - they went out of their way to find a way to help. No pharmacy ever acted as gatekeeper - they did everything they could to get us the medicine and limit the cost.

Everybody wanted to help, and everything was covered. But there were certain bureaucratic rules, and boxes to check, and forms to fill out, and people to sign off, and it just took too long and was a pain in the ... you know where.

This, I think, is the sort of frustration most Americans have with our current system. Not bankruptcy for lack of insurance, not dying in the street for lack of care, not paying too much for those last few months of life. Just bureaucracy and red tape and a whole new pain in the @$$ every time you turn around.

But most Americans have also stood in line to renew a drivers license, or to mail a package, or to get the local tax office to correct an error.

So why would any reasonable person believe that more government will fix the actual frustrations we have with the current system?

Great quotes, great thoughts

A friend once remarked to Abraham Lincoln that he had no use for books, since he'd come up with many of the same thoughts himself. Lincoln, an avid reader, responded, "Books serve to show a man that those original thoughts of his aren't very new at all."

I think that is a useful admonition, and reason to save and reflect on the thoughts of those who have gone before us. Here are a handful of my favorites - I'll post more from time to time.

"Be kind, for everyone is fighting a great battle." Philo of Alexandria

“A government big enough to give you everything you want is a government big enough to take from you everything you have.” Gerald Ford, 
Address to a Joint Session of Congress, 
August 12, 1974

"If ye love wealth greater than liberty, the tranquility of servitude greater than the animating contest for freedom, go home from us in peace. We seek not your counsel, nor your arms. Crouch down and lick the hand that feeds you; May your chains set lightly upon you, and may posterity forget that ye were our countrymen." Samuel Adams

My visit to the balmy tundra

I started a quest a few years ago to see a game in every NFL stadium. It’s a very long-term goal – so far I have only been to six, including many games at the home field of my Dallas Cowboys.

I grew up in Wisconsin, but have never been to a Packers game, either at Lambeau Field or at the old Milwaukee County Stadium, back when the team played half its home games there. My brother, who met me in Green Bay, had been to a game in Milwaukee once, but was also visiting Lambeau for the first time.

I know my Cowboys will be going to Lambeau later this year, but I avoid Dallas road games because, as part of the stadium experience, I like to buy the home team’s hat, and I obviously could not do that if the Cowboys were in the house. I don't think I could have picked a better game to attend than Bears-Packers - the 177th meeting of these teams in the NFL's longest-running rivalry.

I had bought a parking pass ahead of time to save searching for a spot. It turned out I didn’t really need to. We met our niece for lunch in the afternoon, and we could have left the car right there for the same $25 I paid. The restaurant was only a couple blocks from the stadium. From what I observed, the many stores and restaurants nearby offer ample parking with a short walk to the stadium. Our spot was in a lot right next to the Packers practice field, on the east side of Lambeau. For those who may not know, the Packers are one of only a handful of teams that do not travel for training camp. They practice year-round on a practice field, and indoor facility directly across the street from the stadium. Forget about parking in the actual stadium lots – they are 100% season ticket holders.

Out in the lot, there was tailgating as far as the eye could see. There was a pretty high percentage of hardcore fans who arrived in RVs and other converted delivery vans, custom painted with Packers colors and logos, many with full, 25 foot flagpoles erected, waving the Green Bay flag. One had a funny poster displayed, showing a mock-up of “Madden 2012” with Bears QB Brett Favre on the cover; another had a sign declaring Ted Thompson, not Brett Favre to be a “traitor.” I particularly enjoyed the polka-like music, with several dozen fans singing along to “The Bears Still Suck.” A lot more people joined in the sing-along after the game. It all seemed to be in good cheer and good fun, though. Even the Bears fans just laughed and shook their heads. It’s hard to imagine a fight breaking out in this place.

The stadium itself still sits on the same spot where it has since its dedication in 1957, but if you remember the old green facade, that was replaced by a mostly brick exterior in a major renovation in 2003. Inside the stadium, the concourses are wide and roomy, and there are plenty of concessions. (One of my favorite offerings was “Brett Favre Waffle Fries.”) We entered through the main doors. Just outside are two massive statues – one of Curly Lambeau, and the other of the hallowed Vince Lombardi. People waited politely to the side for a turn taking pictures with Vince.

We went inside pretty early so we could get our hats at the Pro Shop, and then tour the Packer Hall of Fame Museum. The museum will cost you an extra ten bucks, and on game day it is only open to ticket-holders. On display are uniforms going back to the original “Acme Packers,” a recreation of Vince Lombardi’s office, where you can go in and even sit down at his desk, plenty of video running and even a full size sculpture of the two lines, and Bart Starr, lined up for that final play of the Ice Bowl. They are proud of their team history and tradition in Green Bay, and it really comes through. They don’t even gloss over the down years (the 70s and 80s.) There are sections for every decade.

On to our actual seats, and we found that one thing which was not altered in any of the renovations over the years is the classic stadium bench seating all the way around. In addition, all the luxury boxes are up top – three levels of them – but the lower bowl is all benches. There is no upper level overhang, although there are some rows at the top (behind a rail) with actual chair seating. The majority of the fans, though, sit on metal benches. They rent stadium seats with a cushion and back for six bucks, and many fans bring their own.

I have to say that Packer fans are some of the friendliest you’ll meet. There was some good-natured ribbing of the Bears fans (and there were pretty many of them) but not once did I think a fight, or even an argument, would break out. I have always noticed on TV that when they zoom in on the fans, no matter how the game is going, they always seem jolly and cheerful. I can report that the cameramen are not being selective. Even with the Packers trailing in the fourth quarter, in the home opener against a hated rival, these people are all smiles, dancing to the music during “TV time-outs,” and commenting to each other what “good ball game” it is.

In similar situations at Texas Stadium, the mood gets rather grim. Not at Lambeau.

Are they loud? You bet – and exactly when they are supposed to be. I found it very easy, though, to carry on conversations. I don’t know how they manage to sound off so loudly on each opponent down (especially third,) then stop and chat politely in between, but that’s what they do.

I don’t mean to be too over the top here – after all, as a native Wisconsinite, these are my people – but it really is just a very happy place to watch a football game.

The Packers do not have cheerleaders, but they bring in college cheerleading squads for games. We had the (co-ed) squad from UW Green Bay at our game. There is also a drum line which appears on the sideline, and in random spots around the stands. They are called the Tundra Line.

The grass looked like turf to me, which was surprising, because I could not believe they would switch from real grass. Turns out, they haven’t. It is still real, but now enhanced with something called DD Greenmaster fibers.

The weather was hot (for Green Bay); in the mid-80s, although it was more comfortable in the evening. The game, of course, was terrific. I love it when the home team wins, especially with a come from behind, last minute score.

Whether you try to tour them all, like me, or just want to check out a few NFL stadiums, put Green Bay high on your list!

The cry-babies in the White House

During last year's campaign, Obama struck me as rather thin-skinned. He reacted to Sarah Palin's joke about community organizers by childishly mispronouncing "Wassilly" in an interview. Despite the fawning press corps' constant repetition of how cool he was, I always thought he seemed to react very angrily to any sort of criticism.

Chris Wallace, it would seem, agrees:

16 September 2009

Insurance companies don't provide health care; doctors do...for now

In touting his notion that we can stop wasting so much money on the very sick and very old if we defer treatment recommendations to an independent panel of "experts," President Obama seemingly leaves open the question of what exactly would qualify one as an "expert."

For most people, doctors would rank pretty highly as health care experts. In fact, they're the first ones we think of aren't they?

Investor's Business Daily offers us today a new poll of 1,376 practicing physicians nationwide. More than 70% of them do not believe the president's plan can cover all of the currently uninsured while improving care and reducing costs. No big surprise there. After all, you have to take a fair amount of math to get through college and medical school, and the math on this one is very simple. The doctors are not offering a mere opinion, but a scientific conclusion based on the numbers and the facts. Consequently, two thirds of them oppose the reform proposal.

But that's not the real shocker of the poll. The real bottom line of Obamacare is this: if Obamacare passes, 45% of doctors say they "would consider leaving their practice or taking an early retirement."

Add to this the 600 Catholics hospitals that their bishops have vowed to close if the Freedom of Choice Act (another Obama favorite) were to pass, and the future of health care under the Democrats' vision for America looks rather grim.

12 September 2009

Price is no object if the cause is just

In the current health care debate, much of the Republican opposition has centered around various objections to the cost. It is certainly legitimate for our elected representatives to concern themselves with a properly balanced budget - indeed, it is their clear fiduciary responsibility. However, there is a danger in focusing solely on such arguments, because debates about cost really really amount to debates about how to nationalize health care, rather than whether to do so, and the latter is the debate we should be having.

Just as a hypothetical, say the Democrats reached into their magic top hat and pulled out a magic money machine that could socialize medicine with a balanced budget. Would that make it the right thing to do? Obviously, there is no magic money machine, but there are magical rhetorical tricks which are not so far-fetched. The Democrats are using them now: Obama's pledge not sign a bill that will add "one dime" to the deficit, playing around with projections, and drawing moral equivalence to prior deficits. They do not have to prove it is paid for, they only have to lessen concern about the cost, and they win the argument.

Nearly a hundred years ago, G.K. Chesterton argued forcefully against the futility of debating "efficiency." Efficiency, he explained, is not a philosophy for action; efficiency, and success, can only be settled after the fact. The ground on which we must argue before the fact is not whether a policy will be efficient, but whether it is, "in the abstract, right or wrong."

Like it or not, this is exactly the ground on which Obama argues. You can talk until you are blue in the face (or green in the eyeshade) about how high the deficit will run, and his answer will always come down to the one he made to conclude his address to the joint session of Congress.

In that speech, he quoted Ted Kennedy's argument that nationalized health care "is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."

Indeed, Obama furthered the argument by implying that the question is already settled; that to ensure "security" and to reward hard work and responsibility, government intervention "has always been the history of our progress."

What national leader is answering these arguments with equally forceful moral arguments? Who will stand up and say that progress in America has never been measured by the soothing, guiding hand-outs from Washington, but by the courage and achievement of individuals. Who is arguing that Obamacare will not affirm, but will unalterably change "the character of our country," and for the worse?

The opposite of government-run health care is not the absence of health care, it is the presence of freedom. Free patients are free to decide for themselves what treatments are worth paying for. Free doctors are free to research, free to innovate, free to volunteer their time to help the poor. Free people make free decisions. Governments can only follow cold, bureaucratic rules, and ensure compliance by force; it is the nature of government. It is why we must not allow our poor and our sick; indeed, our own bodies, to become matters of public policy.

We must remain human beings, not abstract categories of spending; individuals, not objects; citizens, not subjects. That's why Obamacare must be stopped.

10 September 2009

Simon welcomes Cousin Oliver to "Idol"

Well, nearly overlooked in last night's health care hub-bub, apparently the folks at Fox have settled on a successor to Paula Abdul. Comedienne Ellen Degeneres will fill out the American Idol judging panel, along with Simon Cowell, Randy Jackson, and Kara DioGuardi.

Hey, I guess it's still the top-rated show on TV, and I know it was just a fig leaf of credibility, but up until now all the judges had some sort of background in the music industry. Even Paula.

I'm sure she'll be funny. So is Dennis Miller, but he just didn't fit in on Monday Night Football.

And really, haven't we seen this kind of thing before in a hit show's waning years?

J'accuse cuts both ways

I was as startled as Speaker Pelosi, Vice President Biden and President Obama seemed to be when Rep. Joe Wilson of South Carolina shouted out "you lie!" during the speech last night.

I thought from the moment of the shout that it had potential to become a bigger story than the speech itself. I’m not sure if that will actually turn out to be the case, but I am amused by some of the commentary from liberal corners, condemning Wilson's outburst.

Lest we forget, Wilson’s accusation came on the heels of Obama himself offering three or four consecutive responses to his critics that consisted of nothing more than his own assertion that “they lie.” When two sides both yell “You lie!” it becomes somewhat more important to determine which of them is actually telling the truth. Enter the AP, with a startlingly unbiased “fact check” which cannot be reasonably construed to conclude anything other than that, well, Obama lied.

We can get all wrapped around the axle(rod) condemning the lack of “civility” that Wilson displayed, but his reaction was not isolated, and not unjustified.

The president did nothing more than repeat his own unsupported assertions and accusations that have driven many Americans to the same sort of frustrated outburst at town hall meetings all summer long.

Obama clearly did not advance his cause last night, and it is wishful thinking by liberals to pretend that Joe Wilson did it for him.

It's also about what he didn't say

In his speech before Congress, the president tried to evoke, at times, a sense of patriotism, historical precedent, and national purpose to build support for his proposals. It is interesting to note that there is an important historical anniversary approaching; one that you would think the President of the United States would have found worth mentioning in a speech to a national audience.

Yet, just 36 hours before the eighth anniversary of the September 11th attacks on our nation, the only reference President Obama could muster during a speech before a joint session of Congress was a sneering remark that the war was one of "many initiatives over the last decade (that) were not paid for..."

09 September 2009

Elementary math

In case you did not catch it, in his speech tonight, President Obama referred to "more than thirty million American citizens who cannot get coverage." That's a pretty big difference from the "47 million uninsured" number which has been tossed about for months.

Why the change?

The White House explains tonight that they have subtracted 10 million illegal immigrants and 5 million they believe can afford insurance, but choose not to get it.

Those are interesting concessions, which I think need to be highlighted, because they are the most damaging to his overall call for radical reform. By reducing his estimate of those who "cannot get coverage," he maintains the call for universal coverage, yet concedes that the number of uninsured is not the same thing as the number who need government help to get it.

The same census report which concluded that 46 (not 47) million were uninsured also shows that 17.6 million of them make more than $50,000 a year. It is not unreasonable to conclude that all of those can get coverage if they choose. In addition, the Centers for Medicare and Medicaid Services reports enrollment of 18 million more people in those programs than the Census Bureau reports. Other estimates put the number of reported "uninsured" who are currently eligible for government programs conservatively at 10 million.

The number that "cannot get coverage" is now reduced to 9 million. Another 5-10 million of the uninsured are only temporarily without coverage; for example, people between jobs who opt not to pay for COBRA or temporary coverage.

Clearly, there is some overlap between these groups, but it is clear that the number of people who truly "cannot get coverage" is not only dramatically lower than the number Obama himself has now abandoned, but is likely closer to 5-8 million people.

That may be a problem the American people think the government should address, but a radical overhaul of the entire insurance industry, medical industry and tax code is not the way to do it.

Equally gratuitously denied

In case you didn't catch it, one of Obama's assertions that his opponents were lying was met with a shouted "you lie!"

Reportedly, the shouter was Rep. Joe WIlson, R, SC. I would not say he was rabble-rousing. It is a well-accepted rule of logic that a gratuitous assertion may be equally gratuitously denied.

UPDATE: I read that Sen. McCain has called on Rep. Wilson to apologize for calling the president a liar. I assume he will also be calling on the president to apologize for repeatedly calling his critics liars.

UPDATE #2: Wilson has apologized. Will Obama?

Assertions are not arguments

I have always thought President Obama comes across a bit school-marmish; a bit of a scold. I honestly cannot remember hearing a president shout as much as he did tonight.

I was disappointed, but not surprised, that he did little more than repeat the same things he has been repeating for months as support for his reforms has plummeted.

He can say until he is blue in the face that talk about "death panels" is a lie, but I have read Obama's own words on the topic. After explaining that "...the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here," he goes on to say that the only way to reduce those costs is to reduce the care, and to do so you "have to have some independent group that can give you guidance."

No, he didn't say the words "death panels." But he clearly indicated that care for those who are terminally and chronically ill, as well as those at "the end of their lives," currently receive too much treatment, and an independent panel ought to be formed to determine the proper limits of their care.

If he wants to say that is not, and cannot become, a death panel, he needs to offer something more than a simple assertion that those who say it does are lying.

08 September 2009

Does covering preventive care save money?

As many others have demonstrated in some detail, preventive care does not save money in the aggregate. But let's skip the details, and think about it in terms of a simple analogy:

Requiring insurance companies to provide preventive care services would save money only if you don't actually get the services; the same way Netflix makes money only when you don't watch all the movies.

Think about it: on the two movies, unlimited plan you could cycle through six movies a week, 24 movies a month. Your $15 monthly fee would not even cover the postage on that. Netflix does not make money when you watch all the movies your plan "covers." Netflix makes money when you leave the movies laying on the table for a couple of weeks, which is what most of us do. If we all started watching a movie every night, one of three things would have to happen:
  1. The monthly fee would go up.
  2. They would start taking a lot longer to send out movies.
  3. Netflix would go out of business.
That isn't a knock on Netflix - they are a great company, providing a service people value. It's just basic math, and there is no way around it. Companies only make money if they take in more than they put out, and insurance companies and medical facilities are no exception.

Universal coercion

I posted previously about how "preventive care," if it is truly to be provided universally, must involve coercion. (If I don't want to get a prostate exam, who's going to make me?)

Along with "preventive care," the term "universal coverage" gets bandied about as a goal of health care reform. But what does that really mean? The Associated Press now reports that the current reform proposal in the Senate Finance Committee includes fines of up to $3,800 per family for failure to purchase health insurance.

For a reform that at one time was being sold as help for people who cannot afford health insurance, that fine sounds mighty steep to me. The simple fact, though, is that somewhere in the neighborhood of one third of the oft-repeated "47 million uninsured" in this country have household incomes above $50,000.

They can afford it. They choose not to buy it. You and I may disagree with their priorities, but the simple fact of the matter is that there is only one way "universal coverage" can be extended to these millions of people:

Somebody has to make them buy it.

06 September 2009

21st Century political discourse

Just a quick thought: If your political arguments fit in your Facebook status, they are not likely to be well reasoned.

04 September 2009

The revolution is what he does. It's all that he does.

Over at the American Spectator, Quin Hillyer has a very important analysis of Obama. In short, he warns conservatives not to take too much solace in Obama's falling poll numbers, nor in the popular uprising against health care reform. Obama, he points out, is not Jimmy Carter. He is smarter, does not have the same kind of opposition within his own party that Carter faced, and on the right, he faces no unifying leader, such as Reagan had become for Republicans in the late 1970s. As they say, read the whole thing.

Any disagreement with his analysis seems like nitpicking, as I think Hillyer's got it about right. But here I go anyway.

I share his assessment of Obama as an absolutely committed left-wing ideologue, and agree that Obama does not care about his poll numbers - at least not right now. I am convinced that if he can get through enough of his program on health care to make the slide to socialized medicine irreversible, he would willingly lose re-election.

I am not as convinced that he is a shrewd tactician, as Hillyer describes him. He did win the nomination against a Clinton machine that many thought all-powerful, but it is also a fact that Hillary Clinton, recent image rehabilitations notwithstanding, has never been particularly likable. Her campaign's mis-steps, and the howling wind of press approval at Obama's back had as much to do with his nomination as any shrewdness of tactics. His approach tends not to be shrewdness, but brute force.

I also think it has become clear that Obama's extremely high self-regard, and the cult of personality around him, simply cannot be parodied. I think they still believe that their devotion to the Dear Leader can and will infect the population at large. That will be their Achilles heel, because Obama is not, in fact, an inspiring speaker. His personal attempts to persuade regularly fall flat. His "personal narrative" is old and tired now. He exhibits no leadership. Rather, he passes the buck to third-rate hacks leading Congress.

Yet the danger remains, because I do not believe, no matter what happens, Obama will ever back off, and he has already exhibited an almost pathological inability to admit personal error. He has a single-mindedness of purpose, and an absolute commitment to radical change. With those two things, and a compliant Congress, he doesn't need shrewdness or popularity.

Even if health care reform dies this year, the fight is far from over.

An ounce of prevention is worth a pound on your door?

In the current health care debate, one idea that keeps getting tossed out there is that we could all be so much more healthy if only there were more "preventive care."

Let's set aside, for the moment, the well-established fact that universally applied preventive care would increase aggregate health care spending. Let's also leave aside that some doctors are beginning to question whether some screening does more harm than good. Those points have been discussed elsewhere - the Congressional Budget Office even pointed out that universal preventive care would increase, rather than decrease costs. There is another point that I think is far more fundamental, in particular as it pertains to the notion that preventive care will make us all healthier.

Preventive care consists of things like annual physical exams, and screenings for things heart disease, high blood pressure, and some cancers. And all of that is voluntary. Most of the people who do not currently receive preventive care already have insurance and income sufficient to pay for it.

To take one example, one study showed that as few as 61% of women over the age of 65 - a higher risk group for breast cancer - received regular mammograms. All of them were covered by Medicare, which pays for annual mammograms.

Similar statistics can be found for a variety of other recommended screening tests and preventive care examinations. Whatever the real benefits of preventive care, it can't help you if you don't get it.

Yet large numbers of us simply do not seek those procedures, even though we already have both "access" and insurance, and there is no reason to think those habits will change simply because our insurance company does.

So, if 40% of little old ladies don't want to get their annual mammograms, who's going to make them?

01 September 2009

Come back here and follow me!

Wow - now that debate is almost over, and most of the Democratic Congressional leadership is seeking a fallback position on healthcare, President Obama is planning to lay out his plan - a plan "they can really sell." Yeah, because up until now, there just wasn't enough "Obama" in "Obamacare." Whether he likes it or not, the current plan is already his.

But I love how MKHammer puts it:

So, Obama sat back while most of the substantive legislative wrangling happened, spouted platitudes from the bully pulpit while a skeptical public imposed its will on his massive majorities, lost his chance at an abbreviated debate and an August vote, and went on vacation when things really got rough only to descend from the Martha's Vineyard Mountain with tablets inscribed with the more reasonable consensus ideas Congress has been forced to consider since his own ambitious vision tanked so spectacularly.

Stand back, look cool, don't get too involved, wait for things to shake out, adopt eventual consensus as his own idea, claim victory. Yeah, nobody saw this coming, unless of course they had paid attention to his entire career.