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Krauthammer And The CBO Take On Obama’s Healthcare Plan

I have developed a grudging respect for Charles Krauthammer, as many of you know. And on this issue, he, along with the Congressional Budget Office, have a whole lot to say in this article, Why Obamacare Is Sinking, which highlights some of the glaring issues with Obama’s plan:

What happened to Obamacare? Rhetoric met reality. As both candidate and president, the master rhetorician could conjure a world in which he bestows upon you health-care nirvana: more coverage, less cost.

But you can’t fake it in legislation. Once you commit your fantasies to words and numbers, the Congressional Budget Office comes along and declares that the emperor has no clothes.

President Obama premised the need for reform on the claim that medical costs are destroying the economy. True. But now we learn — surprise! — that universal coverage increases costs. The congressional Democrats’ health-care plans, says the CBO, increase costs on the order of $1 trillion plus.

In response, the president retreated to a demand that any bill he sign be revenue-neutral. But that’s classic misdirection: If the fierce urgency of health-care reform is to radically reduce costs that are producing budget-destroying deficits, revenue neutrality (by definition) leaves us on precisely the same path to insolvency that Obama himself declares unsustainable.


Obama engage in “misdirection”?? Oh, c’mon, no way!!! Ahem. Anyone who has paid attention knows that Obama is all about misdirection, as is the rest of his party:

The Democratic proposals are worse still. Because they do increase costs, revenue neutrality means countervailing tax increases. It’s not just that it is crazily anti-stimulatory to saddle a deeply depressed economy with an income tax surcharge that falls squarely on small business and the investor class. It’s that health-care reform ends up diverting for its own purposes a source of revenue that might otherwise be used to close the yawning structural budget deficit that is such a threat to the economy and to the dollar.

These blindingly obvious contradictions are why the Democratic health plans are collapsing under their own weight — at the hands of Democrats. It’s Max Baucus, Democratic chairman of the Senate Finance Committee, who called Obama unhelpful for ruling out taxing employer-provided health insurance as a way to pay for expanded coverage. It’s the Blue Dog Democrats in the House who wince at skyrocketing health-reform costs just weeks after having swallowed hemlock for Obama on a ruinous cap-and-trade carbon tax.

The president is therefore understandably eager to make this a contest between progressive Democrats and reactionary Republicans. He seized on Republican Sen. Jim DeMint’s comment that stopping Obama on health care would break his presidency to protest, with perfect disingenuousness, that “this isn’t about me. This isn’t about politics.”

Ah, yes, my senator seemed to have gotten under Obama’s skin, didn’t he?? Teehee! I don’t care for DeMint all that much, but that was a bit funny. Especially because DeMint highlighted this point:

It’s all about him. Health care is his signature reform. And he knows that if he produces nothing, he forfeits the mystique that both propelled him to the presidency and has sustained him through a difficult first six months. Which is why Obama’s red lines are constantly shifting. Universal coverage? Maybe not. No middle-class tax hit? Well, perhaps, but only if they don’t “primarily” bear the burden. Because it’s about him, Obama is quite prepared to sign anything as long as it is titled “health-care reform.”

This is not about politics? Then why is it, to take but the most egregious example, that in this grand health-care debate we hear not a word about one of the worst sources of waste in American medicine: the insane cost and arbitrary rewards of our malpractice system?

When a neurosurgeon pays $200,000 a year for malpractice insurance before he even turns on the light in his office or hires his first nurse, who do you think pays? Patients, in higher doctor fees to cover the insurance.

And with jackpot justice that awards one claimant zillions while others get nothing — and one-third of everything goes to the lawyers — where do you think that money comes from? The insurance companies, which then pass it on to you in higher premiums.

As a psychiatrist, I am sure Krauthammer knows whereof he speaks. I have to say, that is an insane cost, and of course it gets passed on to the patient (not just for neurosurgeons, but all doctors). And there is another unseen cost:

But the greatest waste is the hidden cost of defensive medicine: tests and procedures that doctors order for no good reason other than to protect themselves from lawsuits. Every doctor knows, as I did when I practiced years ago, how much unnecessary medical cost is incurred with an eye not on medicine but on the law.

Tort reform would yield tens of billions in savings. Yet you cannot find it in the Democratic bills. And Obama breathed not a word about it in the full hour of his health-care news conference. Why? No mystery. The Democrats are parasitically dependent on huge donations from trial lawyers.

Didn’t Obama promise a new politics that puts people over special interests? Sure. And now he promises expanded, portable, secure, higher-quality medical care — at lower cost! The only thing he hasn’t promised is to extirpate evil from the human heart. That legislation will be introduced next week.letters@charleskrauthammer.com

I should say, while there are lots of frivolous lawsuits, there are also suits that need to be filed. But I would not be surprised if Krauthammer’s claim is entirely accurate – inflated costs from doctors trying to cover their, um, assets, from unnecessary lawsuits.

But the last part is the funniest – especially since Obama seems to have no real ethical center. I guess for him to introduce legislation that would “extirpate evil from the human heart” would be a case of “Physician, heal thyself,” wouldn’t it?

  • listing starboard

    “The Hammer” is awesome. Hey, still waiting for that big scandal about Palin that you thought prompted her resignation.

  • tzada

    CNSNews.com
    Conyers Sees No Point in Members Reading 1,000-Page Health Care Bill–Unless They Have 2 Lawyers to Interpret It for Them
    Monday, July 27, 2009
    By Nicholas Ballasy, Video Reporter

    (CNSNews.com) – During his speech at a National Press Club luncheon, the chairman of the House Judiciary Committee, Democratic Congressman John Conyers (D-Mich.), questioned the point of lawmakers reading the health care bill.

    “I love these members, they get up and say, ‘Read the bill,’” said Conyers.

    “What good is reading the bill if it’s a thousand pages and you don’t have two days and two lawyers to find out what it means after you read the bill?”

    http://www.cnsnews.com/public/content/article.aspx?RsrcID=51610&print=on

    me:
    Well what do they get the big bucks for?

  • listing starboard

    Any surprise that his uncouth wife Monica Conyers would be guilty of taking bribes as a city councilperson?

  • Rob G in Chicago

    While some medical malpractice cases may appear frivolous, many, if not most states require the cases to be screened by a committee that includes medical doctors before filing. If doctors would stop behaving like cops and covering up for the bad apples within their ranks, there would be far fewer cases filed, far fewer judgments against doctors, and, perhaps lower malpractice premiums, but I wouldn’t count on insurance companies doing the right thing.

  • WMCB

    Pshaw. Everyone knows that as Obama said, we can make this puppy a cost-saver by cracking down HARD on all that nefarious TONSIL THEFT that is so rampant in the medical community.

  • oowawa

    I’ve heard that appendix theft is also a big problem . . .

  • kat in your hat

    OT: Drudge_Report AUDIO: 911 CALL… http://tinyurl.com/l7roac Gates/ Crowley

  • Adopted

    Krauthammer is good. But everytime he patronizes or marginalizes Sarah Palin, I kick in $100 to her PAC. It’s kinda like a drinking game for me :)

  • oowawa

    Both of these problems could be effectively handled by setting up a Tonsil Czar and an Appendix Czar, with associated committees, to adjudicate cases involving these questionable organs.

  • Adopted

    In my neighborhood people are stocking up on guns and getting their knee replacements. Just in case Stealthcare passes.

  • kat in your hat

    RRR Amy, thanks for posting. I always want to read what Krauthammer writes, but then forget and only get reminded to read him here at No Quarter.

  • bho boo

    Didn’t Obama invite CBO officials to the White House for “an offer they couldn’t refuse”?

  • bho boo

    Please continue to call grisly, lethal, inhuman, communist “Obamacareas it’s all his. He owns it, it’s his baby.

  • LDW

    The main problem with Obamacare is not how it should be funded. The main problem is that it leaves the broken American system in place, and just throws more money at it. Both the Insurance & Legal industries presently suck billions out of the American healthcare budget without adding anything productive. Obama’s plan would just give the insurers even greater revenues, and do virtually nothing to stop them from cherry-picking healthy patients and dumping the unprofitable ones onto the government.

    The answer, as far as I can tell would be to bring in single payer health insurance with several 3-year ‘decade’ plans. If Medicare is now available to 65-year-olds, make it available to all 55-year-olds, and then 3 years later to all 45-year-olds, etc., etc. And all small businesses should be allowed to opt in on a sliding scale. A payroll tax starting at about 3% should be levied for the smallest businesses (up to, say $1M payroll) and then go up to about a maximum of 5%. If the plans also include full outpatient drug insurance, then these amounts would have to be about 1% higher.

    And, of course, Medicare should drive a hard bargain with drug companies to control prices.

    The private insurance industry would then be reduced to ‘top up’ services, like having a private room, or chiropractic services.

    And yes, bring in tort reform. To start with, lawyers should not be allowed to get paid a percentage of a settlement. They should be reimbursed for their time and disbursements only. Settlement money in a lawsuit should go to the people the judge awarded damages to. Furthermore, there should definitely be a ‘cap’ amounts paid out. Too many Americans think that an Extreme Makeover can be theirs if only they sell their sob story just right they’ll land in the lap of luxury. Settlement monies should be intended to allow people to maintain a dignified life, not launch them into multimillionaire land.

  • bho boo

    The medical end is better than fine, it’s the insurance end that needs attention and would cost less than 1/40 the mass of money he wants for Obama”care”.
    Worse than the military, the multititudes of denied experienced older patients will have usurper lawsuits flying since he would sign this eugenics/euthanasia/get in your records/bank accounts bill. He admits he was born British himself, and that is not going to go away.

  • WMCB

    LOL!

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    Me? I don’t remember saying that, so if you can refresh my memory, I’d appreciate it (I’ve had a lot going on of late). Thanks.

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    LOL, oowawa – yes, more czars are just what we need to handle this situation!

    Rob, thanks for the info. Much appreciated. I guess that might be some of Krauthammer’s own bias as a physician…

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    :-D I hear ya – he does make sense on some things, for sure, but it seems Palin is fair game to everyone, just like Clinton…

  • Karma

    So that is why the doctor saved mom’s tonsils in jar…..tonsil theft!!

    And to think we believed that silly story that is was because they were the worst ones he had ever seen.

  • HARP

    The plan would make subsidies available only to households getting insurance through the new “exchanges,” insurance pools set up in each state as a parallel system to job-based coverage. And full-time workers in all but the smallest firms would be barred from entering the exchanges, at least for a time, so they wouldn’t have access to the new entitlement.

    This means that two households, identical in all respects including income, would be treated very differently depending on whether they got their insurance through the exchange or through their employer. At twice the poverty level, a family of four today makes $44,000. Such a family insured through an exchange would pay no more than $2,200 for a policy that could cost $12,000, so it would receive a federal subsidy totaling nearly $10,000. The family next door, meanwhile, with the same income but with health insurance provided through the workplace, would receive an implicit tax break for the $12,000 in employer paid premiums worth only $3,600. That’s a bonus of more than $6,000 for being in the exchange–or a penalty of $6,000 for having employer coverage. This disparate treatment would be widespread. The Census Bureau counts 102 million people under age 65 in households with incomes between 150 and 400 percent of the poverty level, but the Congressional Budget Office (CBO) estimates that only 20 million of them would receive insurance through the exchanges in 2014.

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    Okay, this is a joke, right? Now our representatives shouldn’t be expected to know abt what they are voting? If they don’t READ the damn bill, how the hell do they know for what they are VOTING???

    How in the world have our elected officials gotten so far removed from doing the actual work they were sent to do? How can they possibly be doing “the people’s business” when they have bills so long and wordy, that no one knows what they are saying, even if they DID read them? This is just ridiculous! (As an aside, I can’t believe I ever had respect for Conyers…)

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    Okay, now you’re just making my head spin. That is just ludicrous!

    Thanks for laying that out, HARP. I appreciate your making sense of it for us!

  • listing starboard

    My Bad R3A-my apologies, you never assserted that, I read it somewhere else, so sorry!!! Still love me some Krauthammer though!

  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    Whew, thank heavens, Listing! I was afraid I had missed something!

    And no worries – now I want to know, too! :-D

  • Doc99
  • http://www.rabblerouserruminations.blogspot.com/ Rabble Rouser Reverend Amy

    Dang, Doc99 – that was quite the lesson in debt spending. Holy SMOKES!!!

  • Doc99

    That should be in the conversation about med mal reform, integral to any HCR.

  • Betty

    That’s the truth, right there. Finally someone says it. It is so easy to blame victims but if the fact surrounding a malpractice claim were presented to a jury of our peers and they were so outraged that they “awarded” a huge settlement that is how our system works.
    The high cost of malpractice insurance is the fault of practicing physicians, since physicians, instead of correcting the malpractice within their ranks, overlook it time after time. Of course they would sooner try to tie our hands by limiting the amount of money that can be awarded by a jury.

    Who is the one physician that says there should be a autopsy after every death, even if the death occurred in the hosp? He is on our side.

    And you are also right on about not trusting the insurance co to lower the rates.

  • Dem NO MORE

    Conyers is 80, his wife is semi-”retarded”–time to pull the plug on both of them.

    Oh, maybe you didn’t see this…
    http://www.youtube.com/watch?v=YZQLxVO-qjM

  • Dem NO MORE
  • checkagain charlie

    um… seems this is a case of people seeing what they want to see. far from being blindsided by it, the CBO report on the house plan is what dems and obama wanted to hear. meaning that 1 trillion dollar ten year cost was in line with expectations. also, as the cbo report states, their analysis does not take into account new revenue (new taxes on nation’s highest earners, employee subsidies for companies don’t provide coverage) or reductions in medicare spendine, which are a part of the plan. that total is, wait for it… 1 trillion. so the costs are offset. the deficit increase is zero.

    now let’s compare this to demint’s plan, which offers health care vouchers to individuals and families (2,000 a year, 5,000 a year). how does the plan pay for this giveaway? with tarp paybacks. what happens in 5 years when the payback tarp money is dry? uh… the country stops growing and no one will ever need heath insurance again? nope. there is no plan. also, wouldn’t a voucher program take pressure off business from providing coverage, because their employees would have another option? and without having to then pay a subsidy – like in the house plan – wouldn’t this drain the gov’t even further as they have to cover the cost of the vouchers?

  • WMCB

    So if my surgeon doesn’t read my chart or my lab tests before he does surgery, an acceptable excuse is, “Well, it was all really long and complicated?”

    WTF???

    And if bills are too complicated to be understood by those voting on them, maybe the solution is to write the damn bills in plain english, NOT to just give up on reading or understanding the bills?

    These people are criminal. They really are.

  • Barry

    Kruthammer sets up his article by framing healthcare reform very narrowly. He says: “If the fierce urgency of health-care reform is to radically reduce that are producing budget-destroying deficits, revenue neutrality (by definition) leaves us on precisely the same path to insolvency that Obama himself declares unsustainable.”

    This is far too narrow a definition of healthcare reform and what is being attempted. It is not only about cutting costs. Healthcare reform has always been about three things: (1) coverage, (2) level of service, and (3) cost.

    The bill that is being worked on will mean that 97% of Americans will be covered by health insurance. The extra cost required to do this will be covered by taxes on the wealthy, surcharges on businesses who do not participate, and strategic medicaid and Medicare cuts, making it deficit neutral. Krauthammer seems to admit this. The CBO also actually agrees that it will be deficit neutral. That seems like a pretty good outcome to me. At minimum you get everyone covered in the U.S. without increasing the deficit.

    The “investor class” is a code word for the rich or top 1%. Under this plan if you as an individual earn $80,000 or more you will pay 1% more in taxes. Hardly a sum to that will kill the “investor class”. If you earn $1 million or more you will pay 5.4% more in taxes. The “investor class” did very well over the past 8 years.

    Krauthammer’s argument about small business is complete BS. Most small business will be exempt from the surtax and many will be given a public option that may reduce their healthcare expenses. Here is a comment from a small business owner that paints a very different picture:

    “Along with my wife, I am a small biotech business owner that provides health insurance to its two employees. We rent laboratory space from another small technology-based business, with six employees. Our health premiums went up by 17% and 20%, respectively, this year. Both of us strongly support every aspect of the President’s health plan, including the public option, and would happily contribute 8% of our respective payrolls to buy into affordable plans. We pay much more than that, and within the next few years, will have trouble meeting the cost of insuring ourselves and our employees.” R. Star, San Francisco, July 27th, 2009

    The second part of this is can you also cut overall costs from healthcare reform. It is very debatable whether the system that is being set-up does this? Does it provide pressures that will force cost cuts in the future? One part of the thinking on this is the public option may create enough new competition that private insurance companies will have to learn to do things more efficiently or with less profits to compete. This could reduce prices and costs in the system. Both Kruthammer and CBO do not deal with this point. The CBO does not even include new system incentives or new potential pressures that could force costs down in their analysis.

    See this:
    http://delong.typepad.com/sdj/2009/07/jonathan-cohn-on-the-congressional-budget-office-and-health-care-reform.html

    Krauthammer harps on the malpractice costs. Not sure what this exactly has to do with what is being proposed. It is a side issue that will likely be dealt with separately in the future. I think the Democrats understand that there may have to be a better balance with malpractice insurance costs. I am not sure Tort reform will get one single additional person insured.

    Passing a new healthcare bill is an important first step. Healthcare reform will evolve over years. What is immediately important is to get everyone covered and begin the process of reform.

    If Kruthammer thinks “Democratic health plans are collapsing under their own weight…” then he is really delusional. Momentum seems to be building to get something done and get something meaningful done. There may be a “Waterloo”, but the real question is who’s Waterloo?

  • Barry

    You could say this about any legislation. Every piece of legislation is complicated and long.

    However, there has been plenty of opportunity for members of congress to get an idea of what is going on.

    Democrats in the House have already held 10 Caucus meetings on health care, 79 hearings on health care reform, 550 town hall events in their districts about health care, and three House Committees have heard 45 hours of debate and amendments on health care reform legislation.

  • http://greggshealthinsurancenews.blogspot.com/2009/07/opposition-plan-is-in-works-from.html Gregg’s Health Insurance News

    The end result of reform if the currently proposed plan passes is less car, less competition, and no decrease in consumer costs.

  • I’m a Linda too

    Great article.

  • politicalidentitycrisis

    Democrats are sick, deranged lunatics! No wonder that is what they called conservatives! I am a reformed Democrat, now Independent and cannot imagine ever voting for one again! That even includes Hillary,sad to say. I am not sure what she is doing and not sure I can trust her again! I hope it will become clear if I ever get the chance again, but Hillary should team up with Sarah for 2012 as Independents and shake things up!

  • politicalidentitycrisis

    Very informative! I sent it around through email!

  • http://www.noquarterusa.net/blog/2009/07/28/you-expect-us-to-read-this/ “You Expect Us To READ This??” : NO QUARTER

    [...] representatives on the floor insisting bills are actually read before they go up for a vote (H/T to NQ Reader tzada, for the alert). Don’t take my word for it, though. Here Representative Conyers is saying [...]

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