Wednesday, September 9, 2009

Lumpen Bureaucratiat

The American people will not accept the status quo when it comes to health care, we are reminded by Tom Daschel. Nancy Pelosi, Harry Reid, Barney Frank, Steny Hoyer toe the progressive line, insisting that the American people are demanding changes in the health care system. They want "universal coverage" for the greater good, a progressive ideology that justifies the redistribution of wealth and support changes for the many to benefit the few.

Candidate Obama promised to address the number one issue on the mind of the American public (they believe), the reform of health care, careful to avoid any link to the inevitable tax increase on the middle class that will be needed to pay for the reform, while hiding any semblance of a plan, in laying out grand principals: coverage for all with low cost high quality health care coverage. When pressed, he promised to rid Medicare of waste and abuse, soak the rich with a tax increase, and punish the health insurance industry by prohibiting sound underwriting principles. In short, increase the costs for the health insurance industry and redistribute the wealth to accommodate the reform of the largest component of the GDP, after defense, the health care industry. All to accommodate 5 million people who can not afford health insurance and to subsidize the health insurance for 10-12 million who make enough but chose not to buy insurance. To risk the health insurance of 90% of the population, 85% happy with their coverage.

President Obama, after countless speeches on health care reform, continues to lay out the same broad principles, quality health care for all at low cost. President Obama has left the writing of the legislation to the progressive wing of his party. Fearing a liberal backlash, he continues a pattern of ducking difficult issues needed for true reform so he leaves no fingerprints on a bill that may bankrupt America. A pattern of avoidance that can be seen in his Illnois Senate voting record, where he voted present more times than any other state legislator.

We are told health reform is good for business, for the people, and for the country. We are asked to suspend disbelief to support a reform that promises something for nothing. We can deliver high quality, low cost care to everyone and pay for it without raising taxes on the middle class (we are warned to be prudent consumers, that if it is too good to be true, it probably isn't). But if the President says it is true, we are to expected to be true believers.

We are also told that what is being considered by Congress is hog-wash. The Congressional scorekeepers have scored the bill passed by the House and have concluded the promise of savings is just that, a promise. It will never happen. Indeed, if passed into law, over the next 10 years the deficit will increase by 9 thousand Billion dollars (that's 9 trillion dollars, folks). This from a body that, according to a recent Rasmussen poll, 57% of the voters would throw out of office in mass based on their job performance. Now that is confidence in the Bureaucratiae. House polls in the 30% range of approval for the job they are doing, is paralleled by the ratings of Pelosi and Reid Even the President's rating has dipped below the 50% level, with more people expressing disapproval than voicing approval ratings for the handling of the domestic agenda. He still maintains a high level of support, in spite of the public's skepticism of his handling of the economy and the domestic agenda.

History is filled with inspired leaders, tapping the roots of discontent found in the masses, to overturn existing leaders, take control of nations, and impose their will on the people who made possible their revolutions. It is filled with the ruins of empires, masses subjected to progressive ideology, massive wealth distribution, chronic poverty, low productivity, and anemic economic growth. We have witnesses mis-steps in foreign policy lead by diplomacy by appeasement, the fall of prime ministers, the horrors of war in the name of ideologies.

One thing in common with the leaders of the 20th century who plunged the world into world war and isolated nations in a cold war lasting the better part of 40 years and Obama is that these leaders gained their positions by emphasizing progressive ideologies against the back drop of populist unrest. Promising a cure to all evils by the redistribution of wealth, demonizing business and their leaders, laying waste to years of progress by blaming the engines of growth for the disparity of income, and promising a new day. Isolation, trade barriers, appeasement with the enemies, were the norm, but underneath diplomacy was the bodyguard of lies. The most virulent of the populist revolutionaries made purges of the intellectuals, creating a more progressive intelligentsia. The masses, no better after the revolution, became the silent majority ruled by leaders who no longer needed to seriously respond to the will of the people, the progressives were in charge and they knew what is best.

The progressives had become the tyrants, the despots, the dictators. The people outside of the progressive elites were the tools to be exploited, to be ignored. The will of the leaders substituted for the will of the people.

Today, our leaders run the risk of marginalizing the vast majority of the population. the American people have voiced great concern about their priorities. Yes, they would like health care improvements. They would like to see the rate of inflation of the health care in line with the general rate of inflation. Since Medicare and Medicaid was passed, the medical care cost index has been above the rate of consumer costs in general. With the Government running over 50% of the health care system, cost increases have consistently been more than twice the rate of growth of the general consumer costs. Health insurance premiums have been consistent with the governmental inflation rates. There are a lot of reasons for the high rate of inflation, but the least important reason is general price increases, the more specific culprits are increased medical loss ratios (the medical costs incurred by the insurance companies exceed the underwriting standards meaning more use per thousand population, increases in input costs of labor and capital incurred by providers, increased medical technology costs for better diagnostic equipment, drugs, and procedures, and increased waste in the systems do to lack of controls), population dynamics, and the structure of the delivery system.

The American people have also strongly voiced their priorities. They told their elected representatives at town hall meeting after town hall meeting in August that Washington should be focusing on the Economy and jobs creation, the Budget deficit, and the country's mounting debt problem. Carbon credit programs, environmental programs, health reform, and the numerous tax increases to pay for all the progressive reforms should be put on the back burner until the country has returned to economic health, jobs have been created, and the deficits reduced. A plan needs to be in place to shore up the strength of the dollar, build financial credibility for our financial institutions, and create the environment that stimulates business formation and job creation.

Only the progressives believe that their "green" programs and their income re-distribution schemes are stimulative. They convinced enough hapless moderates to vote for a non-stimulating stimulus program. They believe, truly, that by providing a government option to the private insurance companies that the country will be able to reduce the cost of health insurance for the vast middle class and reduce the deficit. With competiton from a government option, the consumer will make rational choices and look for value for money. It will force the insurance companies to change their business model, give up underwriting standards, and meet the price the government program, supported by the healthy tax revenues from the new tax increases imposed on a shifting sand definition of middle class taxpayers.

Can we believe what they say? Remember, Congress doe not have a great track record on estimating future costs of their landmark programs. In fact, with all their experts and the geniuses in Congress at the time of Lydon Johnson's Great Entitlements explosion and the passage of Medicare and Medicaid, the trajectory of costs forecast for these two grand entitlements was hopelessly underestimated leaving the shortfall to be made up by the now taxpayers in the form of higher and higher payroll related medicare taxes and still facing the prospect of insufficient capital to cover the costs of the entitlement. With budge gimmickry practiced by both parties over the past two decades, Congress wanted to avoid the difficult decisions of yesterday for a future generation. We have now run out of generational time to pass the buck.

Remember the budget overruns with Medicaid. When originally adopted, the cost trajectory for future program costs were woefully underestimated. Congress stepped in and did what they do best, they passed the buck and changed formulas for cost sharing and sent the bill to the states, keeping the majority of the overruns off the Federal books.

In fact, we can not believe what Obama promises, there is just no evidence that Obama, Congress or the administration can deliver the forecasted expenditures, without voodoo accounting used by Congress to ignore outer years and time the changes to meet "targeted" budget goals, goals that bear no relationship to the real run rates that can be expected, run rates that Corporate America must rely on to get a true picture of financial resources need rather than budget gimmicks to obscure the facts and give a true transparency that we were all promised.

Take back your country. Let your senators and representatives know where you stand on the health care issue. Let Obama know that you expected to be heard. Let your friends and neighbors know that sweet talk and shallow promises by an emptied- suited President imposing his will on the American public will not fly. Spin, innuendo and incomplete facts and facts out of context just will not make health reform anything but a fiasco. When Obama talks of shared sacrifice, he wants you to sacrifice so he can share the benefits with those less fortunate, even at the expense of the 90% of the insured poulation and at the expense of those over 65 who depend on security and stability to make it through the days, weeks and months. Real reform will require everyone to sacrifice. Unfortunately, Obama's plan does not address real reform, it does not give a path that is credible on changing how we cover our entitlements, how costs will be reduced, and how reform can be achieved when he has cut deals that minimize the cost reductions from the largest elements of the health care system, the physicians, hospitals, and the insurance industry, the very industry he wants to destroy.

It is not hard to understand why there are skeptics. It is even harder to understand why Washington does not get it.

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