Thursday, September 10, 2009

The Speech: Evaluation of ObamaCare

Last night Obama tried to regain the initiative on health care. Whether or not this works remains to be seen. One thing is for sure though, he was stingy with the truth. Let’s take a detailed look at what he said.

The Public Option

It should come as no shock that Obama wants a public option. He claims that having a public option will “keep insurance companies honest,” although he also proposes other regulations that he claims will fix the problems with insurance companies. But if those regulations fix the problems with the insurance companies, why would we still need a public option?

The public option will compete against private insurers in an insurance exchange that Obama proposes to set up in four years. Why we need to wait four years is not clear, though that does conveniently delay this plan until after his re-election. I guess we wouldn’t want voters distracted by their private insurers going out of business just before the election. . . that might keep them from focusing on "the issues."

But don’t fret, Obama assures us that this health exchange will be welcomed by private insurers because “insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers”. . . that they can already compete for now, but don’t. Incentive, you use that word Mr. President, but I don’t think it means what you think it means.

Obama also tries to calm our fears by pointing out that “less than 5% of Americans would sign up.” Though how he comes up with that number is not known. Indeed, 16% of Americans are currently uninsured. So are the other 11% just fakers? And if we’re only worried about 5%, then why upset the other 95%? Why not create a new Medicaid Part F for those 5%? Wasn’t it Obama himself who began his speech by saying,
“Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch.”
I guess that was just hollow rhetoric?

In any event, insurers should not fear the new public option, Obama tells us, because it won’t be subsidized:
“I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects.”
How exactly is that going to work dumbass. .. er, sorry, Mr. President? These people, according to you, are too poor to afford insurance (and many of them have hugely expensive uninsurable conditions)? So how are you going get them “affordable” insurance without subsidizing their care? And if you can work that magic trick, why can’t you do the same for Medicaid? Has Medicaid done something wrong? Has it offended you oh Great and Powerful Lord?

But wait, he has an answer for how the public insurance option will be so cheap:
“By avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers.”
Really? Profits at private insurance companies are estimated between 3% and 8%, that’s hardly abusive. And profits aren't considered overhead. . . unless you're a communist. Moreover, in terms of overhead, there is nothing more bogged down by overhead, waste, fraud and abuse than government. Private insurance costs on average $4,700 per person in this country. Government insurance (Medicare/Medicaid) costs $11,093. So I’m going to call a big old steaming pile of Pelosi on that one bub.

You Will Be Forced To Have Insurance

Yes, Virginia, there is an evil Santa Claus and he will force to you buy insurance. He hasn’t told you how much it will cost yet, but I assure you it will be more than you can afford:
“That's why under my plan, individuals will be required to carry basic health insurance — just as most states require you to carry auto insurance. Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers.”
And do you know why we need this? Because right now “those of us with health insurance are also paying a hidden and growing tax for those without it — about $1000 per year that pays for somebody else's emergency room and charitable care.”

Actually, the figure for uninsured reimbursement is $35 billion a year. Spread over 300 million Americans that works out to $116 each, not $1,000. That's about 30 cents a day each. Personally, I’d rather pay the $116 than force everyone to buy insurance every year, but I’m crazy like that.

In any event, don't fear that you won’t be able to afford being forced to buy insurance. If you truly can’t afford it, you won’t be required to have it:
“There will be a hardship waiver for those individuals who still cannot afford coverage, and 95 percent of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements.”
But doesn’t that defeat the purpose of this whole thing? Now you’re saying that the very people this program is designed to reach will be given an exemption from the plan, so that they don’t have to buy insurance. . . leaving them uninsured. WTF? Tell me again why we’re remaking one sixth of our economy? And how does that save me my $116?

Let’s Fact Check Obama’s “Facts”

Obama also gave us a series of facts last night, about which he stated: “These are the facts. Nobody disputes them.” Let’s dispute them. . .

Obama: “There are also those who claim that our reform effort will insure illegal immigrants. This, too, is false — the reforms I'm proposing would not apply to those who are here illegally.”

Reality: Believe it not, this is actually kind of true, in a deceptive sort of way. This bill provides that no illegal aliens may participate in the programs set up under this bill. BUT, it does not stop them from continuing to do what they do now -- getting free health care in emergency rooms. The taxpayer will continue to pick up that tab, just not under this particular plan.


Obama: “There are now more than 30 million American citizens who cannot get coverage.”

Reality: I could have sworn the propaganda number was 46 million Americans? In any event, you and I know from our prior articles that the real number is only 7.3 million.


Obama: “In just a two year period, one in every three Americans goes without health care coverage at some point. And every day, 14,000 Americans lose their coverage.”

Reality: Now I can’t verify this number, no one can because it’s made up. But if you think about it. One in three Americans means 100 million people. Doesn’t that seem a little higher than the 30/46 million figure they keep bandying about? And what’s the 14,000 every day? That works out to a total 5.1 million a year. How does that get to 100 million every two years? Looks like you’re 95 million short dumba. . . Mr. President.


Obama: “Not a dollar of the Medicare trust fund will be used to pay for this plan.”

Reality: Oh, how to refute this one? How about a quote from the same speech Obama gave last night: “Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan.”


Obama: “Don't pay attention to those scary stories about how your benefits will be cut. That will never happen on my watch. I will protect Medicare. The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud.”

Reality: Obama is talking about cutting payment to Medicare providers by $500 billion -- $50 billion a year. He claims this can be found in waste, fraud and abuse. However, the HHS Office of Inspector General, which pursues these matters, has recovered only an average of $1.2 billion per year. And all of the experts agree that this will lead to significant cuts in benefits.


Obama: “Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because. . .”

Reality: Huh? Bush left Obama a deficit of $700 billion, too much to be sure, but Obama added $1 trillion to that. So drop the crap about facing a trillion dollar deficit when you walked in the door you lying sack of . . .


Obama: “I will not sign a plan that adds one dime to our deficits — either now or in the future. Period. And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.”

Reality: Actually, no. To make this claim work, the Democrats have designated most of the costs as being “off budget.” They thus don’t count toward the deficit, even as they explode the deficit. This is a self-deceptive tactic used by diet-breakers, crack addicts, and Congresses.

Moreover, when you consider all the costs, something else becomes clear quite quickly: Obama’s numbers make no sense. Obama claims the cost of his plan will be $900 billion. To pay for this, he claims to have found “savings within the existing health care system — a system that is currently full of waste and abuse. . . That's not my judgment — it's the judgment of medical professionals across this country.”

Oh, well if medical professional say it, then it must be true. Let’s see $900 billion in waste, fraud and abuse. About as much is spent each year on private health care as government health care. Thus, assuming waste, fraud and abuse exists, there is no reason to think it will be more than another billion a year (the same as in the government half). That leave Obama $890 billion short.

And of course, you shouldn’t believe the $900 billion figure either. The current House plan is estimated to cost $1.6 trillion, and even that was wildly optimistic.

But never fear, Obama’s not just relying on waste, fraud and abuse, he’s going to require preventative care like mammograms and colonoscopies which he claims “makes sense, it saves money, and it saves lives.” However, studies have shown that most preventive care -- particularly tests like the ones Obama mentions -- actually cost more money than they save.

According to the pesky Congressional Budget Office, “The evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.” Moreover, kill-joy CBO Director Douglas Elmendorf concluded in July that “we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount.” That’s tech speak for “not going to save you a penny Barry.”

Oh, almost forgot, Obama does propose to form committees to examine the possibility of considering whether or not it might be worth examining the possibility of thinking about tort reform of some kind in some small places: “It's a good idea, and I am directing my Secretary of Health and Human Services to move forward on this initiative today.” Of course, as these are matters of state law, this claim is entirely fallacious. But hey, it sounded kind of ok.


Obama: “Nothing in this plan will require you or your employer to change the coverage or the doctor you have.”

Reality: That’s absolutely true. And for those of you who have read my article on short term thinking, you will understand why liberals will believe this. But what ObamaCare does not do, is guarantee that your insurer will continue to offer the plan you have or that your employer will continue to carry it. The Democrats have estimated that three million people will lose their employer based insurance if this plan passes. I’m thinking they forgot to carry a one somewhere. The fine will be around 8% of salary, and the average private insurance costs around $4,700 right now. Thus, it will make sense for employers to drop their coverage for anyone earning less than $58,750 per year.

According to the Census Bureau 61% of households earn less than that. At a minimum, that’s 183 million people. Only 3 million huh?


Obama: And one final point, Obama stated, "When I spoke here last winter. . . we were losing an average of 700,000 jobs per month. . . but thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink."

Reality: That number is indeed down. We are currently losing 550,000 jobs per month.


It was a pretty speech though. . .

28 comments:

ScottDS said...

Any thoughts on Obama's remarks re: the "death panels" business? I'll say it now because I usually keep my mouth shut: I'm not a Sarah Palin fan*, and I am not inclined to believe her anymore than any other politician.

I personally have no problem with euthanasia and end of life counseling (my parents already have "pull the plug" in their will) as long as the family decides, as opposed to government deciding for us.

*My dislike has nothing to do with where she's from, her family, or any number of reasons for which others might not like her. That's all I have to say about that. :-)

Sanmon said...

Andrew,
Last night President Obama stood in the House Chamber to reveal his plan today you reviewed his speech. But where is the Plan? I waited to see if the Plan would be posted on White House web site, I see no Plan!

We can dissect the speech. But we cannot dissect the plan. We can count the lies but we cannot count on the Man.
And here is why we cannot count on the Man EVER!

A few months back he stood in front of a Tele-prompter and said We are Not a Christian Nation. Last night he he stood in the House Chamber, and in this chamber there is only one statement etched in marble, Only One. In this vast room only one Motto and no other. He stands last night proud to present his Plan confident to present his Plan he stands strong to present his Plan. I see no Plan only words and platitudes. Applause roars from his trained seals as he speaks in front of the house motto as he says to his seals "I will be the President to bring you health care like no other President has done before me and none will do after me." "I will bring you health. "I will save this nation." So many know the Motto he stands in front of, the only motto in the House Chamber. The only words etched in marble. The only words glaring right above his head.
Those are:
In God we Trust

Unknown said...

ScottDS: The idea of a doctor being part of the process in explaining the options of surgery, chemotherapy, radiation therapy and the like along with the risks versus simply making the remaining time less painful is not the worst thing anyone ever suggested. But it's just part of the incrementalism. When too few doctors recommend "it's time to go, you useless old person" the plan will be changed to bring in the bureaucrats. I'm not the world's biggest Palin fan either, but her description of "death panels," however inflammatory and presently inaccurate is not that far off-target for when counseling is replaced by bureaucratic "guidelines" for eliminating "cost ineffective" treatment for the elderly and chronically ill.

I don't think you mean "euthanasia" in its commonly-accepted textual meaning. It means actively ending a life, with or without consent of the patient. I have a living will, which allows the doctors to withhold extraordinary efforts to keep me alive. But I don't want any doctor or any bureaucrat deciding it's "time for me to go" and injecting me with some lethal cocktail. And I particularly don't want them making that decision because ordinary means to preserve my life wouldn't be "cost-effective."

AndrewPrice said...

Scott, you don't have to be anyone's fan here. Our policy (if you will recall) is that we do not endorse any candidate. There are no sacred cows here -- we're about truth no matter who it hurts.

(And people should NOT turn this into a pro/anti-Palin thread).

The idea of "death panels" probably should be dealt with in an entirely separate thread because you're touching upon a lot of different and complex moral/religious/ethical issues that really aren't easy to address in a single comment.

Moreover, the "death panel" issue is entirely a political issue, it's not really relevant to the functioning of the health care plan.

Indeed, while the idea of "death panels" worked well to scare people, the truth is that it already happens in our system every day.

Doctors, hospital boards, insurers, and families all make these kinds of decisions every single day. Sometimes, it's about suffering, sometimes its about morality or religion. But usually it's about money.

The real issue is about rationing. We ration already because there is more desire for health care than there is supply. In fact, pricing is a form of rationing. If you are willing to pay for something, you can get it. If you aren't, then you can't.

The problem with Obama's plan is that you will no longer make that decision. The government will make it for you. And whereas you would have based the decision on whether or not it is worth it to you to pay for the treatment, the government will make the decision on whether or not treating you is worth it to the system.

ScottDS said...

Andrew and LawHawk -

Thank-you both for your (as usual) illuminating comments. I realize it's a complicated issue too big for one thread; I just wanted your $.02.

I have nothing further to add at this point. :-)

Unknown said...

Andrew: Are you suggesting that Dear Leader may not have been entirely honest in his healing the sick and raising the dead speech? LOL

My biggest question (well, after asking myself how we ever allowed this schmuck to get elected in the first place) was: "If we can save $700 billion or $800 billion while improving medical care just by cutting waste, duplicatiion and inefficiency, why don't the Obamacrats and the RINO fellow-travelers prove it to us by doing exactly that with Medicare and MedicAid?" Do that, and I'll consider supporting Obamacare. (Don't worry, I haven't gone crazy. I know it can't be done, and even if it could, the government is the last entity on earth that could do it).

AndrewPrice said...

Sanmon, I see no connection between Christianity and his health care plan -- two different issues.

In terms of there being a plan, he laid out the requirements for the plan last night. He gave about a dozen fairly detailed points that he wants. Since he is relying on five different Congressional panels to assemble the plan, there is no need for him to write his own version, he's told them what he wanted.

Reagan was the same way. He didn't present finished legislation for the things he wanted. He spoke in broad principles and interspersed them with specifics. He then left it up to his people in the Congress to draft the appropriate legislation or his agency heads to draft the appropriate regulations. That's how its done.

AndrewPrice said...

Scott, did we answer your questions? Or are you still looking for more?

ScottDS said...

Yes, you answered my question. I simply don't have any more questions right now (my brain is still in sleep mode). :-)

On another note, what are your thoughts on the Republican response?

P.S. Just to prove what a huge nerd I am, whenever I hear "You lie!" (which is what the Congressman said) I naturally want to follow it up with "On Ceti Alpha V, there was life! A fair chance!" :-D

AndrewPrice said...

Lawhawk, You're applying logic where there ain't no logic.

If the things he claims can be done, then he should do them before messing with the rest of the system. But you and I know that they can't be done, and he's simply lying to try to convince people that there won't be any pain. He thinks that once the system is in place, people will accept it and whatever "pain" needs to be done can be done then.

It's like drug dealers giving out the first hit for free.

AndrewPrice said...

Scott, LOL! I hadn't thought about that, but it would have been beautiful! Kaaaaaaaaahhhhn!

My thoughts on the Republican response are less than charitable. Weak points, poor reasoning, no political instincts, poorly delivered -- and worst of all, they had days to come up with something devastating.

I think the Republicans as a group need to start taking classes in politics, argument and public speaking. Right now, they all stink.

Sanmon said...

Your right Andrew my bad, I was thinking in this term:

hy·poc·ri·sies
1. The practice of professing beliefs, feelings, or virtues that one does not hold or possess; falseness.
2. An act or instance of such falseness.
hypocrisy [hip-ok-rass-ee]
Noun
pl -sies
1. the practice of claiming to have standards or beliefs that are contrary to one's real character or actual behaviour

But your right. You can take down the post it does not belong here.

Unknown said...

Andrew: You're right about the ordinary process for getting Congress to enact a bill. My problem with Obama's speech, is that he uses language like "under my plan," or "I can guarantee . . . ." Like the Congressman with the sign, I keep asking "what plan?" His messianic zeal is the problem, not the method. Reagan and other great presidents would address Congress by saying "what I would like to see is . . ." or "I want to see Congress pass the following . . . " Obama talks with certainty about what will or will not happen under his plan, and there is no plan. Just grandiloquent wishes, lofty phrases, phony accounting and economics, misdirection, demagogic appeals to "trust me," interspersed with the occasional outright lie.

What he did in that speech (and most of his previous speeches on the subject) was act as if he actually has a plan, and if those damned demagogues and tea partiers would just get out of the way, Congress would enact it. That's why the speech was dishonest and demagogic. And it also explains why he warned those who actually would work with his people that he won't tolerate "petty politics and game-playing." It was truly one of the most partisan and hostile speeches before Congress that I have seen in a lifetime of watching the D.C. circus.

Unknown said...

ScottDS: I'll be briefer than Andrew on the Republican response. "C-R-A-P."

AndrewPrice said...

Lawhawk, Of course it was, it was a "base speech" delivered on national television. This speech wasn't intended to sway you or any Republican. It was aimed entirely at his left flank.

He needs to fire up his base because they've either turned on him (the hard left) or fallen asleep (the soft left).

He needed to deliver a speech that attacked "the enemy" -- one that demonized the right people (Republicans, boogeyman Palin, insurers, the rich, etc.) to get his base angry. He needed to call it "his plan" to give them something to rally around. And he needed to give specific demands to give them something to put on their signs and as a yardstick against which they can judge how well the Congress is complying with his wishes.

Hence, you saw it as angry, demagogic and deceitful. But his base will have seen it as a re-start, a call to action.

I'm just pointing out in my article all of the BS that he spewed as part of his speech. Because that's the best way to defuse demagoguery, to meet it with fact rather than hyperbole or outrage.

Unknown said...

Andrew: "I'm as mad as hell, and I'm not going to take it anymore. In fact, I'm outraged!" Oops, I did that wrong. Although I think a little good healthy righteous indignation is in order, I agree that not only should we remain thoughtful and consistent, but it's exactly how we can defeat him. Demagoguery can only get him so far, and then he has to quit talking in platitudes and answer direct questions and offer concrete proposals. Then we've got him.

AndrewPrice said...

Lawhawk, I'm a firm believer in fighting on many fronts. So there is always room for an "indignation front."

But there is nothing more devastating to a demagogue than to laugh at him and point out how obviously wrong the foundations of his argument are. That's the one kind of argument demagogue’s aren't prepared to fight -- it makes them look wrong and stupid and it just drains the emotion out of their appeal. And since emotion is all they are offering, that's devastating.

StanH said...

Barry will be certain that Government Healthcare is deficit neutral if he has to take every last dollar of taxpayers money, he nobly proclaims.

Lawhawk it’s a banner day on the boards when you get to use grandiloquent in response, Ha!

patti said...

listen, i just want you to know it's really hard reading through my tears from laughing at this "How exactly is that going to work dumbass. .. er, sorry, Mr. President?"

i'm linking this to facebook so all the youngans can have an education today.

*dumbass* hehe....

Unknown said...

StanH: Dear Leader does inspire me to great heights of pomposity and loquacious luminosity. See--it's contagious.

AndrewPrice said...

Thanks Patti! I call 'em like I see 'em.

DCAlleyKat said...

Obama cashed in a huge chunk of political capital to rally his base.
Question #1 Will it work?
Question #2 Will it be worth the cost?
Sort of his own Cost Benefit Analysis Death Panel. And that brings...
Question #3 Politically speaking is supporting "him and his plan" an asset or a liability to one's 2010/12 campaign for re-election?!

Tennessee Jed said...

Having looked forward to today's analysis by a variety of sources, I'd have to say, regarding this post Andrew, (and with apologies to James Bond,) "nobody does it better."

There was also a guy on Neil Boortz's radio show this morning that was pretty good at analyzing the specific politics at play. I think the guy was named Matt or Mitch from a source called Insider Advantage. I have never checked out Boortz's webside (or if he even has one) but if he does, it will probably be on there.

AndrewPrice said...

DCAlleyKat,

I'm not sure I agree that he cashed in a lot of chips. CNN's poll seems to show that Democratic viewers outnumbered Republicans 3-1, so I don't think he was speaking to a lot of people other than his base.

Will supporting him help or hurt? Honestly, I think it will do neither among the general population because the bill won't take effect for several years. So it's passage will be a non-event for them, until things start to go wrong -- at which point they won't remember the cause.

BUT, 2010 and 2012 aren't about the general population, they are about turn out. And supporting Obama will bring out huge numbers of Republicans, but few Democrats. So I would say it will hurt them.

Finally, will this speech work? No. As proof, I offer the fact that the biggest thing they've latched onto is the "you lie" comment. If that's the only thing that came out of this speech to excite the base, then it failed.

Writer X said...

Andrew, this is outstanding. I heard on the radio that the AP actually did a "fact check" of the speech, too. I doubt it was as thorough as yours. Anyway, I was surprised that they would even write such an article.

AndrewPrice said...

Jed, I thank you sincerely! :-)

AndrewPrice said...

Writer X, Thanks. Tell your friends! ;-)

I read the AP article. It was ok, but rather shallow. They looked at a couple of pure facts and one or two assertions, but they never looked very deeply or at the logic behind what he said.

BevfromNYC said...

Did anyone happen to see Charlie Rose Show after the speech? Thaddeus McCotter, Rich Lowry, the editor of NYT, and other former legislator who I don't remember were on doing a post mortem of the speech. It was interesting, but even the NYT editor wasn't really snowed. But, what I really want to know is WHY DON'T THE REPUBLICANS GET MCCOTTER TO DO THE REBUTTAL????? Sorry, I had to yell. He is just incredibly smart, direct and he knows what he is saying. It is almost worth moving to Michigan just to be represented by him.

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