The Wallet is Mightier than the Mouth

James Taranto discusses Obama as a celebrity in regards to ObamaCare and how young people are just not that into it:

Obama supporters have a quaint faith in the power of marketing. They don’t seem to grasp that persuading people to vote for one politician over another–essentially a cost-free proposition–is a far smaller order than persuading them to purchase an expensive product, especially one that offers a poor value for their money.

With all respect due to Mr. Taranto, I think the problem is not one of marketing, but of reality. President Obama seems to think that saying something will bring it into being, as if he had watched too many Hollywood movies wherein a particularly inspiring speech changed the course of history.  A speech can remind people why they fight, but it can’t save lives; it can inspire people to try something, but it cannot ensure their success; and there is nothing about speech that is inherently accurate.

Since this is a health care law and policy blog…

I should probably blog about the ObamaCare roll-out. But really, there’s not much to say that Instapundit or Patterico have not said better than and before I say it.

Here’s a sample: Patterico on a cancer patient who is dying and whose insurance got cancelled.  As Dianne Feinstein just told us, this is not unexpected: the point was that you could keep your health care plan until ObamaCare was enacted.

The ObamaCare website underestimates the cost of plans by as much as half.  ObamaCare hurts poor, rural Americans  (but they voted for Mitt Romney, so who cares?). That might be why ObamaCare “deepens the disconnect between Main Street and Washington.” After all, people on Main Street use Firefox or Safari, and one state exchange can only be viewed in Internet Explorer.

As I’ve long said, a big government naturally favours big business: they can buy a seat at the lobbying table, while you and I have very limited (or no) influence. It shouldn’t be a surprise that premiums are going up because Big Pharma bought favourable treatment.

Ultimately, I have a really hard time blogging about the ObamaCare roll-out because I was so wrong about it. I thought that prices would go up, coverage would go down, and people would be forced into plans they didn’t want. I had no idea that it would be this bad. Sorry, Fog of Law readers: I predicted a tidal wave and a storm surge; we got a tsunami.

ObamaCare Round-Up

The ObamaCare exchanges are set to open 0n 01 October.  In the final week before that happens, I’ll post several collections of links on the subject.

Da TechGuy explains how the House Republicans can keep the government moving during a shutdown and not fund ObamaCare. (I will note that there are rules for a government shutdown, which involve only marginally more pain than the sequester.)

The “price” of some insurance plans is dropping, but that is only because the actual insurance plans are less comprehensive than they were before.  More on that subject from Avik Roy of Forbes.

Bill Clinton explains that ObamaCare depends on fleecing the young, whoops, I mean, getting the Young Invincibles to buy insurance.  His comment about “maybe a hundred bucks a month or so” is completely disingenuous: I’m a 32-year-old woman with no preexisting conditions, a non-smoker, and of a very healthy weight, and I pay $353 per month.

I’m not alone in that; Fox News details the story of a family whose insurance premiums are skyrocketing under ObamaCare.   His family used to pay $333 per month, but is now paying $965 per month.  Who really needs an extra seven thousand dollars every year?  That’s only the cost of a decent used car.

Amanda Marcotte writes that ObamaCare does not involve Uncle Sam policing anyone’s sex life.  (A quick debunking: the Politi”fact” rating is based on conflating a lot of semi-relevant questions, e.g. about electronic health records being part of the ARRA, not the PPACA.  Nowhere does it address the fact that electronic health records will be a massive violation of privacy.)

Prof. William Jacobson compares ObamaCare to Medicaid: the “right” to medical treatment, without any doctors who are willing to provide it.  (As I keep saying, there is no such thing as a positive right in a free society: such ‘rights’ require someone else to provide the good or service, and eventually, no free person will do so under the pricing and regulatory structure of the government.)

Paul Rahe on the value of Ted Cruz’s filibuster.

Between Scylla and Charybdis

You know, sometimes I get bored of writing about the whole debacle that is ObamaCare, so I write about UFOs.  But then I can’t help but point out, over and over, how the news that comes out every day shows us what a disaster this thing will be.  The latest, via Instapundit:  Democrats are thinking of taxing expensive health care plans (valued at more than $14,000).

“Okay,” you think, “What’s wrong with taxing Cadillac health care plans?  If you want to have health care that pays for acupuncture, aromatherapy, and such, you should be paying taxes on that, not getting it tax-free.”  To which I say: yeah, except the feds are now mandating that everyone buy Cadillac health care, and the average family plan under ObamaCare will be $15,000. 

Well, that’s diabolically brilliant, Congress: mandate that everyone buy expensive ‘insurance’, tax people who don’t buy it (by accusing them of being free riders), and tax people who do buy it (by accusing them of having luxury health plans).  Evil, but effective.

Gov. Jindal Rejects ObamaCare

Here’s Gov. Jindal’s letter to Kathleen Sebelius, Secretary of the Department of Health and Human Services.  This blogger’s favourite part:

When the PPACA was proposed, the President promised that if individuals liked their current health care insurance, they could keep it. However, the PPACA model will actually force individuals into the broken, government-run Medicaid system and into heavily-regulated, government-run health care plans (deemed “minimal essential coverage” by the Federal government).
Individuals should have the right to select what health care plan is best for them, and not be limited to a one-size-fits-all product that a political process deems is “essential”. By mandating that certain benefits be provided in all insurance plans, the price of premiums will increase, leaving individuals unable to continue the coverage they like and a price they can afford.

In practise, “minimum credible coverage” forcibly diverts huge sums of people’s money into health care spending.  You are forced to, by law, purchase a very expensive, frills-intensive health care plan, or pay a penalty.  Once you have three “free” doctor’s visits per year, you may as well use them in order to get what you pay for.  Ditto “free” contraception, in-vitro fertilisation, or a host of other goodies that people would normally go without.

It’s like requiring everyone to purchase every meal at a Ritz Carlton buffet, then saying that this will bring down the cost of meals and reduce obesity.  The way to reduce health care spending is to improve people’s ability to opt out of non-necessary procedures, rather than requiring them to purchase coverage for every procedure imaginable and then creating a panel of people to (arbitrarily) deny care.  In my buffet analogy, it would be like the government jumping into the buffet line to tell people that they can’t have any food at all.

Gritting my teeth over the asinine Lena Durham

In case you missed it, Lena Durham has an Obama ad that compares voting to losing one’s virginity.  As an accomplished woman, I find it infuriating to be told to vote with my ‘lady parts’, as opposed to getting to vote like men vote – on the economy, the military, the national debt, and quantitative easing.

Since this is a health care policy blog, I’m going to hone in on this gem for today’s rant, whoops, I mean, blog post:

Your first time shouldn’t be with just anybody. You want to do it with a great guy…Someone who cares about and understands women. A guy who cares about whether you get health care insurance, specifically, whether you get birth control.

[Emphasis mine] I’ve been sick and I’ve been injured.  Like, frighteningly sick.  ‘Needed a tumor excised from my breast’ sick. Hit by a car – twice. Fractured a femur on a different occasion.  Had abdominal pain for two years that took three doctors, two ultrasounds, an MRI, and exploratory surgery to diagnose.  Even got whooping cough back in middle school.

And this empty-headed bitch thinks that those things can be compared to having to go to Target to buy her own birth control?

In fact, it’s not just that you can’t compare recreational use of contraception to having a huge chunk of abnormal cells removed from your body; the larger issue is that loading up health insurance plans with mandatory goodies means that in order for me to insure myself against the risk of needing cancer treatment, I have to pay for Sandra Fluke and Lena Durham to do the horizontal bop.

The Mafia couldn’t have dreamed up this good of an “offer you can’t refuse” scenario.  “That’s a nice wife you have there; looks like she’s expecting.  Wouldn’t want anything to happen to her during delivery or to your new baby, right?  So you would be willing to pay for the contraception of every irresponsible adult woman in America, right? Thought so.”

The Pioneer Institute on the “Cadillac Tax” that will hit Massachusetts residents

Full brief is here.

As Josh Archambault explains, Massachusetts has very high premiums and health care costs.  The “Cadillac tax” is the Scylla of ObamaCare: get too fancy a health care plan, pay a penalty.  (The Charybdis element – get too basic a health care plan, like one that doesn’t cover contraception, and pay a fee – is more well-known.)

As Archambault explains, many middle-class families in the Commonwealth will pay this penalty:

For the 10 years following the introduction of the tax:

• Business employee on a family plan will owe $86,905 in additional taxes.
• Police officer on a family plan will owe $53,907 in additional taxes.
• Teacher on an individual plan will owe $20,807 in additional taxes.

I’m not a RomneyCare fan.  We all know that.  But RomneyCare at least helps Massachusetts remain as the mecca for the best medical care in the world.  ObamaCare does the opposite: it reduces payments for Medicare (which accounts for 50% of hospital spending in Massachusetts), taxes health care plans that pay for MGH and Brigham & Women’s, and taxes medical devices at 2.5% of total sales.

The RomneyCare of 2012 is not the RomneyCare passed by Gov. Romney

Today, residents of Massachusetts must purchase health insurance that meets 43 different requirements, such as limiting prescription drug co-pays to $250 per year and all deductibles to $2,000 per year per individual.  A lot of 80/20 plans (in which the insurance covers 80% of the cost, the patient covers 20%, and out of pocket maximums are in the range of several thousand dollars per year) do not meet “minimum credible coverage” guidelines.

As I’ve been saying for a year, the requirement in Massachusetts is not “buy insurance or pay a fine.”  It’s “buy really expensive insurance, loaded up with things you may not need nor care about, or pay a fine – even if you have pretty decent health insurance.”

As Amit Roy explains in Forbes, this is not what Gov. Romney envisioned nor passed into law.  Romney’s initial plan was to have people carry catastrophic health insurance (or a bond for the same), covering everything over $10,000, which would offset the free-rider problem arising from EMLATA.  (It also has the nice effect of ensuring that almost no one will declare bankruptcy over medical expenses, because very few people declare bankruptcy over four figures of debt.)

Gov. Romney’s mistake was to leave the details of “minimum credible coverage” to an administrative agency (the Health Connector board), rather than to sign a bill into law that explicitly states what qualifies as credible coverage.  There is always a danger that a law will be amended over time, with new goodies given out to voters at the expense of someone else – even the voters themselves – but such amending is done in the full light of day, by state representatives who may be telephoned, petitioned, lobbied, or voted out of office.

The Individual Mandate Tax, explained

Grace-Marie Turner of The Galen Institute outlines the many taxes and fees that will be imposed upon Americans who do not buy government-approved health insurance.  She also hits on this important point:

Remember that the government will determine what health insurance policies meet its approval to satisfy the individual mandate. If citizens decide they prefer a different health plan, they would have to pay for that insurance as well as pay the new tax.

The press often presents the individual mandate as a dichotomy: buy health insurance, or pay a fine.  It ignores the fact that you can have health insurance – and good health insurance, appropriate for your own needs – and still have to pay several hundred dollars in penalties.

If your health care plan doesn’t cover birth control, prescription drugs, several “free” doctor’s visits, or has an out-of-pocket limit that is “too high”, you will end up buying health care and paying a fine.  The alleged purpose of the individual mandate is to protect consumers from waiting until ill to purchase health care – the quid pro quo of requiring insurance companies to take all comers, thus preventing consumers and insurance companies from cherry-picking.

There is an iota of logic in not wanting people to switch from an inexpensive, high-deductible plan to an expensive, comprehensive plan should they fall ill, as there is some logic in reducing uncompensated care.  However, the government’s solution of requiring every person to buy high-priced health insurance creates an entirely new group of problems (i.e. raising the cost of care and the bureaucracy needed to access said care), and is aimed directly at “reforming” that which works well.   The 250 million Americans with health insurance are not the problem in need of a solution: approximately 90% of them are satisfied with the health care available to them. Yet the slew of ObamaCare requirements will obligate millions of those Americans to change their health care plan or to pay a fine.