ObamaCare: When Socialist Theory Meets Practice
America is lucky to have had two great social theorists: Yogi Berra and Richard Feynman. Had the Democrats heeded their words of wisdom when the issue of ObamaCare arose they'd not be sliding down the slippery slope they greased all by themselves.
Yogi's warning is nice and succinct:
"In theory there is no difference between theory and practice. In practice there is."
Professor Feynman said much the same thing but in a few more words:
"The real question of government versus private enterprise is argued on too philosophical and abstract a basis. Theoretically, planning may be good. But nobody has ever figured out the cause of government stupidity and until they do (and find the cure) all ideal plans will fall into quicksand."
Whichever version you choose, it's clear that Democrat stupidity is at the heart of Obamacare, the entire juggernaut is sliding into quicksand and taking the party down with it as bits of the law become implemented, other bits have been delayed, waived for some buddies, or jettisoned as unworkable by an administration which consistently confuses executive and legislative functions. The Republicans now face a dilemma of how best to save us from the monstrous overreach of this statute without allowing the DeMSM (a coinage expressing the partisan pro-Democrat mass media) to blame them for the onrushing disaster.
A. A Little History
Democrat leaders have been seduced for ages with the socialist medical programs of Europe and (until Obamacare) unsuccessfully tried to duplicate that plan here despite the overwhelming successes of the most advanced medical and pharmaceutical care available in the U.S. and general happiness with the existing system.
This time around the Democrats were helped by the World Health Organization, which produced what Scott W. Atlas at Commentary has indicated may be "The Worst Study Ever?"
The World Health Organization's World Health Report 2000, which ranked the health-care systems of nearly 200 nations, stands as one of the most influential social-science studies in history. For the past decade, it has been the de facto basis for much of the discussion of the health-care system in the United States, routinely cited in public discourse by members of government and policy experts. Its most notorious finding -- that the United States ranked a disastrous 37th out of the world's 191 nations in "overall performance" -- provided supporters of President Barack Obama's transformative health-care legislation with a data-driven argument for swift and drastic reform, particularly in light of the fact that the U.S. spends more on health than any other nation.
In fact, World Health Report 2000 was an intellectual fraud of historic consequence -- a profoundly deceptive document that is only marginally a measure of health-care performance at all. The report's true achievement was to rank countries according to their alignment with a specific political and economic ideal -- socialized medicine -- and then claim it was an objective measure of "quality."
WHO researchers divided aspects of health care into subjective categories and tailored the definitions to suit their political aims. They allowed fundamental flaws in methodology, large margins of error in data, and overt bias in data analysis, and then offered conclusions despite enormous gaps in the data they did have. The flaws in the report's approach, flaws that thoroughly undermine the legitimacy of the WHO rankings, have been repeatedly exposed in peer-reviewed literature by academic experts who have examined the study in detail. Their analysis made clear that the study's failings were plain from the outset and remain patently obvious today; but they went unnoticed, unmentioned, and unexamined by many because World Health Report 2000 was so politically useful. This object lesson in the ideological misuse of politicized statistics should serve as a cautionary tale for all policymakers and all lay people who are inclined to accept on faith the results reported in studies by prestigious international bodies.
A careful reading of the report indicates it was largely an endorsement of using health care provisions to redistribute wealth and centralize administrative power in the government; it was not, as touted, a survey of "the quality of health care". After a careful review Atlas concludes:
If World Health Report 2000 had simply been issued and forgotten, it would still be a case study in how to produce a wretched and unreliable piece of social science masquerading as legitimate research. That it served so effectively as a catalyst for unprecedented legislation is evidence of something more disturbing.
What we have here is a prime example of the misuse of social science and the conversion of statistics from pseudo-data into propaganda. The basic principle, casually referred to as "garbage in, garbage out," is widely accepted by all researchers as a cautionary dictum. To the authors of World Health Report 2000, it functioned as its opposite -- a method to justify a preconceived agenda. The shame is that so many people, including leaders in whom we must repose our trust and whom we expect to make informed decisions based on the best and most complete data, made such blatant use of its patently false and overtly politicized claims.
To the fraudulent factual foundation for the creation of ObamaCare, the means by which it was enacted was equally outrageous.
Arguing that ObamaCare will prove a disaster for the Democrats, the great Noemie Emery provides a comprehensive but short reminder of how this Rube Goldberg legislation was passed:
Though [Scott] Brown failed to stop the bill's passage, he stopped it from being passed in a form in which its survival was possible. With Brown in the Senate, a conference committee wasn't an option, so the House had to pass the Senate bill as it was.
"What landed on the president's desk was incomplete and unfinished," said Jonathan Adler. "Not all of its parts fit together, complicating implementation and providing greater opportunities for litigation from those who thought the law goes too far."
What else Brown did was make Obama and Democratic congressional leaders force the bill through on a technical loophole that further inflamed the enraged opposition, which waged all-out war in the 2010 midterms, and turned record numbers of state houses red.
As a result, only 16 states are committed to running Obamacare exchanges, a critical fact that may ultimately doom the whole enterprise. If not enough people join the exchanges, the rickety house will collapse.
B. Where we are
Every day that passes the public learns more of the unsavory aspects and high costs of this misbegotten legislation, and when the administration isn't waiving its application to its donors and cronies, it is delaying yet another feature of it.
At Forbes, Avik Roy's been documenting the backstroking:
In recent months, President Obama and his subordinates have waived or delayed a number of Obamacare's notable features, such as the law's employer mandate, and its procedures for protecting taxpayers from fraud and identity theft. Earlier this month, in that context, I obtained a heretofore-unpublished memorandum from the Congressional Research Service. The CRS, Congress' non-partisan in-house think tank, compiled 82 deadlines that the Affordable Care Act mandates upon the first three years of its own implementation. Remarkably, it turns out that the White House has missed half of the deadlines legally required by the ACA. And some of those deadlines remain unmet to this day.
He has noted that although, as usual, the administration is trying to shift the blame to its political opponents, the blue states are having the most problems meeting the law's requirements. (It's interesting isn't it, that polities that prefer centralized, heavy regulating administrations tend to be the most bureaucratically inept?)
What is proceeding are "exchanges" and hiring of "navigators" all of which look like Chicago-style payoffs to supporters and the institution of which provide reasonable fears of total erosion of personal privacy in this country.
My friend Rick Ballard describes the "exchanges" being set up in particularly colorful, but accurate terms:
OFA "navigators" explain the toothless nature of [Obama]care penalties and pitch declaring income slightly above poverty level in order to maximize the subsidy. They also steer "clients" to Friends of [Obamacare} exchanges and quite possibly front the initial policy payment. The Friend of [Obamacare] exchanges markup premiums way above the actual cost to reinsure, collect the government subsidy, and pocket the difference.
These navigators, by the way, will have access to your most personal information and are not receiving even a Manning-Snowden type security check. Life Site News has more on this scam in the making:
The Obama administration has awarded Planned Parenthood more than $655,000 of taxpayer funds to hire "navigators" for the president's health care reform law, the Affordable Care Act (ACA). State affiliates in Iowa, Montana and New Hampshire were among the 105 organizations receiving $67 million in federal grants.
HHS will not require background checks or fingerprinting of employees, and a previous criminal conviction -- including one for identity theft -- does not necessarily disqualify an employee from becoming a navigator.
Navigators and their assistants will have access to the federal data hub, an online nexus containing information from the Department of Health and Human Services and seven federal departments: the IRS, the Social Security Administration, the Department of Homeland Security (DHS), the Defense Department, the Office of Personnel Management, the Veterans Health Administration, and the Peace Corps. [Emphasis supplied.]
Here's a more detailed picture of what promises to be the next Solyndra type ripoff of the federal purse.
The problem with a 90-day grace period for premium payment is that at the end of it you must pay for three months of premiums, when you couldn't afford to pay one month in the first place. A lot of people won't be able to do that, but meanwhile they have been running around with an insurance card receiving health services.
What then? Who is on the hook for those services? HHS has decided to split the baby. The insurance company will have to pay for the first month of non-coverage, but providers (doctors and hospitals) will have to absorb the costs incurred for the second two months. That could be a whole lot of money. The (formerly) insured person will be canceled after three months, but they get to re-enroll again at the end of the year without penalty. (And we were told one of the purposes of this law was to solve the "free-rider" problem. Oh, well.)
Along with paying for services during the first month of the delinquency, the insurer must: 1) notify HHS of the non-payment; 2) notify providers of the possibility of denied claims during the second and third months; 3) notify the insured that he/she is delinquent; 4) continue to collect the advanced tax credit on behalf of the policyholder; 5) return the tax credit for the second and third month to the Treasury; 6) issue a termination notice to the insured at the end of the grace period. Oh, and the carrier must also determine whether the insured has a disability as defined by the Americans With Disabilities Act, and make "reasonable accommodations" for such individuals. These are pretty substantial administrative burdens, and the costs will aggravate the Minimum Loss Ratio requirement for the carrier.
So, how many people do you suppose will do this? I would wager just about everybody. Why not? You can get 12 months of coverage for nine months of premiums and suffer absolutely no penalty.
Government Home Enforcers, too. In case the "navigators" provision isn't making you concerned for the safety of your accounts and angry enough at the predictable ripoffs, here's a report on the HHS enforcers. HHS is paying $224 million to check up on you and your home environment:
If you're already queasy about the role played by the IRS in assuring your compliance with Obamacare's numerous mandates, you may need to lie down after reading this column. It turns out that our Beltway masters are not content with their new authority to peruse your tax returns and medical records. They will also authorize state agencies throughout the nation to send government inspectors to your house if a "home visit" is deemed appropriate pursuant to HHS guidelines ostensibly meant to "create social and physical environments that promote good health for all."
According to the title page of the document announcing this program, HHS has the authority to fund such visits by virtue of the Social Security Act "as amended by the Patient Protection and Affordable Care Act [Obamacare]." It describes this metastasis of HHS power as "an unprecedented opportunity ... to improve health and development outcomes for at-risk children." But the program also provides unprecedented opportunities for violations of your privacy, your right to educate your kids as you see fit as well as your Constitutional rights under the Second and Fourth Amendments.
The Chicago Tribune, which twice endorsed Obama for President (and in two earlier races worked with his campaign offices to get his opponents' sealed court documents unsealed) is begging to have this law delayed and rewritten:
Chicago Tribune: How President Obama is flouting Obamacare: More reasons to delay and rewrite this ill-conceived law. "Granted, any president may decline to enforce statutes he believes are unconstitutional. But Obama is making no such claim here. Basically, he is admitting that parts of law are impossible to enforce on the deadlines imposed by Congress -- deadlines he signed into law. He's also admitting he doesn't want to have Congress make these changes, for fear that if lawmakers get their mitts on this unpopular program, they would at least debate far more extensive changes than he'd like."
C. Should Congress Step in and How?
Noemie Emery argues persuasively that implementation of Obamacare will prove disastrous for the Democrats:
Demographic allegiances aren't always stable, parties cannot re-brand themselves in a vacuum, and the current contenders will be judged, not for who they appear to be today but on who they become in the next three years.
The time has long passed when Obamacare could be called a success; what remains to be seen is the size and the scope of the chaos it brings; and what this will do to its party of origin.
No man is an island, and no island is detached enough to be immune from this wreckage, if only through the harm it has done the economy. Ask not for whom this bill tolls, all of you Democrats. This bill tolls for thee.
The problem is it is equally disastrous for the rest of us, too.
Should the Republicans sit on their hands and let this misbegotten law crash on the shoals and take down the party that wrote and enacted it? Or should they defund it or delay its implementation?
Can they Defund it?
Some have argued that the Republican-controlled House cannot defund the law without causing a shutdown for which they'll be blamed.
Heritage argues they can and should defund it
Myth #1: Congress cannot defund Obamacare.
Congress defunds mandatory spending on appropriations bills every year. In fact, it has even defunded part of Obamacare already -- billions of dollars in "mandatory spending" for the co-op program .
Myth #2: Obamacare opponents are trying to shut down the government.
This isn't true, either.
As Heritage health care expert Chris Jacobs says in the video above, "Conservatives want to keep the federal government open -- we just want to shut down Obamacare."
Legal expert Hans von Spakovsky explains how this could be done . Funding the federal government -- with the exception of Obamacare -- "would force the President and his supporters to explain why they would shut down the government to fund  an unfair, unaffordable, and highly unpopular law that is so unworkable that the Administration has itself admitted it cannot manage to implement major portions on time such as the employer mandate to provide insurance."
Then there's what's been called "the Delay Coalition".
Kimberley Strassel at the Wall Street Journal finds much to favor this approach, at least if defunding fails.
Whereas shutdown would prove a complex and messy PR job, the public is already highly educated on the big ObamaCare issues. A majority opposes provisions like the individual mandate, and is worried by the exchanges. The president's own delays have handed Republicans powerful messaging tools. They can enlist the public to pressure Democrats to grant individuals the same mandate reprieve Mr. Obama has gifted to business, and to delay exchanges that lack the verification and security procedures necessary to protect taxpayers and confidential information.
Delay proponents maintain this strategy answers the "last chance" question. A one-year delay would kick these provisions to the heat of the 2014 midterms, a point at which Democrats will be more loath to continue. It provides Republicans the opportunity to make 2014 another referendum on ObamaCare, furthering their cause of holding the House and retaking the Senate -- at which point they'd be far better positioned to dismantle the law. A government shutdown would only hurt their election prospects.[snip]
There's an internal debate over whether Republicans should push for a delay of the entire law, or isolated pieces. And there's disagreement over tactics, emphasis and the chances of success. All of which is healthy.
Most of the signatories to the Delay coalition letter are also on record supporting a House vote to defund ObamaCare. They, too, advocate putting the heat on the left. But they argue that, if and when a defund bill fails to proceed in Harry Reid's Senate, Republicans need a savvy and proactive alternative to shutdown, one that has a chance of success.
I don't know what the answer to the defund or delay dilemma will be. Maybe Yogi 's admonition is all we can say right now:
" It ain't over 'til it's over "