Americans are about to get snookered by the greatest political con in history. I speak here of Democrats’ frenetic effort to convert the country’s private health care – a mere 1/6th of the economy – to a nationalized system that will (by their own account) cover more people, cost less, and give better care. Big Media organs report these claims uncritically, but millions of people are beginning to realize that the three results cannot all come true. In fact, the likelihood is that only the first will – although not to the comprehensive extent promised.
If the truth is dawning, then why does the thing seem to be sailing inexorably on to passage? Part of the answer lies in political strategy. When President Bill Clinton tried to nationalize health care in 1993, he commissioned his wife, Hillary, to head up the effort. She assembled a team of political apparatchiks (e.g., Ira Magaziner) who worked out all the details in private. They then rolled out the “finished” plan, assuming that the hoi polloi would embrace it enthusiastically.
There is a classical naval-warfare tactic called “crossing the T.” In it, your column of ships crosses the front of the enemy’s column, bringing full broadside fire onto the enemy’s lead ship – which is almost a stationary target – usually damaging or destroying it. Successive ships in the enemy’s column then take full fire as they move up toward the crossbar of the “T.” In this way, your force destroys the enemy, ship by ship, with superior fire.
When the Clinton plan was rolled out, opponents performed a maneuver like this, except there was only one “ship” in the Clinton squadron. By floating their completed plan, with plenty of time for the enemy’s squadron to cross in front, the Clintons invited defeat. Opponents blasted the plan, publicizing and lampooning controversial details until hostile fire sank it. Hillarycare was never brought to a Congressional vote. Even Democrats wouldn’t touch it.
Barrack Obama and Rahm Emanuel learned from this fiasco and made sure not to repeat it. Instead of producing a finished plan that could be properly scored by the CBO and scorched by the media and reform opponents, the administration let a “hundred flowers bloom.” Five different bills are in various stages of development in different committees of both the House and Senate.
This makes it impossible for opponents to concentrate fire on “the plan,” since there are multiple plans, none of which is sufficiently mature be scored accurately by the CBO. Even the much-ballyhooed Baucus plan – “completed” and approved by the Senate Finance Committee this week – is not complete. Although its low-cost CBO-scoring evoked a chorus of Democrat "hallelujahs," that highly dubious scoring depends on wildly optimistic assumptions that almost certainly will prove to be incorrect.
In addition, Democrats have added an “air dimension” to the naval metaphor by floating The One above the fray in Airship Obama, from which he makes repeated declarations of the glorious new plan’s features. An uncritical media continues to report these pronouncements breathlessly, but most of them belie the actual content of the bills under development. What Mr. Obama is selling won’t really be the final product, but the public won’t know that until it’s too late.
Congressman Joe Wilson made a scene when he shouted “You lie!” during Mr. Obama’s address to a joint session of Congress, after the president claimed that the reformed system doesn’t cover illegals. In the ruckus over Mr. Wilson’s “bad manners,” both media and congressmen somehow failed to notice that Mr. Obama was technically wrong and Mr. Wilson was right. The president aims to legalize illegals, thereby making them eligible for care under the new system. In addition, the Supreme Court has previously ruled that illegals cannot be denied needed health care.
By thus presenting a phalanx of “targets,” Democrat strategists have contrived to make opponents of government-run health care waste their ammunition. Meanwhile, the “ships” keep moving forward. The unofficial bills get all the attention, but the final legislation will not be any of them.
The real plan will be constructed in secret by Democrat insiders who will advance it via a final blitz, before the public and any nosy reporters can learn what it contains – a kind of “submarine” attack (to complete the naval metaphor). Americans will not comprehend until it’s too late how much extra they will pay for care of reduced quality, or how many of the “uninsured” will still remain uncovered under the new system. The Dems’ new strategy is: “passage first, details later.” It will be called “brilliant,” if it works.
Many Americans breathed a collective sigh of relief when the Senate Finance Committee dropped the so-called “public option” from the Baucus bill. This looked like a “win.” But government-run insurance was only a problem – not the problem. The government will not go directly into the insurance business. But at the end of the day, the public option doesn’t matter if government takes a major role in the delivery of health care. Federal bureaucrats will say which doctors can treat which patients in what way; they will control how much can be spent on which treatments.
Government will ration care by amortizing the cost of treatments across a patient’s Quality-adjusted Remaining Years (QARY). A 95-year-old man desiring a hip-replacement, for example, might not get it because he has too few QARYs left to make the operation cost-effective. The cost spread over his 2 or 3 remaining QARYs might exceed government limits on $$$/QARY.
This is where Sarah Palin and other conservatives got the “death panels” idea. Dems have screamed that no such thing is proposed, but the QARY method amounts to denying treatment deemed impractical, based on a patient’s age and health. Some of that treatment could determine if a patient lives or dies. This is in the Baucus bill. It is certain to be part of any final legislation.
Other equally radical features of the Baucus bill also run counter to what Mr. Obama has promised in his soaring speeches. Although he has repeatedly promised that health-care costs will be reduced for all Americans, the money for covering millions more people obviously has to come from somewhere other than from “Obama’s stash” (as one Detroit resident famously put it).
The biggest surprise cost-bomb is going to hit the demographic group that produced Mr. Obama’s biggest majority in the election: young people. I don’t know how many thought they would get “free” health insurance (or health care), but under the Dems’ reform legislation it ain’t gonna happen. Millions of healthy young people who have been doing without insurance will either have to buy insurance or be slapped with a fine. That’s not exactly free. It might be noticed.
But there’s a smack in the chops for every demographic group, not just young people. The millions of people who already buy health-care insurance will find their premiums higher because of a single government stipulation that has high populist appeal: no exclusions or surcharges for pre-existing conditions. This means that insurance companies will not be able to deny coverage or make it more expensive to an applicant who has a pre-existing condition.
It sounds great until you see that people might “game” the system by not buying insurance until they’re sick – sort of like waiting to buy car insurance until you’ve had an accident. Obviously, this will drive insurance premiums up for everyone, so insurers can pay for the treatments they will be forced to cover. There is no free lunch. If government decrees that there is, many insurers will simply decline to issue policies. That will be a real smack in the chops.
People whose companies furnish so-called “Cadillac” policies will also find a surprise” in their pay envelopes. Most of the government plans-aborning, if not all, call for taxing insurance policies that cost more than a certain amount – e.g., $15,000 a year. Millions of people don’t realize that this tax will touch them. They have no idea how much their policies cost because their employers pay most of the premiums. Although legislators differ on whether to tax the individual, the insurance company, or the employer, the result will be the same – a cost passed on to the individual. (Look for congressmen to quietly exempt themselves from this tax.)
Finally, oldsters will get a cold mackerel right in the kisser, too. The Baucus plan targets Medicare as a source of “savings” amounting to as much as $500 billion ($50 billion a year) to finance the reforms that will cover millions of currently uninsured people. That venerable shibboleth, “waste, fraud and abuse” (first mentioned in the Dead Sea Scrolls, I believe) is tagged as a cornucopia of savings which will actually make the Baucus plan produce a net “credit” against the deficit. It won’t be so, however. If those savings were really available, they would have already been realized. It is all just part of the same scam.
Thus, the Obama health-care reform “flotilla” sails forward in a spread formation, not a column. It is diversionary strategy at its best. Unless the American people wake up and flood their senators and representatives with calls, e-mails and letters to stop it, they will wake up one morning to find that the world’s greatest health-care system has been supplanted by a reform “plan” whose details were hitherto unknown. If it happens, we’ll have only ourselves to blame.