Robert J. Samuelson has a good article at the Washington Post on some of the Illusions of Cost Control. He makes a pretty good point about politics in this country: We ALWAYS take the easy/obvious way out:

There’s a parallel here: housing. Most Americans favor home ownership, but uncritical pro-homeownership policies (lax lending standards, puny down payments, hefty housing subsidies) helped cause the financial crisis. The same thing is happening with health care. The appeal of universal insurance — who, by the way, wants to be uninsured? — justifies half-truths and dubious policies. That the process is repeating itself suggests that our political leaders don’t learn even from proximate calamities.

Argument 1: The uninsured use expensive and ineffective emergency rooms for primary care. Once they’re insured, they’ll have regular doctors. Care will improve; costs will decline.


A study by the Robert Wood Johnson Foundation found that the insured accounted for 83 percent of emergency-room visits, reflecting their share of the population. After Massachusetts adopted universal insurance, emergency-room use remained higher than the national average, an Urban Institute study found. More than two-fifths of visits represented non-emergencies. Of those, a majority of adult respondents to a survey said it was “more convenient” to go to the emergency room or they couldn’t “get [a doctor's] appointment as soon as needed.” If universal coverage makes appointments harder to get, emergency-room use may increase.

Argument 2: Insuring the uninsured will dramatically improve the nation’s health and thus decrease healthcare costs.


Medicare’s introduction in 1966 produced no reduction in mortality; some studies of extensions of Medicaid for children didn’t find gains. In the Atlantic recently, economics writer Megan McArdle examined the literature and emerged skeptical. Claims that the uninsured suffer tens of thousands of premature deaths are “open to question.” Conceivably, the “lack of health insurance has no more impact on your health than lack of flood insurance,” she writes.

How could this be? Possible explanations include: (a) many uninsured are fairly healthy — about two-fifths are age 18 to 34; (b) some are too sick to be helped or have problems rooted in personal behaviors — smoking, diet, drinking or drug abuse; and (c) the uninsured already receive 50 to 70 percent of the care of the insured from hospitals, clinics and doctors, estimates the Congressional Budget Office.

Here’s the bottom line on healthcare cost control:

Unless we change the fee-for-service system, costs will remain hard to control because providers are paid more for doing more. We have to change the provider INCENTIVE! Just giving people free health insurance makes the problem worse. Healthcare providers will be able to continue doing more and getting paid more because there will be NO INCENTIVE for consumers to shop for the best prices OR control their own costs!

In the president’s SOTU last night, he said regarding health care:

But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know.

Here is a simple approach that will work:


Part A. will:

  • because all workers will be required to pay for 100% of their insurance out of their own pocket, they will have shop and negotiate for the lowest insurance rates.
  • remove the disparity between what the self employed pay for insurance and what regular, previously employer-subsidized workers pay.
  • Just as self-employed workers presently do, to keep their insurance premiums low, all workers will negotiate larger deductibles, giving them a strong incentive to question and negotiate the charges of their healthcare providers…driving down costs.

Part B. will:

  • remove in-state and regional  monoplies of insurance companies … increasing competition and driving down rates.

Part C. will:

  • drive down the cost of insurance since legal fees that need to be paid by that insurance will be less.

Part D. will:

This 4 point approach will accomplish the goals the president outlined, but it requires real change, the kind of change that Mr. Obama’s special interest backers (like unions and banksters) will not support.  McCain had a proposal in his campaign to tax the employer paid part of health insurance, but the special interests and Mr. Obama shouted it down.  McCain ran a poor campaign and deserved to lose, but this proposal was on the right track.  Too bad,  Obama’s offer for real change is a farce

Here is the official summary of bill that has been put together by the Senate Health, Education, Labor and Pension Committee (emphasis added):

Authorizes a demonstration program to improve immunization coverage. Under this program, CDC will provide grants to states to improve immunization coverage of children, adolescents, and adults through the use of evidence-based interventions. States may use funds to implement interventions that are recommended by the Community Preventive Services Task Force, such as reminders or recalls for patients or providers, or home visits.

Upon further analysis of the committee’s draft, the bill lists eight specific ways that states may use federal grant money to carry out immunization-promoting “interventions.” Method “E” calls for “home visits” which can include “provision of immunizations”:

Funds received under a  grant under this subsection shall be used to implement interventions that are recommended by the Task Force on Community Preventive Services (as established by the secretary, acting through the Director of the Centers for Disease Control and Prevention) or other evidence-based interventions, including—“(A) providing immunization reminders or recalls for target populations of clients, patients, and consumers; (B) educating targeted populations and health care providers concerning immunizations in combination with one or more other interventions; (C) reducing out-of-pocket costs for families for vaccines and their administration; (D) carrying out immunization-promoting strategies for participants or clients of public programs, including assessments of immunization status, referrals to health care providers, education, provision of on-site immunizations, or incentives for immunization;(E) providing for home visits that promote immunization through education, assessments of need, referrals, provision of immunizations, or other services; (F) providing reminders or recalls for immunization providers;(G) conducting assessments of, and providing feedback to, immunization providers; or (H) any combination of one or more interventions described in this paragraph.

Home interventions?! Requiring vaccines?! This all sounds really crazy, but this is exactly what is being rammed down our throats right now. Since when does the Government know best when it concerns you and your children’s health? Apparently since January 20, 2009.

Now, I am not one of those people that think all vaccines are bad. I think vaccines can play an important part in the health of a society. However, I do not think that the Government needs to be deciding which vaccines should be required and which shouldn’t.

This scenario written by CNSNews may be a reality in the no-so-distant future if we don’t wake up from our dreams of utopian society:

There is a knock at the front door. Peeking through the window, a mother sees a man and a woman, both in uniform. They are agents of health-care reform.

“Excuse me, ma’am,” says the man. “Our records show that your eleven-year-old daughter has not been immunized for genital warts.”

“And your four-year-old still needs the chicken-pox vaccine,” says the woman.

“He will not be allowed to start kindergarten unless he gets that shot, you know,” says the man—smiling from ear to ear.

“So, can we please come in?” asks the woman. “We have the vaccines right here,” she says, lifting up a black medical bag. “We can give your kids the shots right now.”

“We are from the government,” says the man, “and we’re here to help.”

The American reports the Obama Administration argues that healthcare reform will lower the defict by cutting costs:

The administration proposes three main reforms to reduce healthcare costs: First, increased use of information technology, particularly electronic medical records; second, disease management, the intensive treatment and follow-up on chronic diseases such as diabetes; and third, comparative effectiveness research, which is cost-benefit analysis to find the best treatment for each dollar of cost.

But here’s the problem: the CBO, the official scorekeeper for any health reform proposed in Congress, has stated none of the reforms proposed by the administration is likely to significantly cut healthcare costs. In fact, according to CBO, these reforms could even increase costs.

The key to lowering costs, [CBO director Doug] Elmendorf stressed, is changing incentives. His testimony used the word “incentives” 33 times, by my count. Both the income and payroll tax exclusion for employer-sponsored healthcare and the third-party payer structure of most health coverage encourage patients to demand services and doctors to provide them even if the value of those services does not exceed their cost. The result: high costs and wasteful treatment.

On another key Obama initiative the reports:

Last week, the Congressional Budget Office issued a cost estimate for H.R. 2454, the American Clean Energy and Security Act of 2009. The bill would establish not one, but two “cap-and-trade” programs designed to limit the release of undesirable gasses into the atmosphere.

“Cap-and-trade” is when the government limits (”caps”) the emissions of greenhouse gasses and hydrofluorocarbons then issues tradeable credits for emissions. The idea is to force industries to find the most efficient ways they can to reduce these gasses and improve the environment.

But cap-and-trade don’t come cheap. The estimated cost of the bill is about $12,000 per U.S. family. It’s the most costly bill in the current Congress, just like a similar bill was in the last Congress.

The Obama regime fires those who don’t play ball or come to different conclusions than the administration.  Just ask the Director of Americorps.  The Director of the Congressional Budget Office is hired by Speaker Pelosi and Senator Reid…but, since they do whatever Obama says, look for them to fire CBO Director Elmendorf soon… It’s truly a shame, as Elmsdorf is simply speaking the obvious truth. We need more like him in government, not less.