As a researcher I love how the internet works, and how fast factoids become facts. Case in point: Cato's latest diatribe at Delmarva Dealings : Tort Reform Will Save $54 Billion Why won’t the Democrats even discuss it? Obviously they won’t discuss tort reform because trial lawyers rank up there with hedge fund socialists, Hollywood, and Big Labor as primary funders of the coming “People’s Revolution”. That said, when the Congressional Budget Office (CBO) admits that tort reform would save Americans $54 BILLION over the next decade, it’s something that should be discussed … IF Democrats were interested in health care REFORM. Unfortunately, the party of Obama is not interested in REFORM. They are interested in a TAKEOVER. Clicking through the only link in the story, we reach this WaPo story that, curiously does not contain a link to the CBO report it cites: Congressional budget analysts said Friday that lawmakers could save as much as $54 billion over the next decade by imposing ...

From the Gormogons : Sen. Max Baucus (D-MT) unleashed his long-awaited "bipartisan" health care reform bill September 16 (since amended, with more goodies for everyone). Yesterday, the Congressional Budget Office (CBO) released its estimate of the Baucus bill's price tag: $829 billion over ten years, allegedly reducing the federal deficit by $81 billion over the same time frame. Mind you, the Baucus bill will only raise the insurance coverage rate 9%. What the CBO does not highlight, however, is that Sen. Baucus cooked the books. Under the Baucus plan, revenue enhancement (taxes) goes into effect immediately. Coverage does not kick in for two and one-half years. So, to make the numbers work, Sen. Baucus has to collect ten years of revenue to cover seven and one-half years of cost. 'Puter thought the whole thing smelled a little fishy, so he gave Sleestak an abacus, a quill and some parchment and set him on the CBO math. Using the above numbers, Sleestak calculates tha...

This is what WaPo says, in the lead paragraphs of a new story, that the CBO scoring of the Baucus health insurance reform plan would do: A health-care reform bill drafted by the Senate Finance Committee would expand health coverage to nearly 30 million Americans who currently lack insurance and would meet President Obama's goal of reducing the federal budget deficit by 2019, the nonpartisan Congressional Budget Office said Wednesday. The bill would cost $829 billion over the next decade, but would more than offset that cost by slicing hundreds of billions from government health programs such as Medicare and by imposing a 40 percent excise tax on high-cost insurance policies starting in 2013. All told, the package would slice $81 billion from projected budget deficits over the next 10 years, the CBO said, and continue to reduce deficits well into the future. It would also expand coverage to 94 percent of Americans by 2019, the CBO said, up from the current 83 percent. This is what ...

From Angus at Kids Prefer Cheese : I actually think we are going to get a reform that is both worse than the status quo and worse than a pure single payer system. Kudos to our Congress! As I understand it, insurance companies will not be able to refuse to cover some one, nor will they be able to charge high risk people a premium that reflects their risk. The price won't be uniform, but the maximum variation will be well below what it would take to correctly price the variation in risks. As I noted before, this will make premiums for healthy people extra high. And as the WSJ pointed out yesterday, at least on the margin, it will make healthy people want to hold off from getting any insurance until they are actually sick. Problem solved, you say? Ahh, but now it appears that the third leg of the trinity will be rule that it will be illegal to not have insurance! So young healthy people will be forced to buy way overpriced (relative to their risk) insurance. Plus if said young healthy...

It's not just President Obama, but he does tend to fall into the trap too often. I don't really know anybody who has taken seriously those supposedly inspiring Presidential anecdotes that crop up in speeches all the time. Carter, Reagan, Clinton, the Bushes--they all embellished the stories that their speech-writers fed them. But it can really bite you on the ass in a speech that is at least partly about other people distorting the truth : Last week, when the President addressed the Joint Session of Congress in a speech on health reform, he referred to some of the untruths – okay, lies – that have been spread about the plan and sent a clear message to those who seek to undermine his agenda and his presidency with these tactics: "We will call you out." Unfortunately, as Lynn Sweet at Politics Daily points out , that speech came with an anecdote that ... wasn't true: When Obama spoke to Congress about health care reform on Sept. 9, he attempted to put a human face...

I'm starting to wonder. With key Democrats like Max Baucus and Nancy Pelosi taking massive contributions from the health insurance lobbyists; with President Obama likewise accepting such contributions and cutting a sweetheart deal with the pharmaceutical companies, it looks more and more like the original plan may have been to feint left, then cut back to the right the whole time. Look what corporate America has so far achieved: Big Pharma, for a bribe of only $150 million, has been indemnified against losses in excess of $80 billion over the next decade. Big Insurance, in exchange for having to actually treat some of its current customers, is seeing the purchase of its product made mandatory by the government, leading to the addition of tens of millions of new customers and rules that allow it to spread risk and cost across greater [possibly even inter-state] populations. Big Law has managed to keep tort reform completely off the table, despite President Obama's carefully par...

Not. Nancy Willing provides links to the details of Nancy Pelosi's cozy ties to health insurance lobbyists that, strangely enough, emerge right after the Speaker indicates she finds room to compromise on a public option being removed from the health reform plan. Explain again how either wing of the Demopublican Party is anything other than corporate shills. Yep: they care about you. They really do.

... even if I have nothing to say about the President's speech, because by now it's been done to death. But here's how I know--not as a Libertarian but as an American--that the Federal government doesn't actually give a rat's butt about whether I--or Smitty, for that matter--goes broke due to health care bills, and that the so-called reform is all about creating new customers for health insurance companies. Looking back through the documents assembled for last years' taxes the other day, I recalled exactly why we were glad to see 2008 end. With my wife's back surgery and my son's chronic fatigure and my younger daughter's braces we had over $13,500 in direct out-of-pocket health care expenses. And we couldn't deduct a penny of it from our taxes. Given our income [which is information you don't really need] we would have to have spent several thousand dollars more before we could deduct anything, and then we would only be able to deduct whate...

... which goes a long way toward explaining why we, as a society, can't actually have a realistic conversation about issues of medically futile treatments for terminally ill patients. Thaddeus Pope of Medical Futility explains--be sure to savor the segment in bold: Yesterday, I wrote here about a West Virginia court that ordered a hospital to continue treating a brain dead patient. For context, it is worth mentioning that such orders are regularly obtained by family members from courts across the United States. One of the more visible, recent cases was that of Motl Brody at DC Childrens. Granted, usually (though not always) the courts grant only temporary (stop-gap) relief, giving everybody a chance to catch their breath and explore options. Rarely does the court issue a permanent injunction. On the other hand, the physiological nature of these cases typically means that there is no need for families to ask for permanent injunctive relief. The patient will, within the TRO o tempor...

You'll have to visit this screen capture from the Obama campaign's Organizing for America website to see this, because they have now pulled it down. For those who don't want to squint, here is the relevant snippet: “All 50 States are coordinating in this – as we fight back against our own Right-Wing Domestic Terrorists who are subverting the American Democratic Process, whipped to a frenzy by their Fox Propaganda Network ceaselessly re-seizing power for their treacherous leaders.” Very likely this was a user-generated page rather than a staff-created page, meaning that the once it was pointed out to them Obama staffers removed the material. But they did so by essentially denying it ever existed, as you will find if you click this link : The URL you clicked references an event that does not exist. This event may have existed at one time but been subsequently deleted. I've noticed this tendency on Organizing for America before: at one point there was a graphic appear...

To be clear: I have serious doubts about the efficacy of tort reform in driving down medical costs, and anyone who has examined Tom Baker's seminal research on medical malpractice will probably share them as well. That said, it is politics and not policy that drives what goes into the health insurance reform bill, as Shirley quotes Howard Dean as admitting: "The reason why tort reform is not in the bill is because the people who wrote it did not want to take on the trial lawyers in addition to everybody else they were taking on, and that is the plain and simple truth. Now, that’s the truth.” Actually, that's not the truth. It's not like the people drafting the bill wanted to take on tort reform but were somehow afraid of a confrontation with trial lawyers. Not hardly. Here's what progressive strategist George Lakoff has always maintained about tort reform and trial lawyers : Another multifaceted conservative strategic initiative is "tort reform," w...

Keith Hennessy explains . The logic and documentation are lengthy and wonkish; if you have doubts read the entire post yourself. What Hennessy concludes is that the President routinely says things like this: Now, what I’ve proposed is going to cost roughly $900 billion — $800 billion to $900 billion. That’s a lot of money. Keep in mind it’s over 10 years. So when you hear some of these figures thrown out there, this is not per year, this is over 10 years. So let’s assume it’s about $80 billion a year. It turns out that about two-thirds of that could be paid for by eliminating waste in the existing system. Problem? Best estimates and the loading sequence of the benefits are calculated to average $160 billion per year rather the $80 billion the President keeps claiming. Moreover: current predictions are that by 2019 the cost will have reached a annualized $202 billion . Here's what Hennessy concludes: So the President is off by at least a factor of two. This becomes partic...

.... which is what you get when, after accepting a $150 million advertising buy-in from the pharmaceutical companies in exchange for putting an upper limit on what reform could cost them, President Obama decides to hold a high-level, one-on-one consultation with former Senator Tom Daschle in the Oval Office : According to the White House, Obama and Daschle "agreed that substantive reform that lowers costs, reforms the insurance industry, and expands coverage is too important to wait another year or another administration, and they agreed to stay in touch over the coming weeks and months as this critical effort moves forward." Of course, this required significant spin, as WaPo reports , due to the inconvenient fact that Daschle's law firm represents one of the largest private insurers that is dead opposed to such reforms: But Daschle is also working closely with lobbyists, through his job at the Alston and Bird law firm, as an adviser to United Health Group, one of the nat...

If you don't see the video display, click the link. Monty Python The very last line explains why politicians in America will never be kings.

Richard Drooling has an amazingly original op-ed in the NYT that includes something to piss off everybody on all sides of the health care debate [that's my standard for an excellent piece of work]. This is the sentence that struck me: Eight million children have no health insurance, but their parents pay 3 percent of their salaries to Medicare to make sure that seniors get the very best money can buy in prescription drugs for everything from restless leg syndrome to erectile dysfunction, scooters and end-of-life intensive care. I have to admit that I had never thought of that one. Let's unpack it. Nearly 22% of non-elderly uninsured families earn more than $40K per year. About 5% of non-elderly uninsured families earn more than $80K per year. Those families, who cannot afford to pay for their own children to be insured, pay as much as $1,200-$2,400/year in Medicare taxes to provide national health insurance for seniors. This makes sense, exactly how? I'm sure someone wil...

How many points does it take to make a line? Today I have three. Point 1: The Obama administration backs away (but doesn't back away, but then again does) from the idea that a public option is essential to a successful health insurance reform bill. No matter what they say from this point on, they have wounded the public option as gravely as if it were an embattled Supreme Court nominee (remember Harriet Myers?) about whom a President says, I'm standing behind her 1000% percent . Point 2: Democratic Senator Kent Conrad says, “Look, the fact of the matter is there are not the votes in the U.S. Senate for the public option, there never have been.” . That last clause-- there never have been the votes for a public option --has been more or less ignored in the MSM thus far. That's a mistake: it is critical to the political process. The American political process--kind of like the free market-- always sets up a "middle" whether the parties or the candidates wa...

Sometimes the obvious can escape almost everybody-- except Robert Reich in this case : My friend, Keith, from New Orleans, just emailed to say he attended a local "town meeting" on health care and tried to get a word in favor but was almost hounded out of the room. Why are these meetings brimming with so much anger? Because Republican Astroturfers have joined the same old right-wing broadcast demagogues that have been spewing hate and fear for years, to create a tempest. But why are they getting away with it? Why aren't progressives—indeed, why aren't ordinary citizens—taking the meetings back? Mainly because there's still no healthcare plan. All we have are some initial markups from several congressional committees, which differ from one another in significant ways. The White House's is waiting to see what emerges from the House and Senate before insisting on what it wants, maybe in conference committee. But that's the problem: It's always easier to s...

From Medical Futility blog : There Will Be "Death Panels" but They Have Nothing to Do with Advance Care Planning In yesterday's New York Times, distinguished health economist Uwe Reinhardt accurately distinguishes the movement toward greater cost control and the proposed Medicare reimbursement for advance care planning. Re H.R. 3200 sec. 1233: "The thrust of . . . the Senate bill and of Section 1233 of the House bill, was to enhance the probability that the end-of-life care actually received by a person should conform to his or her own preferences, rather than either the physician’s or the government’s preferences." Re Rationing: "As health spending grows, year after year, roughly twice as fast as the payroll that supports private health spending in this country, Americans sooner or later will have to confront the hard questions about access to expensive treatments . . . ." There are already death panels--private insurance, Medicare, Medicaid, and the ...

From Libertarian Republican : Chairman of the Blue Dog Democrats, Rep. Mike Ross of Arkansas, earlier today predicted that no public option for health care would make it into the final version of health care legislation. The remarks came right before a Chamber of Commerce meeting in El Dorado (pronounced El Dor-ey-do). El Dorado TEA Party chairman John Wilson said Ross made the prediction during a fifteen-minute one-on-one conversation between the two immediately prior to the Blue Dog Democrat's meeting Wednesday with the El Dorado Chamber of Commerce. Wilson said that "Today I had a chance to look Ross in the eye... The Congressman gave me clear, concise answers that were on subject, and made no attempt to sidestep or evade any of my questions and concerns." Wilson went on to say that according to Ross: the final version of the legislation will not include a controversial government-subsidized health insurance plan that's been dubbed a "public option." If ...

On Shirley's advice [wow--Shirley in this post and Chainsaw in the previous one--this is becoming a curmudgeonly night) i have visited Keith Hennessey . I am going to have to give up my Biggest Wonk hat. Anyway, Keith makes a long and convincing argument that the shift in language from health care reform to health insurance reform does not signify an attempt by President Obama to carve out a fallback plan by which he could "declare victory" with a reduced plan that only reforms insurance and does not provide a public option: Other than the shift in communications strategy, I see no other signs of a change in strategy by the President or his team. They do not appear to be preparing for a health-insurance-only fallback bill. I cannot see how one would make such a bill work in practice. You need the individual mandate, the subsidies, and offsets to make it work as a policy matter. Even if you could make the policy work, going with a narrower insurance-only bill would...