Certainty of decline, probability of catastrophe 336
Read only a few pages of HR3200,The Affordable Health Care Choices Act 2009, and once you’ve got the gist of what they’re saying let your eye wander over a hundred or so more, and you’ll know beyond all doubt that you are now owned by the government. The link:
To put it bluntly, this act has changed the USA into the USSA – the United Socialist States of America:
Here is part of Mark Steyn’s must-read article on the immediate and future costs of it:
On the day President Barack Obama signed Obamacare into law, Verizon sent an e-mail to all its employees, warning that the company’s costs “will increase in the short term.” And in the medium term? Well, U.S. corporations that are able to do so will get out of their prescription drugs plans and toss their retirees onto the Medicare pile. So far just three companies – Deere, Caterpillar and Valero Energy – have calculated that the loss of the deduction will add a combined $265 million to their costs. There are an additional 3,500 businesses presently claiming the break. The cost to taxpayers of that 28 percent benefit is about $665 per person. The cost to taxpayers of equivalent Medicare coverage is about $1,200 per person.
So we’re roughly doubling the cost of covering an estimated 5 million retirees.
Now admittedly the above scenario has not been, as they say, officially “scored” by the Congressional Budget Office, by comparison with whom Little Orphan Annie singing “The Sun’ll Come Out Tomorrow” sounds like Morrisey covering “Gloomy Sunday.” Incidentally, has the CBO ever run the numbers for projected savings if the entire CBO were laid off and replaced by a children’s magician with an assistant in spangled tights from whose cleavage he plucked entirely random numbers? Just a thought.
This single component of “health” “care” “reform” neatly encompasses all the broader trends about where we’re headed – not just in terms of increased costs (both to businesses and individual taxpayers) and worse care (for those retirees bounced from company plans into Medicare), but also in the remorseless governmentalization of American life and the disincentivization of the private sector. As we see, even the very modest attempts made by Congress to constrain the 2003 prescription drug plan prove unable to prevent its expansion and metastasization. The one thing that can be said for certain is that, whatever claims are made for Obamacare, it will lead to more people depending on government for their health arrangements. Those 5 million retirees are only the advance guard. And, if you’re one of those optimistic souls whose confidence in the CBO is unbounded, let’s meet up in three years’ time and see who was correct – the bureaucrats passing out the federal happy juice, or the real businesses already making real business decisions about Obamacare.
Can we afford this? No. Even on the official numbers, we’re projected to add to the existing $8 trillion in debt another $12 trillion over the next decade. What could we do? Tax those big bad corporations a bit more? Medtronic has just announced that the new Obamacare taxes on its products could force it to lay off 1,000 workers. What do those guys do? Well, they develop products such as the recently approved pacemaker that’s safe for MRI scans or the InterStim bladder control device. So that’s a thousand fewer people who’ll be working on new stuff. Well, so what? The public won’t miss what they never knew they had. So, again, the effect is one of disincentivization – in this case, of innovation.
If existing tax structures can’t cover the costs, what can we do? Start a new tax! The VATman cometh. VAT is Euro-speak for “value added tax.” … This is yet another imposition on businesses, taking time away from wealth creation and reallocating it to government paperwork. If the Democrats hold Congress this fall, I would figure on VAT sooner rather than later.
All of the above is pretty much a safe bet. What about the imponderables? Even Obama hasn’t yet asked the CBO to cost out, say, what happens to the price of oil when the Straits of Hormuz are under a de facto Iranian nuclear umbrella – as they will be soon, because the former global hyperpower, which now gets mad over a few hundred housing units in Jerusalem, is blasé and insouciant about the wilder shores of the mullahs’ dreams. Or suppose, as seems to be happening, the Sino-Iranian alliance were to result in a reorientation of global oil relationships, or the Russo-Iranian friendship bloomed to such a degree that, between Moscow’s control of Europe’s gas supply and Tehran’s new role as Middle Eastern superpower, the economy of the entire developed world becomes dependent on an alliance profoundly hostile to it.
Which is to say that right now the future lies somewhere between the certainty of decline and the probability of catastrophe. What can stop it? Not a lot. But now that your “pro-life” Democratic congressman has sold out, you might want to quit calling Washington and try your state capital. If the Commerce Clause can legitimize the “individual mandate,” then there is no republic, not in any meaningful sense. If you don’t like the sound of that, maybe it’s time for a constitutional convention.
When prevention is not better than cure 148
Charles Krauthammer writes:
Think of it this way. Assume that a screening test for disease X costs $500 and finding it early averts $10,000 of costly treatment at a later stage. Are you saving money? Well, if one in 10 of those who are screened tests positive, society is saving $5,000. But if only one in 100 would get that disease, society is shelling out $40,000 more than it would without the preventive care.
That’s a hypothetical case. What’s the real-life actuality in the United States today? A study in the journal Circulation found that for cardiovascular diseases and diabetes, “if all the recommended prevention activities were applied with 100 percent success,” the prevention would cost almost 10 times as much as the savings, increasing the country’s total medical bill by 162 percent. Elmendorf additionally cites a definitive assessment in the New England Journal of Medicine that reviewed hundreds of studies on preventive care and found that more than 80 percent of preventive measures added to medical costs.
This doesn’t mean we shouldn’t be preventing illness. Of course we should. But in medicine, as in life, there is no free lunch. The idea that prevention is somehow intrinsically economically different from treatment — that treatment increases costs and prevention lowers them — is simply nonsense.
Prevention is a wondrous good, but in the aggregate it costs society money. Nothing wrong with that. That’s the whole premise of medicine: Treating a heart attack or setting a broken leg also costs society. But we do it because it alleviates human suffering. Preventing a heart attack with statins or breast cancer with mammograms is costly. But we do it because it reduces human suffering.
However, prevention is not, as so widely advertised, healing on the cheap. It is not the magic bullet for health care costs.
You will hear some variation of that claim a hundred times in the coming health care debate. Whenever you do, remember: It’s nonsense — empirically demonstrable and CBO-certified.