Columnist.
President Obama's health care law is supposed to insure 32 million additional people by this time next year. These newly insured will try to consume nearly twice as much medical care as they have been, and most of the rest of us will be forced to have more generous coverage than we previously had. There will be a long list of preventive services that all plans will be required to cover, without deductible or copayment, along with many new services. These changes will boost the demand for medical care considerably.
There is stirring on the left. Now that the odds that ObamaCare will crash and burn have ticked up a notch or two, the words "single payer" are being heard more frequently. [For those who have been living under a rock, "single payer" is what we used to call "national health insurance," and before that "socialized medicine" and before that "government-provided health care," by people who today call themselves "progressives" but used to call themselves "liberals" and before that "socialists" in some cases -- all in the hope that continual re-labeling will make the ideas actually seem sensible.]
Actors. Actresses. NFL football players. Baseball players. Librarians. Mayors. City councilmen. Members of AARP. The Obama administration is looking far and wide, leaving no stone unturned in a relentless search for...well...for help. Help with what? Help with getting people to enroll in health insurance plans this fall. And why is that? Because the administration is facing the very real possibility that its signature piece of legislation may fall flat on its face.
You should care a lot about how health reform will affect your doctor. The reason: it will also affect you. Here's what's happening: hospitals are merging and they are acquiring doctors. In the process, they are making the market less competitive, gaming third-party payment formulas and doing other things that make our health insurance premiums and our taxes higher than they otherwise would be.
The Supreme Court punted on the University of Texas affirmative action case the other day. But the issue won't seem to go away -- except in California. California? Yes, California. Although seen as a bastion of liberalism in the public mind, the state passed proposition 209, banning affirmative action, 17 years ago. So what happened?
Does inequality by itself create moral claims and obligations? If so, is income inequality the most important kind of inequality? Or, is inequality of IQ, attractiveness, life expectancy or social status more important? ... When we use terms like "obligation" and "claim" we are using the language of individualism. But almost no one on the left who writes about inequality believes in individualism. They're all collectivists. What they really believe in is collective decision-making. ... The left is intellectually bankrupt. It has been that way for almost a half century.
Even before the latest Medicare trustees report came out at the end of May, the White House spin masters had already crafted a story to go with it. Medicare's finances have improved, we're being told. The trust fund will last longer. The unfunded liability is lower. One of the reasons is said to be ObamaCare. The core of the new health reform doesn't kick in until next year, but already it's improving things for seniors?
On Oct. 1, millions of Americans are supposed to be able to go online and acquire health insurance on electronic exchanges in the states where they live. But a new GAO report is raising an issue I raised in the *Wall Street Journal* last month: What happens if the exchanges aren't ready?
Have you ever given money to the food stamp program? Do you know anyone who has? Actually, some people do occasionally make gifts to federal entitlement programs. But gifts to the entire federal government were a paltry $241 million in 2010, the last year for which statistics are available. By contrast, Americans donated almost $300 billion last year to private sector charities in addition to volunteer time valued at $158 billion.
On the right, we have Sen. Lindsay Graham (R-SC) ardently defending the NSA's intelligence gathering practices. This is the same senator who opposed background checks for firearms on the theory that such intrusiveness would create a "slippery slope." On the left, we have the New York Times outraged that its editorial board declared that President Obama has "lost all credibility" on the issue. This is the same newspaper that is perfectly willing to give the government complete control over your health insurance, your retirement pension, and many other aspects of your personal life.
Civilization as we know it is coming apart according to the editorial board of *The New York Times*. This is how last Thursday's lead editorial addressed the failure of the states to expand Medicaid, even though the federal government is willing to pick up 100 percent of the costs of the expansion for the next few years...
Why has the topic of "inequality" been getting so much attention in recent years? My theory: people on the left don't have solutions to any other problems. But first things first. What do the writers who are obsessing about it mean by "inequality"? They basically mean inequality of income. That would make sense if we all agree that the most important way in which people are unequal is differences in income. But what if that isn't the case? Almost all of the people who are doing the complaining have chosen professions that earn less income than they could have had. That is, all these professors and editorial writers could have gone to law school or gotten an MBA or done something else that would have earned them more money. Obviously, *money isn't the most important thing in their lives.*
A recent study in the *New England Journal of Medicine* was devastating for proponents of ObamaCare's Medicaid expansion. It finds that (as far as physical health is concerned) there is no difference between being in Medicaid and being uninsured. This undoubtedly caused considerable anguish within the Democratic chambers in Congress and among the liberal health policy community. It's hard to exaggerate what a blow this is to the people who gave us the Affordable Care Act (ObamaCare). Everything about ObamaCare -- from the money we are spending to the damage being done to the labor market to the hassles the whole nation is going through -- depends on one central idea: that enrolling people in Medicaid will give them access to more health care and better health.
President Obama recently proposed raising the federal minimum wage. If the president gets his way, the mandate will jump from its current $7.25 an hour to $9 an hour and be indexed for inflation. In addition, next January the employer mandate goes into effect, which will increase labor costs even more -- all thanks to the Affordable Care Act (ObamaCare). The Congressional Budget Office estimates the cost of the minimum benefit package that everyone will be required to have will be $4,750 for individuals and $12,250 for families. That translates into a minimum health benefit of $2.28 an hour for full-time single workers and about $3 an hour for someone working 30 hour a week. For family coverage, the cost will be $5.89 an hour for a 40-hour-a week employee and $7.85 an hour for a 30-hour-a-week employee.
Josh Barro is the latest in a long line of left-of-center critics who fault Republicans for not being real partners in the health care debate. He writes: >Liberals are tired of being lectured by conservatives about what's wrong with their approach to health policy because conservatives haven't been a productive partner in seeking a fix. Josh is half right. Yes, the left gave us a "fix" in the form of ObamaCare. But I believe it's fair to say that no serious effort was made to work with Republicans. Remember: ObamaCare didn't get one Republican vote on final passage. That's not surprising. A few years back, when the Republicans pushed through the Part D drug benefit under Medicare, I don't think a single Democrat offered to help with the legislation.
I believe we are moving toward two different health systems. Which tier do you think you will be in? In one system, patients will be able to see doctors promptly. They will talk to physicians by phone and email. They will have no difficulty scheduling needed surgery. If they have to go into a hospital, a "hospitalist" (who reports to them and not to the hospital administration) will be there to make sure their interests are looked after. They may even have an independent agency that reviews their medical records, goes with them when they meet with specialists and gives them advice on every aspect of their care.
On Oct. 1, millions of Americans are supposed to be able to go online and acquire health insurance on electronic exchanges in the states where they live. But here is a question that is being increasingly asked by people in the insurance industry: What happens if the exchanges aren't ready on time? Already, the Department of Health and Human Services has thrown in the towel on small-business exchanges that were supposed to allow employees to choose among competing health plans. The opportunity to make those choices has been put off for at least a year, leaving small-business employees with only their employer's plans as options. Prospects for the individuals acquiring insurance on their own aren't much better.
President Obama's proposal to increase the minimum wage, combined with existing ObamaCare mandates, will destroy job opportunities for young, unskilled workers in cities and towns across the country. The minimum wage could jump to $9 an hour. ObamaCare is already the law of the land, and its effects are being felt right now, even though the employer mandate doesn't go into effect until next January. With respect to the new health law, the Congressional Budget Office estimates the cost of the minimum benefit package that everyone will be required to have will be $4,750 for individuals and $12,250 for families. That translates into a minimum health benefit of $2.28 an hour for full-time single workers and about $3 an hour for someone working 30 hours a week. For family coverage the cost is $5.89 an hour for a 40-hour-a-week employee and $7.85 an hour for a 30-hour-a-week employee.
Something is wrong in the hospital marketplace. Government data released this week show that some hospitals in Dallas charge five times as much as other hospitals for the same procedures! This follows on the heels of a Time magazine/ CNN report, showing that hospitals routinely charge ridiculous prices for items and services -- prices that bear no reasonable relationship to real costs. But then we learn that no one is actually paying these prices, except some poor sap who happens to be uninsured and has to negotiate with the hospital on his own.
Within the White House, within the Democratic chambers in Congress and among the (overwhelmingly liberal) health policy community there was considerable anguish this week. The reason: a new study finds that (as far as physical health is concerned) there is no difference between being in Medicaid and being uninsured. It's hard to exaggerate what a blow this is to the people who gave us the Affordable Care Act (ObamaCare). Everything about ObamaCare -- from the money we are spending to the damage being done to the labor market to the hassles the whole nation is going through -- depends on one central idea: that enrolling people in Medicaid will give them access to more health care and better health.
