Meanwhile, back at Obamacare. . .

I have been opposed to President Obama's attempt to reform health care in America since the day I first heard about it. Mark Shurtleff, Utah's Attorney General tweeted moments ago, "One year ago today Obamacare passed. Ten minutes later I sued in federal court and won!"

Orrin Hatch (R-UT) weighs in one year later.

Mitt Romney promised what he would do after being elected president:

"If I were president, on Day One I would issue an executive order paving the way for Obamacare waivers to all 50 states. The executive order would direct the Secretary of Health and Human Services and all relevant federal officials to return the maximum possible authority to the states to innovate and design health-care solutions that work best for them.

"As I have stated time and again, a one-size-fits-all national plan that raises taxes is simply not the answer. Under our federalist system, the states are 'laboratories of democracy.' They should be free to experiment. By the way, what works in one state may not be the answer for another. Of course, the ultimate goal is to repeal Obamacare and replace it with free-market reforms that promote competition and lower health-care costs. But since an outright repeal would take time, an executive order is the first step in returning power to the states."

Watch for increasingly common sense statements like these to break out all over. The old management principle is easy to understand: "Sooner or later everybody knows everything."

The ongoing debate continues. Interestingly, the people who stand to benefit most and are by far the biggest segment of the population who access medical care -- the elderly -- are the most opposed to it. Coincidentally, I have been enjoying the rebroadcasts of Les Miserables (the 25th anniversary concerts on public television), and I now see the repeal of Obamacare as a call to action (see below). The objectives of Obamacare may be admirable (helping the poor and the elderly), but the financial reality of the debt burden on America is something completely different than what is possible. Unless Obama is defeated in 2012, there will be no repeal.

There has been a lot of "heat" over this issue in the last two years, but very little "light." Today, I received a concise summary of the financial reality we face in America (thanks, Tim).

I also stumbled over this YouTube video, an interview with a local businessman in Indiana, owner of several IHOP franchises, who explains his dilemma in attempting to come to grips with Obamacare. He leaves little doubt in your mind why Obamacare must be repealed or defunded. It's a mess for him and other business owners like him. All the mandates in the law will do is drive health care costs so high there won't be any room to operate.

The author quoted in the piece Tim sent to me, Lynn Britton the CEO of Sisters of Mercy (St. Louis) speaking to his executive team last week, stated, "On average, revenue as a percent of GDP has remained remarkably constant since World War II. During the post war era (1945 – 2011) there have been four major tax code 'over-hauls' and 13 total changes to the highest marginal tax rates ranging from a high of 94% to a low of 28% for the highest earning Americans. Said differently, the top marginal tax rate has dropped 71% with almost no effect on revenue as a percent of GDP. Clearly, we cannot tax our way out of our deficit." (Emphasis mine). Now there's a man how understands economics!

The problem with Obama and the Democrats is they got it wrong exactly 180 degrees in the wrong direction. Simply stated (I know, you don't get that very often, do you?) they zigged when they should have zagged. In addition to failing to expand access to health care across state lines and unhinging it from employer/employee programs (ever heard of free enterprise?), they also failed to fix the embedded cost structure and miscreant incentives under existing programs like Medicare and Medicaid. More affordable options get created through competition and consumer decisions from an array of cost choices. Note the key word -- choice. 

Now we face the conundrum with a misguided Washington creation. Employers are left to implement in an atmosphere of uncertainty while the courts wait for the SCOTUS opinion to emerge. Providers are also left to figure it all out themselves. Without the ability to eliminate pre-existing conditions, insurance companies will have no choice but to raise premiums. 

I'm with Tim, who wrote today, "Integrated care with evidence-based medicine is how Intermountain [Health Care] is attempting to do it."

Britton continues his analysis: "Since 1980, revenues as a percent of GDP are substantially unchanged.  However, entitlement programs during that same period have increased seven fold. By far, the largest increase in entitlement spending is Healthcare, rising from about $50 billion in 1980 to almost $800 billion in 2010. A whopping 16 fold increase in thirty years! As a percent of GDP, healthcare spending by government has risen from 1.2% to 8.2%. This change alone (7% of GDP) is nearly equal to the entire revenue the government receives from personal taxes. During the same period, out of pocket expenses by healthcare consumers have declined from 47% of total expenses to only 12% today.  This seems to indicate that lower relative out of pocket expense is at least a contributing factor to the problem." 

The author calls these "social taxes." We would call them entitlements. You can call it a calf's tail if you want, but calling it by any other name than what it is -- a sure-fire recipe for bankruptcy -- is lunacy.

Here's his conclusion: "No other cost in the federal budget has risen as much or as dramatically as healthcare costs. In fact, many other costs which have historically dominated the largest percentage of the budget have decreased by comparison. For instance, all military spending represents 19.9% of the federal budget in FY2010. Consider that in 1965 military spending was 65% of the total. In that same year, Medicare and Medicaid did not exist. Since it is not likely that increased taxes would yield sufficient additional revenue, and since we will not grow GDP fast enough to equalize revenue with spending, budget cuts are the only answer. Some economic advisors are urging the president to cut healthcare spending by 53% across the board. Even that draconian amount would only close 25% of the budget gap.

"Whether the president’s healthcare bill stands or not, there will not be enough revenue to sustain the current level of healthcare spending in the future. In fact, expanding coverage to more Americans will only widen the budget gap. Unfortunately, healthcare providers are likely going to bear the brunt of this social problem. There are few options and if these changes drive lower consumption – then so be it."

Who will stand against this ever-flowing and perpetual ocean of red ink? Watch for statesmen to arise and lead others to the barricades. Come join the crusade and let's get our national financial house in order. The world awaits our decision as a nation.

Download this mp3 from Beemp3.com

Do you hear the people sing?
Singing a song of angry men?
It is the music of a people
Who will not be slaves again!
When the beating of your heart
Echoes the beating of the drums
There is a life about to start
When tomorrow comes!

Will you join in our crusade?
Who will be strong and stand with me?
Somewhere beyond the barricade
Is there a world you long to see?

Then join in the fight
That will give you the right to be free!!

Do you hear the people sing?
Singing a song of angry men?
It is the music of a people
Who will not be slaves again!
When the beating of your heart
Echoes the beating of the drums
There is a life about to start
When tomorrow comes!

Will you give all you can give
So that our banner may advance
Some will fall and some will live
Will you stand up and take your chance?
The blood of the martyrs
Will water the meadows of France!

Do you hear the people sing?
Singing a song of angry men?
It is the music of a people
Who will not be slaves again!
When the beating of your heart
Echoes the beating of the drums
There is a life about to start
When tomorrow comes  

"Symbolic" House Vote Repeals Obamacare

It was newsworthy last week only if you don't tune in to the mainstream media.  They didn't give it much play.  But the newly-elected Republican-dominant U.S. House of Representatives resoundingly voted anyway by a margin of 245-189 to repeal the most costly entitlement program in nation's history.  They don't call this body "The People's House" for no reason!

It's no secret I was opposed to it from the moment it was announced, but more than being opposed to it, I was opposed to HOW it was done.  It is that aspect of the ongoing debate that interests me most today.

There was opposition to Social Security when it first was introduced and enacted into law.  But there was no vote within a year to repeal it.  That was also the case when Medicare was first introduced, along with Medicaid.  None of those programs faced this kind of perpetual anger and frustration from the public, united in their dislike in majority numbers. 

How it was done

The difference in my mind is that unlike Obamacare, the other entitlement programs listed did not pass on a one vote margin bought and paid for in the middle of the night on Christmas Eve in the Senate.  Further, one year after its passage Obamacare has managed to inflame half the states in the nation who have gone to court to challenge its constitutionality.  None of those other programs were struck down within a year of their passage as "unconstitutional" by a federal court.

Handout or empty hand?

We have all been partaking at the trough of government entitlement programs for a long time, and the majority of Americans now like them.  The difference with Obamacare, in my humble opinion, is that it represented a bridge too far in the minds of Americans.  Rather than welcome a handout when the economy had punished so many so severely recently, they pushed back knowing it was not a hand up, only an empty hand promising unsustainable debt and deficits.

Most economists and others who have studied its provisions (I have not) now conclude there is little of anything representing cost savings in the measures enacted.  It went too far, and fewer and fewer have indicated they really want more government intruding into their lives and their choices, especially when it is being paid for with more foreign debt.

Maybe more than symbolic

There is some indication, however, the vote may actually be more than symbolic.  Often, split government produces real progress.  A measure proposed by the White House to a divided Congress thought to be DOA is often debated fairly, both sides expressing their views and a helpful and useful conclusion reached.  Those were the days when a Ronald Reagan could persuade a Tip O'Neill that tax cuts in a bad economy might just be a good idea to present to a Democratic Congress.  It's happened before, why not again? 

The useful reality about debate and a straight up or down vote on proposed measures is that such actions put people on the record, forcing them to declare themselves, compelling them to take a stand for their constituents, and revealing whether or not they give a hang about what their bosses, the people, think and believe.  That's why this vote to repeal is maybe more than symbolic, even though everyone knows it's not a big enough margin of victory to be veto proof and Harry Reid won't let it see the light of day in the Senate, thus dooming it to "symbolic" status.  But only for now, perhaps.

I'm hoping what will happen is Obamacare will die a death of a thousand cuts.  This vote last week extends the debate; opens it up for the first time, really.  Voters will increasingly use the information they glean from successive votes to gauge whether or not they need to do further reassessments about whom they will choose to represent their wishes.  In that sense it may go beyond "symbolic."

SCOTUS will weigh in

I'm wondering what impact this vote will have on the eventual judgment to be rendered by the Supreme Court, where Obamacare will ultimately be adjudicated.  Knowing the Constitution trumps all the laws of the land, will the expressed will of the people stand?  I'm wondering if the SCOTUS also realizes they are subject to the people.  I hope they still are.

Predictably, the administration poo-pooed the whole exercise last week.  Nancy Pelosi openly ridiculed a reporter last year who asked her if she was concerned about its constitutionality, with "Are you serious?"  Well, now we know the people are serious, and so was at least one federal court judge in Virginia.  If this repeal vote was merely "symbolic," then someone forgot to inform the White House about how seriously the new members of Congress have taken their oath to reflect the people's will when they got to Washington.  They heard the message from the voters, loud and clear.  That's why the vote had to be taken -- it's the primary reason they were sent there.

Real health care reform will happen when Obamacare is reversed.  Congressman Jim Matheson (D-UT) said it best:  "It reforms too little and costs too much."  He voted against it last year because he knew he would have no chance for re-election if he had done otherwise, and remains practically the lone man standing among the so-called "Blue Dog" Democrats in Congress who went along with Obamacare.  However, last week he reversed course and voted against repeal.  Go figure.

Why the sustained anger?

So maybe, just maybe, it is more than "symbolic."  There was more than Obamacare factoring into the historic tidal wave that washed ashore last November in Washington.  The voters felt disenfranchised and they were angry at not having their wishes realized.  For me and the vast majority, it started with TARP that opened the floodgates for rampant ($862 billion) stimulus spending failing to stimulate as promised, and a $1.3 trillion price tag on health care reform.  The deficit climbed rapidly to over $1 trillion, then the red ink flowed to overflowing with bailouts for "Government Motors" and Chrysler.

So Americans reacted justifiably -- we tossed out nearly everybody we could and began again, as America does every two years.  It's why this country is so viable.  Even when we make mistakes in judgment the founders gave us the reassurance we could begin afresh every two years.  We've all had to make readjustments in our lives these last two years.  We've cut back, we're learning how to save again, we're reducing debt, and we're somehow surviving in spite of it.  And now we demand the same of our federal government.  Some say individual households don't operate the same way as government.  That's true, because the government can print money.  We can't.  We can send representatives to Washington, however, who will do as we do and stop the presses.

Watch for more fiscal responsibility and big reductions in spending.  Those who refuse will be voted out.  That's the way politics works.  The Piper will be paid.

Chipping away now at Obamacare, and if Americans increasingly can stand by their convictions that it won't produce anything but grief if left to another generation to pay for it, then a large enough majority in both houses of Congress and maybe the White House in 2012 can finally bury it so deeply it cannot resurrect.

Federalism must be re-enthroned

The analysts I have read have been uniformly critical about the measure doing nothing to solve the upward tilt of the cost curve associated with health care, references to "bending the curve" in the years ahead notwithstanding.  Obamacare doesn't address the escalating costs associated with malpractice lawsuits.  The states were given virtually no latitude to develop their own solutions, since health care, like education, is administered at the local level.  Utah was already well underway in its efforts.  Federalism (giving states the right to be self-determining) has all but died in the wake of Obamacare.

Finally, one would hope the individual mandate in the law, forcing Americans to buy health insurance or face fines, must certainly be declared unconstitutional in the end.  This is still America, the land of the free.

But rather than let the moniker "the party of NO" stick, Republicans would be well advised to form committees, hold hearings, and work to craft real solutions lacking in Obamacare.  Keep the parts (if there are any) that might work, and scrap the rest.  We do have a health care crisis.  The costs are out of control, the incentives are skewed in the wrong direction, and Medicare and Medicaid are already too much to bear in a bankrupt nation borrowing to sustain an "even keel" level of care.  What do I mean by "incentives" being skewed?  Physicians and health care providers are reimbursed for a never-ending cycle of life-sustaining expenditures for seniors that extend life but sometimes with the tradeoff for quality of life compromises in the name of advancing medical science.  Aged grandparents and great-grandparents become little more than lab rats for government funded research.  Is that too harsh for you?  That's what we've got now.

Re-enthroning states' rights linked with free market competition among carriers would be a huge first step.  Given choices, let consumers be in charge of their care.  Intermountain Health Care is well on the way to showing the path to the rest of the nation.  The federal government needs to stand down and get out of health care reform and education.

The House last week finally heard and acted based upon the will of the electorate.  Yes, it may be "symbolic" as a repeal vote this year, but if the trend continues look for the electorate to take back the other chamber and the White House before the real damage is done when Obamacare kicks into high gear in 2014.  The question remains, will the angst survive another two years?

Power still resides in the majority that can choose to defund or repeal.  This "symbolic" vote was the first step.