The state opt-out mirage
Doug Powers takes a closer look at Harry Reid’s state opt-out sop.
There’s no there there:
I haven’t seen this section of the bill, but one thing is certain: It will be easier to get Michael Moore through the eye of a needle that for states to opt out of Obamacare.
There will be countless additional funding measures attached so as to ensure that if states opt out, they’ll go even more broke than they already are.
Technically states can opt out of federal education guidelines and run their own public schools any way they see fit — as long as they don’t mind losing millions in federal funding that states have come to depend on.
Technically states can opt out of the federal drinking age and set their own legal age for the consumption of alcoholic beverages — as long as they don’t mind losing millions in federal highway funding.
Hospitals also receive plenty of federal money. Guess what’s going to disappear if your state “opts out” of Obamacare?
Some states are girding their loins:
Utah House Speaker Dave Clark (R) told the (Salt Lake City) Deseret News that “we already have a health-care system in Utah that is bottom three in cost for the nation. As I understand the latest version (of health care legislation) — always subject to numerous changes — I would recommend Utah opt out.”
Utah Senate Majority Leader Sheldon Killpack (R) also expressed skepticism; another Republican state representative, Carl Wimmer, said he will introduce a bill in January “that will get us out.”
Former Utah governor and U.S. Health and Human Services secretary Mike Leavitt, meanwhile, recently published an essay in which he contends that federal health-care legislation “perpetuates and accelerates a century-long emaciation of state governments,” the Deseret News notes.
Connie Hair at Human Events walks through the many unanswered questions about the “opt out” mirage:
Can individuals “opt out” of the penalties and the mandatory coverage? Can individuals “opt out” of paying for government-run health care for everyone else in the country in the form of higher premiums, higher taxes, and Medicare cuts? Can small business owners “opt out” of the higher payroll taxes?
Who decides what a state does? The legislature? The governor? A state referendum? It’s not clear. Also unclear is what exactly happens in Reid’s “opt out” scenario between passage and the drop dead of 2014 for the state “opt out” date, if you’ll pardon the unfortunate juxtaposition.
Reid also said yesterday that he was sending, “… within the next few hours, to CBO…[a] proposal that we’re sending to them for scoring will make us a step closer to achieving a bill this year that lowers costs, preserves choice, creates competition and improves quality of care.”
Like the other Democrat bait and switch scenarios, Reid is not sending a “bill” to CBO for scoring but “… a number of… anyway the proposal…” for scoring. Sources say he’s not merely sending an “opt out” government option proposal, but several others for consideration should he fail to reach cloture for this latest boondoggle.
Conn Carroll at Heritage on Hotel Harry Reid:
Hotel Harry Reid: Reid provided very few details for his “opt out” proposal, but here is what we do know: the government run plan would be available on the first day that major provisions of Obamacare would take effect in 2013, and states would have until 2014 to pass legislation declining participation in the program. This means that a one-vote majority of obstructionists in one chamber of a state legislature, by refusing to act, can consign a state’s residents to an eternity of government-run health care. In 17 states Democrats control both houses of the legislature and the state house. In another 24, Democrats control at least one legislative chamber or the governor’s mansion. That leaves a total of only 9 states where Republicans run the entire show — Texas, Utah, South Carolina, South Dakota, North Dakota, Missouri, Idaho, Florida, and Georgia. That means Americans in 41 states are all but guaranteed to have no choice but to endure the government run health plan. What opt out really means is: You’re already checked in, and if you don’t do so by 2014, you can never leave.
More vapor from Capitol Hill.
***
Doctor Zero tweets: “States will be able to ‘opt out’ of Obamacare, just like 30-year-olds could opt out of the Carousel in Logan’s Run.”
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Healthcare Bill is not within Congressional Power to mandate ANYTHING!
Introduction
My subject today is Federal Mandates: Restoring Constitutional Principles — First Principles. This is going to be a controversial presentation. Most of you have not heard most of what I am going to say, and many of you will disagree with what I say.
We live in revolutionary times as the last election demonstrates. Many of us believe that 1994 was just the beginning of a longer term political revolution. Today I will offer some revolutionary ideas on federal mandates, an issue that goes to the heart of the emerging Constitutional debate.
Let me mention that I was a three term appointee to the Los Angeles County Transportation Commission — appointed by Mayor Tom Bradley. Because of my involvement in transportation, the examples I will use will tend to be from that field — but the general lessons are the same, regardless of the government function.
First Principles
Today I will discuss four principles — first principles — that should be the basis of the continuing debate about federal mandates. Then I will outline three related issues and offer some solutions.
But before moving to first principles, let me advise you of the perspective from which I am operating. It is a democratic perspective — the perspective that the people are sovereign, not government — a belief in popular sovereignty. This is important, because through most of history, the people were not sovereign — and there were governments of men, not of laws. Government was arbitrary — the people had to follow laws that were derived from the whim of the sovereign. America’s supreme contribution to political philosophy and governance is popular sovereignty — that there should be a government of laws — the rule of law, not a government of men. Rule of law requires that government abide by the law, and use appropriate legal mechanisms for making or changing laws. Perhaps Abraham Lincoln put it best, when he referred to government of the people, by the people, and for the people.
Now to federal mandates and first principles.
Principle #1
Principle #1 is this:
THE POWERS NOT DELEGATED TO THE UNITED STATES BY THE CONSTITUTION, NOR PROHIBITED BY IT TO THE STATES, ARE RESERVED TO THE STATES RESPECTIVELY, OR TO THE PEOPLE.
Of course, you recognize this as the 10th Amendment to the United States Constitution.
It is stated clearly in the Constitution, but it does not reflect today’s reality. Indeed, at least one Supreme Court decision essentially declared the 10th Amendment dead.
The 10th Amendment means what it says — and Congressional actions and court decisions to the contrary notwithstanding, it must be restored to its original meaning. If the nation wishes to grant the federal government powers not enumerated in the Constitution, then there is only one legitimate approach —- and it is to amend the Constitution of the United States.
Much of what Washington does will not be found in Constitution the United States.
Principle #2
The second principle is this:
THE CONSTITUTION MEANS WHAT SAYS — AND MEANS WHAT IT MEANT WHEN WRITTEN.
This, of course, includes amendments to the Constitution.
But again, the reality is far from the theory. The Supreme Court and Congress have stretched and changed the intent of the Constitution time and time again. Let me give you an example. When your predecessors held the first NASACT conference 80 years ago, there was universal agreement that the word “commerce” in the Constitution meant trade or exchange. This is what was intended when the Constitution was ratified. “Commerce” did not mean transportation. “Commerce” did not mean business. And “commerce” certainly did not mean labor. At no time during the last 80 years was a Constitutional amendment ratified that expanded the meaning of the word “commerce.” Yet today, the Supreme Court and Congress act as if the Constitution means all of those things and more.
Let me suggest this. If the Supreme Court and Congress can change the meaning of a single word of the Constitution, then we have a government of men, not a government of laws. If the Supreme Court and Congress can change or nullify the 10th Amendment to the of the Constitution, then the First Amendment is in jeopardy, and none of our Constitutional rights are secure. We need a government of laws that respects the mechanisms for changing the nation’s fundamental laws. We have a Constitutional crisis. We must restore rule of law in its fullness.
Principle #3
Now to the third principle:
THE CONSTITUTION GRANTS NO BROAD MANDATE AUTHORITY OVER THE STATES TO THE FEDERAL GOVERNMENT
And of course, this includes federal mandates over local units of governments, since they are all divisions of the states.
A federal mandate is an order or requirement by the federal government that a state, or a local unit of government take some positive action. It doesn’t matter whether the order or requirement is a condition of the receipt of federal funding. You will find no general federal mandate authority in the Constitution.
I believe that the Constitution authorizes only two federal mandates —
1. The federal government may require a state to nationalize its militia.
2. The federal government must require the states to have republican forms of government.
This is not to suggest that the federal government has no power over the states — it does. But its power is largely a power to prohibit acts that violate the Constitution. For example, the federal government can and should prohibit states and their local units of government from violating the Constitutional rights of individuals.
And notice that I didn’t say that the federal government has no broad unfunded mandate authority — I said it has no broad mandate authority. Constitutionally, funded and under-funded mandates are just as inappropriate as unfunded mandates. They are all wrong.
The unconstitutionality of federal mandates is a significant concept. It means that there should be no such thing as a federal matching grant. There are federal powers, and there are state powers. I know that the Supreme Court found matching grants Constitutional. But, the Supreme Court was wrong. The Constitution does not establish any shared powers.
This is not to suggest that the substance of all federal mandates is inappropriate. It is rather to declare that federal enactment and administration is illegitimate.
Some suggest that mandates are authorized by the “supremacy” clause of the Constitution — the clause that says the laws of the United States are the supreme law of the land. The founders made it very clear — and you can find this in the Federalist Papers, the supremacy clause means that, with respect to those powers that are delegated to the federal government, federal law is supreme — the federal government is sovereign. But the states are also sovereign — with respect to the powers not delegated to the federal government nor prohibited to them by the Constitution. With respect to these powers, the states are supreme —- there is no conflict of laws, only a division of responsibility that is clearly delineated in the Constitution.
What does all this mean? With respect to the powers not delegated to the federal government, nor prohibited to the states, the states, respectively, or the people are sovereign. With respect to such powers, the federal government has no more business interfering in the affairs of Alabama or Massachusetts than it has interfering in the affairs of the Mexican state of Sonora, the Canadian province of British Columbia, the German state of Bavaria, or Scotland. It’s as simple as that.
Principle #4
The fourth principle is this.
POWER SHOULD BE RETURNED TO THE PEOPLE.
This is not simply a Constitutional imperative, but it is also a practical imperative, and a democratic imperative.
It is a fact of life that people have more control over governments that are closer to home. Virtually everyone agrees that political power should be housed at the level of government closest to the people that is competent to handle the function. The principle is called “subsidiarity” in the European Union.
Think of it this way. Each California voter has 10 times the impact in state elections as in federal elections. Each Iowa voter 100 times. Each Delaware voter 400 times.
There are also economies of scale — the economies of scale of lobbying. Over-centralization of power makes it simpler for spending interests to have influence — because it is less expensive to influence one federal government than 50 state governments or 20,000 municipal governments.
We see this in the way that Washington, DC spends our money. Think of the silly ways federal money is used. Let me give you just one example.
The federal government is contributing $600 million to build a light rail line in Portland, Oregon that will cost $10,000 per year for each new passenger that it attracts — that’s enough to lease each new passenger three new Ford Tauruses. And the federal government’s own reports say that the line will have virtually no impact upon air pollution or traffic congestion. If Portland wants a light rail line — well and good — let them pay for it. For that matter, if they want to build a monolith — well and good — let them pay for it.
And by the way, they won’t. Just two weeks ago, it took all the strength that could be mustered by the spending interests to convince the Oregon legislature to spend one-fifth of the money they need for the next light rail line. They are assuming that Uncle Sam will pay the rest. I am assuming he will not.
This demonstrates an important principle stated by Nobel Laureate Milton Freidman,
that people are more careful with their own money than with other people’s money.
And indeed it is true. Oregon is more careful with its own money than with money from South Dakota, Tennessee, or Connecticut. It’s just human nature.
We must no longer pretend that federal money comes from somewhere else. States and localities must stop spending federal money on things they wouldn’t buy if they were paying the tab. It is our money. Or more accurately, our children’s money and our grand-children’s money.
And so, around the world, devolution is occurring. In Europe, regions are seeking power from central governments, and the same trend is underway elsewhere. In fact, in Europe there is a phrase that expresses the condition when functions are handled too far away from the people — they call it democratic deficit. Where government is too remote from the people, there is a democratic deficit. I hope that we can import the term to America, and then eliminate the condition.
We need to devolve power to the level of government closest to the people, and we need to do so at the same time as we remove virtually all federal mandates.
Related Issues
Now to the related issues.
The first one is very simple. We must live within our means. This means that we must spend no more to perform a public service than is necessary — when we spend more than necessary, we are wasting the hard earned money of the people. We must face up to a difficult situation.
The Congressional Bi-Partisan Commission on Tax and Entitlement Reform has reported that within 20 years federal revenues will cover only entitlements and interest on the national debt. Nothing for defense. Nothing for infrastructure. Nothing for discretionary programs.
And they said more. They said that if current trends continue, federal revenues would have to increase in real terms by 70 percent over the next 40 years. Notice I didn’t say federal tax rates — I said federal revenues. Now, we all know that it is simply impossible to raise taxes high enough to accomplish that. Even recent federal tax increases that pale by comparison have failed to increase federal tax revenues.
And, within seven years, Medicare will be bankrupt.
What does this have to do with federal mandates? So long as Washington tells Jefferson City what to spend, and so long as Albany spends federal money, we are going to pay more than necessary for government — and we will face a bleak financial future.
But there’s more. We all know that we need a growing economy to produce good jobs and more jobs. Government does not create jobs, the private sector does. Harvard economist Dale Jorgerson has estimated that each additional tax dollar taken by government destroys $1.40 in economic growth. Virtually everyone agrees that higher taxes destroy economic growth.
So again, there is the imperative to control government spending, to secure a better future for generations yet to come, and to secure jobs for those who need them today.
The second related issue is the federal unfunded mandate relief act enacted earlier this year. This is radical legislation — legislation so radical that it couldn’t even be brought to a vote in last year’s Congress. But what a difference a year makes.
While Congress is to be complimented, the unfunded mandates act is just a small step in relation to what needs to be done. The law is limited to unfunded mandates. The law defines unfunded mandates so narrowly that mandates that are a condition of federal funding are excluded. The law gives no relief with respect to existing mandates. And, the law permits new unfunded mandates by a super-majority vote of Congress. This is not enough.
Washington hasn’t quite understood it yet. Let me give you an example. Over the past few months, Congress has agreed that states should be allowed to set their own speed limits. Yet, at the same time, Congress failed to remove federally mandated truck speed limits and appears ready to reaffirm the federal blood alcohol mandate with respect drunk driving. Now why is this?
Are we so suspicious of the Oklahoma legislature that we fear that it will allow rampant drunk driving on the highways of Oklahoma if the federal mandate is lifted? Of course, this is absurd.
Is it that the Oregon legislature is incompetent to establish truck speed limits? Are there but seven people in the entire state of Oregon — two US Senators and five members of the US House of Representatives — who, along with 528 people don’t even live in Oregon — who are competent to establish Oregon’s truck speed limit? Of course not. The 90 state senators and representatives that the people of Oregon have sent to Salem, all of whom, by the way, live in Oregon — these elected people are up to the task.
It is time for real federal mandate relief — not just unfunded mandate relief — and not piecemeal relief.
Now the third related issue —
Federal mandates are pervasive. They do not number in the hundreds. They number in the thousands — perhaps in the tens of thousands or more. Let me give you an example. In 1991, a new federal highway and transit bill was enacted. That bill contains more than 500 federal mandates. And that does not count the mandates that will be found in the 500 pages of federal regulations that supplement the law.
Some of the mandates are very expensive. Others are less expensive. Many simply require your departments of transportation to file a report or to seek a certification from the federal Department of Transportation. But that costs both time and money. Every time highway or transit administrators turn around, they have to be concerned about compliance with federal mandates. Federal law is literally riddled with federal mandates. Piecemeal reform will never do the job.
Solutions
Now to the solutions.
There has been a lot of talk about block grants but insufficient activity. Block grants should be used to transition federal programs and funding to the states and then from the states to their local levels of government. But not all of the money will be sent to state and local governments. The federal government needs to save some money — it needs to balance the budget.
The states and their local units of government have the tools to do their jobs, even with less money. The question is whether they have the political will. Let me suggest some readily available strategies.
First, there is privatization including competitive contracting and vouchers. Around the world, governments are saving considerable amounts of money by using the market to ensure that public unit costs are no higher than necessary. This includes left-wing and socialist governments that are sick and tired of paying more than necessary to produce government services. For example, just the removal of a single federal labor mandate in transit would allow transit agencies to implement reforms that would save more money than they currently get from Washington.
And then there is pork. State and local governments are simply not going to spend their own money to build projects that aren’t needed. Again, they will be more careful with their own money than they are with other people’s money.
But there’s more. When state and local governments do spend their own money on projects, they spend it more carefully. In the mid 1980s, the federal Clean Water Act was amended from a grant program to a revolving fund program. This occurred at least partly because the federal General Accounting Office found that when local governments spent their own money on waste-water treatment plants, they were more efficient, they cost less, they did a better job, and they used better technology. Again … People are more careful with their own money than with other people’s money.
And then there’s the duplication of effort with respect to federal lobbying. Your state lobbyists are tripping over lobbyists from your largest cities and counties. We need to bring them all home. Let the cities and counties lobby their own state legislatures.
There are other solutions as well.
One is the Federal Mandate Relief Amendment, which has already received the endorsement of the Ohio House of Representatives. Ohio has called upon the Congress to propose a Constitutional amendment to the states that would allow the states to exempt themselves from federal mandates. Remember that we are operating from the assumption that federal mandates are unconstitutional. That being so, the sooner we eliminate them the better. States would simply need to make a finding that the broad public policy goals of the programs would be met by the states or their local units of government. And, these findings would not be subject to judicial review.
Another proposed potential constitutional amendment has greater support. In fact, it is expected that it would be recommended by the proposed Conference of the States. It is the Government of the People Amendment. This Constitutional Amendment would allow two-thirds of the states, acting jointly through their state legislatures, to invalidate federal law, portions of federal law, or any other federal action such as judicial or regulatory actions where the states determine such actions to be unconstitutional. The amendment would exempt this process from judicial review. Ratification of the Government of the People Amendment would establish the states as final arbiter of the Constitution. This is consistent with their existing role as custodian of the Constitution — which they retain through their final approval of any Constitutional amendments. A mechanism such as this is necessary to establish a higher authority on Constitutional questions than the Supreme Court, since that body has failed so miserably to protect the intent of the Constitution, especially with respect to the sovereign powers of the states.
And, finally, the states are already involving themselves in legal activities to reassert their authority. In some cases, states are refusing to comply with federal orders they believe to be invalid, and are being sued by the federal government. In other cases, states themselves are suing the federal government. An example is a suit by state legislators against the federal government that seeks to invalidate the Ozone Transport Commission, which was established by Congress and given the power to impose California vehicle emission standards on the Northeast. And it is important to understand that legal actions have much broader ramifications — they can themselves be a lightning rod for focusing public opinion.
In summary, my message is this. The United States has a tradition of government by rule of laws and not by rule of men. Federal mandates are inconsistent with the fundamental law of the United States. And they are pervasive. It is important that steps be taken to remove federal mandates, and this will require a comprehensive, rather than a piecemeal, approach. This is required not only to revitalize the rule of law under the Constitution, but also to conform to the most basic of democratic principles.
Nothing less will be sufficient. Because government of the people, by the people, and for the people is government that is closer to the people.
You know how you can spot a shuck and jive con game? Listen to Obama speak … Reid is just a bit part player in the con.
When your government is in the con game business, you better pay attention before you end up in the gulags.
How can I “opt out” of the next three years of this administration?
That is classic!
But also remember that with God all things are possible.
This is only because of their draconian liquor laws. They must save a bundle on cirrhosis treatment.
Same old, same old. Same with the porkulus bill. States are strangulated into submitting. Chicago politics all the way.
Hey America…I hope you’re paying close attention and have a contingent plan come 2010.
post of the week at least….lol
yep you can opt out but your wallet will still be a lot lighter….
As I said before and opponents should scream: the government can’r even deliver a flu vaccine, they certainly can’t deliver “universal healthcare”, and certainly not cost effectively.
xler8bmw said:
Does that post qualify as a manifesto?
It would be a classic if that were than. Otherwise it makes no sense.
Yes with GOD all things are possible but somehow I do not see the Fat Man being equal with a camel–those camels were doing good work. Now if you can load some bales of hay on Michael Moore, lead him across the dunes……..
But that IS classic! The Federal Opt Out provisions are always power grabs–we need an axe to federal funding.
The states can opt out of anything and when they do, they pull back their share of the National Guard and quit sending their tax money to the Feds.
The second Civil War is a’brewing
xler8bmw: Your comment well worth the read and much more informed and informative than O’s lecture on race.
RedDog: you got that right buddy. Why aren’t the MSM yelling “Katrina”? Where’s Geraldo reporting from the hospital beds when we need him?
This is again one of those days when I just want to scream. This health control thing drags on much longer than the FL recount and there are days when I just can’t take the stress.
We’re fighting against Nero.
Which will, once again, be defined as a racial injustice issue.
If we opt out and quit receiving federal money, does that we mean we no longer have to treat illegals? That alone could save us millions of dollars.
And therein lies the problem. The States are junkies that need to go cold turkey from the Federal pushers.
This really is the Hotel California Bill: you can check out any time you want, but you can never leave.
All you have to remember is, Obama won and you didn’t. That comes right from the horse’s butt. The only ones exempt of ObamaCare will be the crooks in Washington DC. We the unwashed public will be stuck with it.
Obviously ANY public option is government-run health care and a threat to private insurance. The stated objective is to increase competition. That’s easily fixed by allowing insurance companies to sell across state lines. But that wouldn’t further the goal of a single-payer system.
I’d like to opt out of this trojan horse by not even letting it through the gates.
This whole opt out has left more questions than answers (surprise surprise).
If a state opts out are they still going to mandated to provide insurance to all on a state level?
There are some states that may opt out. But there are others, ie. all the blue states, and most red ones that can’t cut the apron ties that will stick all of us with this crap.
xler8bmw: excellent treatise! Back to the Constitution!!
when all else fails, make absurd promises. like gubmint motors promising to take back your car after 30 days if you aren’t happy. amtrack is a great gubmint program, and it only loses 8billion bucks a year.
The thing to remember is that congress (the House and Senate) work for the voter. The are employees of the voter and paid by the voter. If voters do not like their performance, fire them. We do not need term limits, we need responsible voters.
This is not meant to criticize xler8bmw,
but rather to explain a difference in styles…
Some people criticize me for linking to my own blog posts, but I personally think it’s better to link to a post than to submit a 12+ page comment here.
Yeah, the HUMAN Race.
On October 27th, 2009 at 10:40 am, et said:
I should have put a [sic] in that quote. It’s there in the original above. But I think everyone knew that was a typo and read it the right way…
It will be easier to get Michael Moore through the eye of a needle than for states to opt out of Obamacare.
That’s a pretty darn big needle, RedPill.
There might be a good consequence of Reid’s “Opt out” thing. I’m sure its not intentional on his part. It is the awakening in the states that as states there are probably several things that states can constitutionally opt out on in terms of the federal government’s oppression and meddling.
Its not too hard to imagine someone at in state government asking themselves, “If we can opt out of health care, what else can we opt out of?”
Obama, Reid, and Pelosi are like a thief going down the corridor of a hotel from room to room hoping deperately they will find an unlocked room to slip into.
That is now the Obamacare strategy. Twist, turn, manipulate, ANYTHING.
This is not a legislative initative. It is a coup.
As I understand the Opt Out proposal inserted in the bill (outside of committee hearings, by Reid, I might add), it can be explained thus;
You are approached, and an offer is made for you to buy a new car, with all the bells and whistles. You don’t want it, or you don’t believe you can afford it, so you decline the offer.
Unfortunately for you, by declining the offer, you are billed a yearly Declination Fee, and a monthly non-service fee, the total of which is the amount you would pay had you purchased the new car. Others, who were not approached with the same offer, and who have no drivers license, and who do not live in your state, get that brand new car to drive as long as they want, AND get a brand new model every year. Or, so they have been told.
The problem is, the car is not delivered until 2014, after all the salesmen have received their commissions, and all the car lots have received money for their future costs.
Once the 2014 delivery date arrives, the BMV that was promised has been replaced by an electric hybrid, which has no battery, no tires, nor is a recharging network in place for the battery, should you be able to find one.
Look ahead to see the big picture…it is our past. Democrats cannot be trusted!
Short term, tactical thinking is good. But, we also need to think strategically. Those of us Conservatives that are able should consider becoming teachers. Especially of American History, American Government, Political Science and related subjects. We need to counter the indoctrination that our young people are being subjected to, and nurture future generations of Conservatives.
That’s hardly a profound observation. Donks relying on chicanery to realize what they know the American People would never accept if presented to them directly? Who’da thunk?
It’s like Spock’s assessment of the character of Kirk’s actions — even though he did not actually see them — in the episode, “Court Martial:”
“If I drop a hammer on a planet with positive gravity, I don’t need to look down to know that it has dropped.”
Good for Doug Powers to have wasted so many present moments confirming the obvious. He’ll never get them back.
Your money or your opt out! sums it rather nicely.
The needle is thought to be the man gates of the city-after the main gates were shut at dusk. For a camel to enter the needle they would have to get on their knees and walk through–a most difficult task.
If Michael Moore showed up I would shut the man gates and stick him with a needle.
I just had the funniest thought …
Check out the headline (not real, but check it out anyway):
Wouldn’t this be rich?
In either case, EPIC FAIL on the part of Obama and the liberals!
RWR
http://www.rightwingrocker.com
Public Option now is Domestic Contingency Operation, or something. Call a steaming pile of dung caviar, and guess what you still have.
A viable, effective health care reform bill will contain two key points.
1. Tort reform – Reasonable caps on damages, severe penalties for nuisance suits and getting rid of bogus doctors. The average doctor now pays over $40K/year just for malpractice insurance. The idea that this doesn’t add to our medical costs is loopy. Not to mention unnessary tests and procedures from “defensive medicine”.
2. Competition – I buy my auto insurance from Maryland. It gives me the best deal. I have to buy health insurance from one of three companies in state. Competition lowers premiums. Period.
Note to Obama, Reid and Pelosi: we aren’t stupid (we aren’t Democrats). We know that when you hide legislation from the people, it is only because you, in fact, have something to hide.
When you hide things from the people you purportedly represent, are you still representing them? Or just yourselves?
So does selecting what you want covered in your individual health insurance plan, and the flexibility of using pre-tax dollars for medical expenses.
A free market approach, without government restrictions, is always the answer.
Nailed it. Give that man a cigar. A healthcare reform bill should have perhaps 20 or 30 pages, and focus on the real problem. Ronny was right, “Big government is not the solution to the problem. Big government is the problem.”
“2. Competition – I buy my auto insurance from Maryland. It gives me the best deal. I have to buy health insurance from one of three companies in state. Competition lowers premiums. Period.”
That is a yes and no kinda thing. Comparing auto insurance to health care insurance is apples to oranges. Just because they are both insurance does not then mean they are the same in terms of cost/pricing/etc.
When your car needs something for which you need to use your insurance, you don’t go to the body shop and say, “Well I know its a Chevy but I want you to put Cadillac or Mercedes parts on it…” In health care people demand and expect an MRI for a simple headache, they want Mercedes Benz parts when that level of product is not necessary.
Opening state borders providing more companies that can provide health insurance as a product is a good thing. Don’t get me wrong. Just that it is not some panacea regarding driving down cost AND comparing auto insurance to health insurance is apples to oranges.
Here is a list of doctors in the Houston Area that donated to the Democrat Congressional Committee.
Yet again…show me where tort reform has worked to lower health care costs (or stunted its rate of growth). Over half the states have caps on non-economic damages. So you should have lots of examples.
And speaking of unnecessary tests, can you distinguish which ones are from so called “defensive medicine” and which are from self referral practices by doctors with an economic interest in running tests? I am sure the doctors would much rather have you believe that they are just scared they will be sued rather than disclose the economic interest they gain from unnecessary MRIs or therapies they order.
I guess I disagree. I don’t carry collision insurance on my ‘03 ford. I can fix or replace it for less than the premiums over 5 years. Liability is required, and the risk is based on your history and where you drive your car. The interstate competition definitely lowers the premiums, and would for health insurance as well. Proper treatment for an illness or injury does not differ from state to state.
Show me where real tort reform as I described has been implemented. Texas is probably closest, and I understand is the only state where the number of doctors in increasing rather than declining. As far as defensive medicine, it is impossible to determine its impact. But my doctor told me it is common practice and I have reason to believe him.
Again, I don’t advocate tort reform as the solution, but it is certainly a big part of the puzzle.
BTW, I know you’re not an ambulance chaser chap. But you seem to be defending an indefensible practice.
Never underestimate the importance of confirming what you believe to be the obvious. There’s a reason people still get hit by cars while crossing the street, and it’s not because we’ve evolved past needing the obvious stated from time to time.
Now I’ve wasted even more time I’ll never get back. Thanks a lot.
California ($250,000) has had it for 3 decades, Texas ($250,000) has had it since 2004, Mississippi ($250,000) has had it since 2003, Alaska ($400,000) since 1997, Idaho ($250,000) since 2003…
Here. Here is a survey of all 50 states. the notion that tort reform is something that has never been tried but would work if only given a chance is absurd.
What indefensible practice?
Limiting settlement amounts is not all there is to tort reform. Limiting cases that can be brought is a different matter. As an example the suits that nursing homes are having to defend themselves against, the cost which is putting taking care of grandma/grandpa out of reach, causing nursing homes to close nation wide, because they can get sued for a person who is bed bound and not eating getting a bed sore?
Its not JUST limiting settlement amounts that equals cost saving tort reform.
Just do a quick search, find an attorney and sue that nursing home asap.
http://nursing-home-neglect.us/?s_imsid=TC-5326-52642374522-S-6188057522&OVRAW=nursing%20home%20lawsuits&OVKEY=nursing%20home%20lawyer&OVMTC=advanced&OVADID=6188057522&OVKWID=52642374522
Ummm…maybe because, with proper treatment, someone who is bed bound should NOT be getting bed sores. Goodness forbid a nursing home should have to you know…nurse the people that live there.
How do you realistically limit cases without cutting out an entire swath of legitimate claims? You can’t. All you can do is put in place punishments for frivolous suits. Which every state already has.
But in any case, sure there are other aspects to tort reform (modifying joint and several liability for example), and many states have enacted those as well.
Nursing homes are sued so often because so often they are providing horrible horrible care. My wife is a disability law attorney and had to see first hand what some of these places try to get away with when no one is looking. I am sorry, but nursing homes (by and large) get zero sympathy from me.
Not only is that awesome, but I actually think that is something involving Michael Moore that I might pay to see…
thread away!
A report written in ‘05 by a certain Henry Cohen, Legislative Attorney,
American Law Division finds tort reform ineffective. There’s a shocker. You can not see an obvious bias in the pro/con positions? Statistics cited are hardly compelling in the face of the real world realities doctors and insurers are facing.
When I alluded to ambulance chasers the other day, your response as I recall was, “I don’t practice med mal. I’m a good attorney”.
Speaks volumes.
To follow up on this, about 40 states have modified the traditional joint and several liability rule to provide for proportional payment in med mal cases.
About half have modified the collateral source rule (meaning that if you are suing multiple parties or have received compensation from another source from the same injury, you can admit that evidence at trial. Presumably this makes the jury less likely to overaward you.
I didn’t read the report and its findings were irrelevant to my point. The only thing I cared about, and the only reason I linked it, was its chart giving citations and descriptions of the law, if any, in each state to disprove the notion that tort reform hasn’t been tried already.
I think med mal is, in theory, admirable. People that are injured deserve representation and compensation. The “I’m a good lawyer” was more in reference to the fact that my credentials allow me to practice more lucrative types of law.
Interesting argument counsellor. I guess I misunderstood and thought that good might mean good. Just as I believe the definition of is, is is.
I have no problem with people wrongfully injured being entitled to reasonable compensation. I have a big problem with huge unwarranted awards, and frivolous suits settled out of court because it is cheaper than defending them, not to mention the risk of losing.
I also agree with cleaning up bad healthcare, though your condemnation of the entire eldercare industry is a bit overstated. Bad healthcare providers should be found out and eliminated. Good ones who make occasional human errors should be protected.
How big of a problem do you think “huge unwarranted awards” are? For reference, GE Medical Protective, one of the largest med mal insurers in the country said this:
Noneconomic (i.e. pain and suffering) a “small percentage” of total losses. This from the entity that has the most to gain by perpetuating the myth that awards are out of control everywhere and every time. I am sure you can point to well publicized examples of juries gone awry. But that does not mean that there is a systemic problem with jury awards.
You know how this is usually done?
Lawsuits.
“…while at the same time recognizing and compensating the victim of their error.” I am sure you just forgot to add this.
“Nursing homes are sued so often because so often they are providing horrible horrible care.”
So the solution is to make it more costly for them to do business so they have even less money left over to pay the kinds of salaries needed to hire and keep people who will do a good job?
I’m not surprised you and your wife as lawyers can’t seem to think of better solutions than what lawyers do for a living. Know what they say about if every tool in your tool box is a hammer then every problem looks like a nail?
Soon there won’t be places for grandma and grandpa and we’ll be able to take them to chap’s house for care.
Tort reform, its a good thing!
You know how this is usually done?
Lawsuits.
I’m guessing lawsuits have created the environment that instead of weeding them out, the system protects them and keeps the bad one’s in place.
You know, those unintended consequences.
Know how to weed out the bad ones? Ask people like myself in health care who we’d see for doctors/physical therapist/where we’d put our parents.
The market can thin them out quite easily if allowed to work.
Its not hard to imagine a lawyer saying law suits are good for us. I mean come on chap. You really think we think you are objective on this issue?
Your wife does what again?
In Arizona due to a nursing shortage hospitals wanted to train LPN’s to administer and manage IV’s. Do you think the RN associations/board was for it? Don’t you think the RN association came up with all kinds of reasons why it is good for the public that only RN’s get to do IV’s? Well of course. Were they objective about it? Of course not.
So please chap don’t insult us by acting like you have no bias in this deal.
Too many lawsuits, too many lawyers. Sorry, but we’ve lost common sense in this country and have so in part to how many lawyers we have.
And when lawyers become politicians and make laws governing lawyers, we don’t stand a chance.
Lawyers are not going to go quietly on this matter. I’m pretty sure we all agree on that.
But we need effective, serious, across the board tort reform. The sooner the better.
How exactly does the market compensate a victim of malpractice? The satisfaction of hoping that your one incident will influence market forces enough to put the “bad one” out of business doesn’t really pay for that physical therapy you are going to need for the rest of your life, does it?
I didn’t say I was objective. Just right.
“…withreasonable compensation.” I’m sure you just forgot to add this.
I will repeat yet again what I have said many times before: I DO NOT OPPOSE TORT REFORM. I OPPOSE THE NOTION THAT TORT REFORM WILL SIGNIFICANTLY LOWER HEALTH CARE COSTS.
Sorry to take the wind out of your indignant sails.
And its always “too many lawyers, too many lawsuits” until YOU are the one that needs a laywer or someone has screwed you out of a contact or crashed into your car or your mom dies and you can’t figure out probate. And then its okay. Funny how that is.
From a CBO report; The Effects of Tort Reform: Evidence from the States
As usual barrister, objection overruled.
Sure, states will be able to opt out, the same way I can opt out…if you don’t mind the penalties. I can opt out of all of my taxes too…if I don’t mind the penalties. This whole thing is nothing more than a legal scam, to the envy of every ponzi inventor and con artist.
I actually agree with you on this Chap. We are supposed to have the right to a trial by jury, so I assume by extension the jury and by extension the free market gets to decide what’s fair.
Also agree that bed sores are absolutely and entirely the result of absolute neglect.
But seeing how the nursing homes are mostly paid for from government money – I can’t wait for them to take over the hospitals.
Holy hell swede.
How many times do I have to say that lowering malpractice premiums or reducing the amount of lawsuits is not the same thing as lowering health care costs? Are you being purposely obtuse? I have cited evidence many times that healthcare premiums (not malpractice premiums) are going up as high or higher in states that already have tort reform. I have asked many times for someone to cite a study showing HEALTH CARE costs (again NOT malpractice costs) are lower because oftort reform. And yet every time someone quotes the opposite. It’s either illiteracy or a fundamental failure to understand the issue.
chap – Your data I saw 1) deals only with award caps, not comprehensive tort reform (which has not been enacted) and 2) comes from sources with an apparent interest in perpetuating med mal as is. Not so compelling. Also, AP reported over the weekend that the average net for health insurance providers last year was 2.2%. So if they aren’t getting all the money from our exorbitant premiums and the monster malpractice premiums, who is pray tell?
The CBO recently estimated tort reform would save at least $100 Bil over ten years. The idea that this wouldn’t lower healthcare costs to some extent seems loopy. But I am only a commoner with limited cognitive capabilities so accede to your superior intellect.
Are Amish ambulances pulled by draft horses? Just wonderin’
xler8bmw – I agree with your post but geeze, set up a website, post it there, and link to it from here. My scroll finger hurts.
On October 27th, 2009 at 5:28 pm, chapoutier said:
I gathered that on the last go ’round.
But where do you stand on whether or not it is right and proper for the State to force me – and everyone else – to pay for your liver biopsy?
You studiously avoided that question.
Chap, Your’e missing one crucial element of what is so wrong with the American tort system, especially in regard to the deluge of frivolous medical malpractice lawsuits. Juries are encouraged NOT to make rational decisions based on actual evidence. Just look at how John Edwards made his ill gotten millions. Edwards sued a doctor in N. Carolina and actually told the jury about a dead baby whose estate he was representing. Edwards was allowed to tell the jury: “She is speaking through me”. Then he told about an alarm that he said was missed: “She is telling you” and he went on a rant about how the baby’s body was trying to talk to the doctors but the cruel doctors would not listen.
Edwards is man without any moral scruples but he is a highly effective manipulator in the court room. He got this jury and others worked up into frenzies of hate against doctors and hospitals and they gave him millions despite the fact that his cases were based on emotion and anger and not medical expertise. In Europe this could not happen. The Judge would hire his own independent medical experts and the judge could decide on the evidence, not on some absurd Billy Sunday nonsense from Edwards, replete with his crocodile tears. Guys like Edwards can always go into some backwater dusty town, find 12 jurors fresh from the farm and work them up into a frenzy. This is not only wrong, it is crazy.
swede,
Do you have any concept of scale? You think 10 billion a year makes any difference when health care costs were 2.2 TRILLION in 2007?
.45%
Let me repeat that. You think .45% should be the cornerstone for health care reform.
chap – I know about scale. the one in my bathroom lies to me each morning.
Let me summarize this way. You are wrong and I am tired. Case dismissed.
BTW, don’t knock the .45. I have a vintage Colt .45 that is very effective. I could hit a Chihuahua on the run at 50 yards.
Nite.
Awesome comeback. I am wrong despite all evidence to the contrary. Don’t blame your “tiredness” for your inability to come up with actual facts to back up your argument. This thread will be here tomorrow. Feel free to post your evidence then after you have gotten 40 winks or however you apparently need to hold onto the delusional notion that tort reform will save our nation.
“Chihuahua on the run”
Chihuahuas run?
“Also agree that bed sores are absolutely and entirely the result of absolute neglect.”
Nope. Some are, some are not.
Medical malpractice reform will have a huge impact on health care costs and hence on health care insurance. That is so obvious that I don’t know why it is even a debating point. Would we debate whether California is in the Pacific time zone? Puhleez! Because of guys like John Edwards, every doctor has to do do ten tests when one is necessary. It is called defensive medicine. So of course the cost of patient care and then health care insurance goes up like a rocket. It has to. Not so complicated.
So then why hasn’t malpractice reform actually HAD a huge impact on health care costs in PLACES IT HAS ALREADY BEEN IMPLEMENTED? It has been in California for 3 decades. It has been in Texas 6 years. It has been in Mississippi 6 years. It has been in Alaska for 12 years.
If it is “so obvious” that health care costs come down in the states that have implemented it, it should be easy to find a study showing just that. Yet time and time again I ask for one and not once has any of you provided me with one. Even the numbers that are provided by your side (10 billion a year out of a total 2.2 trillion) proves my point. I am sorry, but less than one half of one percent is pitiful.
Please somebody actually try to back up your point with actual evidence.
Morning chap – Yes you are wrong, and your awesome, overwhelming and comprehensive evidence to the contrary deals with only one facit of tort reform and comes from biased sources. Besides, “I am not bound to please you with my answers” – Shakespeare
Having already provided info from the CBO that at the very least calls your dogmatic position into question, let’s try again. The fairytale goes that the evil health insurers are raising premiums through the roof, including averaging over $35K/year/doctor for malpractice insurance, and driving the healthcare costs via their obscene profits. Yet AP (that bastion of conservative thought) finds the insurers are averaging only 2.2% net, which brings an obvious and compelling question.
Where is all that money going? Certainly not to the health providers, many can not cope and are leaving the profession and many hospitals are losing money.
It’s a rhetorical question to most here. We know where its going – into lawyers pockets. Not “good” ones like you, but you know…those “bad” ambulance chasers. I may not be very intelligent, but please don’t insult what little I have by suggesting that med mal lawyers are not making boatloads of money manipulating a flawed system.
OK, on the “scamper”.
No. It doesn’t. Just two examples, Mississippi and Texas both enacted a comprehensive tort reform package that included provisions like limits on joint and several liability, limits forum shopping as well as noneconomic and punitive caps. It has not slowed down the cost of health insurance premiums one bit. But in any case, noneconomic damage caps are by far the most important aspect of any tort reform package. For you to try to pin your tort reform hopes on some ancillary, secondary, aspects shows your desperation in this argument.
No it doesn’t call my position into question. It actually reinforces the absurd notion that health care can be reined in by tort reform (even a comprehensive plan, such as the CBO assumed). .45% .45% .45% That is the number YOU want to hang your hat on?
Dare I hold out hope that you would provide any evidence that doctors are leaving in droves or hospitals are going under?
First off, you like to glom onto the big cases, big judgments, and insanely rich med mal lawyers, like Edwards. That is not the reality of the situation for the vast majority of plaintiffs or attorneys. But lets assume your position of greedy lawyers and runaway juries and huge awards to undeserving plaintiffs. Even still, the fact remains that med mal costs simply do not constitute a large enough percentage of overall health care costs to make a significant impact. This is exactly why I have stated many times that tort reform can be a good idea for many reasons. But one of them is NOT lowering health care costs.
And stop with this “don’t insult my intelligence b.s.” You are hiding behind that to cover the fact that you have still yet to produce any empirical evidence that tort reform brings down health care costs in any meaningful way. And to cover the fact that you still have not addressed or explained the many examples of tort reform that have already been passed that have had no effect on the cost of health care in that state.
Chap, Do you agree that it is a waste of scarce medical and financial resources for doctors to do ten procedures when only one is medically necessary? If so, then you have joined those of us who support medical malpractice reform. Barack Obama, who knows better, tried to arouse antiphysician emotions by telling an audience that doctors will do tests as long as there is money to be made from each procedure. Then, in a separate speech to doctors, he told doctors how much he loves them. But what Obama knows but won’t say is that the doctors are actually losing money by having to do all these procedures. They have to do all the procedures to ensure they won’t be sued for negligent failure to order a test. And then there is the extra issue that if they don’t tell the patient about each possible test, no matter how tangential to the actual treatment the doctor will get a “lack of informed consent” lawsuit. And just the threat of these unceasing lawsuits leads to vastly higher malpractice lawsuits and that is passed along to the patient, as it must. I am not sure how much more proof is needed to make the case for medical malpractice reform.
You don’t think this is true? Google “doctor self referral.” Doctors often have a direct economic interest in ordering exams or procedures for patients. In one notable case, after a group of doctors bought their own CT scanner. Within 9 months their orders for CT scans on their patients had risen 700% More and more doctors are investing in their own equipment (which they can charge for) and ambulatory surgical centers, and then sending their patients to those services. You don’t think this leads to unnecessary testing? I am sure the doctors would like you to believe that it is the big bad attorneys that are forcing the pristine white doctors to run these tests or perform these procedures. Because it gets them off the hook.
But in any case, yet again I am forced to state that I do not have a problem with medical malpractice reform. There are a number of good reasons to support it. And yet again, no one has shown me any actual link between med mal reform and lower health care costs.