Is Health-Care Reform Doomed?


Cato's Michael Cannon spells out the thorny political landscape now facing would-be reformers in Congress:

  • "The Left and the health care industry both want universal health insurance coverage."
  • "But universal coverage is so expensive that Congress can't get there without taxing Democrats."
  • "But if congressional leaders pare back those taxes, they lose the support of the health care industry, which wants its subsidies."

That means industry pushback, which means reform becomes a difficult vote for many Democrats. And that may mean reforms built around universal-coverage just don't work. Read Cannon's whole post here.

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  1. We can only hope. Since anything Congress will do will only make things worse, no action is our best option. First, do no harm.

  2. Actually, John, action in the direction of decentralization (e.g. allowing the sale of insurance across state lines, decoupling insurance from employment, etc.) would be even better than nothing. But no con-gressman on earth would vote to decrease his own power over the rest of us.

    1. I said anything Congress WILL DO not anything Congress COULD Do. You are right, there are lots of small things that could be done that would help. But, Congress will never do them.

  3. Let’s make these Democrat fuckbags be more honest.

    Any registered Democrat pays 30% more in Federal income taxes.

    1. Given the documented cheating of Obama’s appointees, one suspects Dems could easily accommodate an “extra” 30%.

  4. Can it be that Congress has run out of sheep to shear, pockets to pick, purses to snatch?

  5. Basically everyone is stroking everyone else off while standing in a circle and no one is willing to stop stroking for fear the guy stroking them will stop.

    In the end all you get is tired and a mess.

    1. Congress has circle jerks?

      1. Gives new meaning to being “In Session”

  6. According to CBO, a family of four making $54,000 would pay $4,800 for health insurance. The rest of the premium would come from government subsidies. If the family’s income rises to $66,000, the subsidy falls, and the cost of health insurance rises to $7,600. In other words, earning an additional $12,000 requires the family to pay an additional $2,800. The implicit marginal tax rate is $2,800/$12,000, or 23 percent.

    Similarly, a single person earning $26,500 would pay $2,300 for health insurance, but if his income rises to $32,400, his premium rises to $3,700. This yields an implicit marginal rate rate of 24 percent.

    You get somewhat different numbers at other income levels. Typically, however, the implicit marginal tax rates are around 20 percent. Those figures for marginal tax rates are, of course, added on top of those already imposed by existing income and payroll taxes.


    1. Just got the renewal stuff for my companies insurance. Because I moved into a new age bracket, my monthly premium jumped to $234.02, which if I do my math right is $2808.24 per year.

      With the numbers you quoted, I dont see how the congressional plan can possibly save money.

      1. I pay $200/paycheck for my health insurance for a whopping $5200 total for my family of four.

        The company pays 95% of *my* premium, so add that back into my portion and you have another $1680 tacked on for a total of $6880 per year.

        That’s for a $2k deductible, $4k OoP max and high copays.

        The maternity coverage kicks ass, but the rest of it sucks.

        So I guess, technically, the CBO says the government plan would “save” me money on the premium end. I sincerely doubt it would save me in any other way.

  7. Congress has circle jerks?

    Congress IS a circle jerk. In fact, all of politics is a circle jerk.

  8. If only Keith Morris were in Congress.

  9. That means industry pushback

    Why did the perfectly good “resistance” become the overused “pushback”?
    It’s like a virus. Every pundit says it now. Worse than “at the end of the day…”

    1. Those have different connotations. Resistance can mean either passive or at most passive-agressive refusal to cooperate. Pushback is only used for “active” resistance.

      If you don’t like having five words that mean roughly the same thing, English isn’t for you. Maybe you should take up Newspeak.

      1. Bull. How does one resist something “passively”?

        1. There was an obscure fellow named Gandhi who had some ideas about that.

          1. Yeah, I remember him. He’s the guy who taught the world that you can stab somebody in the back “non-violently”.

            Great SOB. Why half the planet deifies that destructive prick I’ll never understand.

  10. Episiarch, that would be wonderful, especially when the shit hits the fan.

    1. By looking placidly at the smug twit who wants you to do something and blandly saying “No.”?

      It has a very different feel that, say, punching them in the face, ro even explaining how you’re getting together a Committee to Unelect the Twit.

      1. I suspect Eddy Mologist would have a problem with the psychoanalytic concept “passive-aggressive.”

  11. I’m happy with a colossal failure to enact anything. Although afterwards, I think we the people should sue to get part of their salaries back in recompense of them not doing a damn thing that is helpful to us. Oh wait, we can’t. They’re in charge of their own compensation.

    Have I mentioned lately that, no matter what they accomplish, we’re screwed? It’s just the degree that is in question.

  12. I hate “at the end of the day” slightly more than I hate “on the ground”

    1. Don’t get me started on “going forward”. You’re talking about time. What other fucking direction are you going to go in?

      1. You seem to be backtracking.

        1. I see it as one step backwards.

          1. We need to be going onward and upward.

            1. Stay the course!

              1. This thread is in a quagmire.

            2. and always twirling, twirling, twirling towards freedom.

              1. That does it. I’m pushing myself under the bus.

                1. Don’t put the cart before the horse.

                  1. No matter where you go, there you are.

                    1. Take her to the pit. Use more honey. Find out what she knows.

    2. Boondoggle!

      1. I have a lot on my plate today. I can slice it and dice it any number of ways.

  13. I predict: if health care reform dies, Dems become invincible through the 2012 elections. Our collective schizophrenia is gonna stick at stupid for awhile.

  14. I predict that if it does pass, no one crying out that it be passed will actually shut up about heath care until we have the shittiest single-payer possible.

  15. Please please please be right, Michael Cannon.

  16. There is plenty of time for them to screw up more, and piss off more voters to get many of them out of office in 2010 and 2012.

    It seems to me that enemies of the democrats will be best served, politically, by health care reform failure. Many moderates have already realized Obama isn’t what they thought and, many on the left are angry at his ineffectiveness. A lefty in my office came up to me Friday and said we agree on something, Obama sucks.

    1. It will depend on when the Dems let the health care bill die. Timing will be important in their ability to spin this onto republicans. If it fails and the economy does the expected second drop, the Reps will be in deep dookie as the Dems blame the economy on the failure of health care reform (as Obama predicted).

      1. 1. Economy stays in the tank
        2. Health care stays the same
        3. ?
        4. A democratic victory.


        1. The media has been reporting that the economy is on the mend. Knowledgable people don’t believe it and think it will drop some mmore before it gets better. Obama said if health care reform fails it will hurt the economy. If reform fails as the economy dips, Obama will be “proved” right and the Dems will reap the rewards on election day because Republicans will get blamed yet again.

          1. It’s hard to make that plausible.
            Anyway, my hope is that the heath care debate will drag on and on, suckign the air out of both cap-and-trade and the financial regulation/institutionalized-favoritism plans. Before finally dying.

            1. Would you have thought Obama’s election plausible 2 years ago? I am merely predicting a possible outcome that depends on the dems timing and the media’s willingness to spin it.

    2. It seems to me that enemies of the democrats will be best served, politically, by health care reform failure.

      Though true, Obama will be the president until at least 2012. I would prefer to see Obama wise up, expel Rahm and his ilk from the staff, and become a Clintonesque free market reformer than to live through another miserable Carter administration.

      I’m not exactly waiting around in a heavy coat, mitts and an ushanka down in Hell for that to happen.

  17. Dems will respond to this with exposures of the “obscene profits and salaries” at insurance companies and calls for an end to their subsidies.

    1. Insurance companies get subsidies?

  18. I hate “at the end of the day” slightly more than I hate “on the ground”

    “Double down” recently moved to the top of my hate chart.

    1. That said, there’s “that said.”

  19. I hate “at the end of the day” slightly more than I hate “on the ground”

    “Double down” recently moved to the top of my hate chart.

    I never used to hear the phrase “going forward,” but now it’s fucking EVERYWHERE.

    1. Where does this crap come from? Did past ages have such tripe? I don’t think they did. And I think the fact that we have such crap is an indication in how poorly educated journalists are now.

      1. But will it resonate with the grassroots?

      2. Memes catch on much faster now due to communication at the speed of light. The only reason medieval Anglo-Saxon pedants weren’t complaining about how “going to” was replacing “will” as an indicator of future tense is because language changed so much more slowly.

        1. It actually used to change more rapidly… and because it did, there were a lot more colorful, spur-of-the-moment expressions. Now as soon as someone says something mildly original, it only takes about a day before it’s being widely used by English-language journalists all over the globe, who cling to it LONG after it ceases to be meaningful.

          That’s how I see it.

          1. That’s a good point. Ease of communication allows new ideas and expressions to spread faster, but it also causes things to be standardized much faster, which inhibits the next generation of new ideas.

            I mean, my brief existence has seen formerly good, useful words like “issues” and “special” completely change in meaning due to the abuse of euphemists. Benchmarking the pace of language evolution would reveal that it’s still pretty impactful.

  20. I think there is a good chance that Obama won’t get renominated in 2012. Healthcare is going to fail. He is going to get us more deeply involved in Afghanistan. Unemployment is going get to and stay above 10%. The dollar is going to crash. The Dems are going to get destroyed in the 2010 election. When that happens, the Left and the media will blame Obama for being ineffective and turn on him. He will leave office more unpopular than Bush.

    1. I agree. I just hope that the country as we know it can survive until then.

      There are times when I kind of wish that we had a British or Israeli style parliamentary system. I think that if we could have a do-over of the election, there’s a pretty decent chance that Obama would lose right now.

      1. I’d just as soon the country didn’t survive “as we know it”. The system is rotten to its marrow and it gets more rotten with each passing year. I can’t disagree with the great George Carlin when he said this country is finished. It’s just like liberties – once you lose them, they are gone for forever. With each incremental step toward stupidity, the country becomes permanently more stupid.

        1. I’d agree if it weren’t for the the simple fact that whatever comes next is most probably going to be worse than what we have now.

          Consider the number and magnitude of stupid ideas that fill the heads of our “intelligentsia” today.

          Are you sure this is the time you want to hit the reset button?

    2. When the dollar crashes/ people stop lending the federal government money, I don’t think the D’s will turn on Obama.

      As the Federal government starts choosing which promises to break (should the constitution survive) there will be a huge socialist/capitalist liberal/conservative scrum, and I’m not confident that free market ideas will prevail.

      1. If the dollar really crashed and the government couldn’t borrow, it would be armageddon. Somebody would have to take the blame. And that somebody won’t be any former Presidents. It will be this President. Once it looks like Obama is hurting the cause, the Left will turn on him. I just hope they don’t kill him.

        1. I hope like hell you’re wrong, and that people see that the government has been making expensive promises (SS, Medicare, Medicaid, the notion that the goverment can reduce the chance of being harmed by a terrorist to zero) that it had no right to make.

          Aw, hell, you’re right. Armegeddon.

        2. I just hope they don’t kill him.

          Thou dost protest too much…

          1. I am sincere. He is worth more dead to them than alive. Alive he is the slow kid who can’t speak without a telepromter and keeps annoying every one. Dead, he is a martyr and the way for every boomer liberal to re-live Camelot and their youth. The worst thing that could ever happen to this country would be for some nut to kill Obama.

            1. Personally, I think the Yellowstone supervolcano erupting would be worse.

    3. John, this is wishful thinking. People really like Obama. They may disagree with him, but they like him. It will take losing a major war, continued double digit unemployment, and either double digit inflation or serious deflation for 2012 to be even close.

      1. Let’s see

        Losing a major war got that (Afghanistan)

        Continued double digit unemployment, even Obama’s people beleive that unemployment will remain over 10% into 2011.

        Inflation, the dollar is tanking and the price of oil, gold and other commodities in dollars is skyrocketing. Last I checked currency devaluation is another name for inflation.

        I can’t see where we disagree Stuart.

        1. I hope you are wrong. Not out of any love for Obama, but things will need to be pretty bad for him to lose.

          People like him, he looks presidental, and voting for him shows that the voter is a good person.

          1. By the way, I dreamed that I was at a karaoke contest and some dweeby guy was singing a Rundgren-esque “Hello, it’s me.” Not a bad rendition, actually. But why would I dream this and why would I, even worse, REMEMBER it? Could your Obama dream and my karaoke dream possibly be related?

        2. Inflation, the dollar is tanking and the price of oil, gold and other commodities in dollars is skyrocketing.

          Rule #1 of investing/speculating/gambling:
          Past Performance Is No Guaranty of Future Results.

    4. This is what you wrote down on that pad you keep next to your nightstand to record your dreams???

    5. It’s really too bad Hillary Clinton probably won’t have the balls to take on Obama for the nomination again. I really suspect she’d beat him, not least of all because Dems would love to pat themselves on the back for nominating the first woman and the first black man, but I imagine the thought of going through that same primary battle again.

      And when I say “it’s too bad,” I mean it’s too bad for her, not for the rest of us.

  21. John, does the incumbent ever not get the nomination? Without turning it down? ( I’m somewhat ignorant of election history and too poor to subscribe to google)

    1. didn’t Dead Kennedy beat Carter for the nom in 1980? or am i just retarded this afternoon?

      1. Nope. He lost but ran all the way to the convention even though he couldn’t win. He was cheered by the media for it to. This in great contrast to the shallacking Hillary Clinton took for not giving up against The Obama.

    2. This hasn’t happened in the era of primaries and caucuses determining the nominees (it did happen back when party bosses made the decision in a back room).

      But that’s probably because the presidents who knew they were going to lose the nomination withdrew before it happened to avoid the embarrassment.

  22. bb, in 1976, Reagan made a charge to take the nomination away from Ford that was only narrowly defeated.

  23. Ben,

    I can think of two instances, in 1952 Truman decied not to run because it was pretty clear he wasn’t going to get the nomination. Then in 1968, Johnson lost a primary to Eugene McCarthy and pulled out of the race. Those are the only two examples I can think of, but there may be others back in the 19th Century. It has happened though and both times that I can think of during bad economic times in the midst of a foreign war.

  24. At the end of the day, unless Congress doubles down on game-changing legislation, the pushback on the ground will prevent impactful synergies to upgrade our healthcare system from going forward proactively.

    Its the conventional wisdom.

    1. Stop it RC! You’re enabling their dsyfunctionality by laying the groundwork for their blame shifting.

      They’ll be coming out of the woodwork, with their noses to the grindstone for this Cinderella story.

    2. That said, it’s all the usual beltway b.s.

  25. R C Dean, you forgot to mention “teabaggers.”

  26. “But universal coverage is so expensive that Congress can’t get there without taxing Democrats”

    One of my favorite jabs at Dems is:

    “Republicans want to pay less taxes. Democrats want Republicans to pay more taxes.”

    They get pretty shitty when I say this:)

  27. Actually RC, that is “warmed over conventional beltway wisdom”.

  28. Its the conventional wisdom.

    Exactly why we need out-of-the-box thinking.

  29. rhofulster, one of my faves is:

    Republicans want to work for a living. Democrats want to vote for one.

    1. That is a good one.

    2. I’m going to appropriate that:)

    3. I always use this to piss of Democrats:

      If Democrats are the party of the poor, why would they want there to be FEWER poor people?

      Oooh, that gets em pissed!

  30. paradigm
    quantum leap
    think outside the box

    Libraries are still stuck in the mid-90s lingo-wise.

    1. Sounds ripe territory for a Mike Judge treatment.

    2. paradigm — Kuhn used it to describe maybe 5 major worldviews in science, now it applies to changes in how companies distribute pencils.

      quantum leap — a really tiny change, moderated typically by a single photon, used to describe a major change.

      think outside the box — I don’t like your answer, think outside of the box (where box=reality)

      1. I think the box has a dead cat in it.

        1. Damn you Tagliaferro! You fixed the result!

          Now I have to send Pavlov’s dog in to find it.

          1. Pavlaov’s dog? That story rings a bell for some reason?

            1. Stop! I just drooled all over my keyboard!

              1. You don’t want to know what that caused me to do on my keyboard!

      2. quantum leap — a really tiny change, moderated typically by a single photon, used to describe a major change.

        ::physics sigh::

        Quantum leaps may or may not be small. The thing about them that is interesting—the thing that makes them special—is that they are discrete in a otherwise continuous world.[1]

        No middle ground is admitted.

        ‘Course, your right that it is never actually used that way in lay speech.

        [1] Even many quantum mechanical phenomena are continuous. See, for instance, the propagation of a free particle.

        1. Yes they are discrete, but the steps are tiny. How much energy does it take to knock an electron from the lowest shell out of an atom? You can’t heat much water with that.

  31. I heard “double down” used so many times in the clips on reason.tv that I think I began to convulse involuntarily at each mention.

    1. Double Down doesn’t even use the gambling term appropriately. The midia uses it to say that someone is going all in on what, at least now appears to be a bad bet. As in “we are losing in Afghanistan but obama hopes to change it by doubling down”. You double down in blackjack when you have a good hand (a ten or an eleven).

      1. I thought you get to double down when you have a pair in black jack?

        1. No you split then. Spliting is where you take a pair and turn it into two hands. You do that when you have say two aces, which is a terrible 12/2 hand together, but seperately can give you two blackjacks.

          The most likly card to get in black jack is some variation of a ten. So, if you have two cards delt to you that add up to 10 or 11, you have a good chance to get 20 or 21. So the odds are in your favor, escpially if the dealer is showing a crap card like a six or a four. In that case you “double down” by doubling your bet on this one hand. The only catch is that you can only hit once on the hand.

          Todays gambling lesson is brought to you by the Degenerate Gamblers of America.

          1. I’ve suspected for some time now that you, John, are a member.

            1. Nah, my wife runs accounting and has made me reform my ways. Much to my consternation.

          2. To clarify – you can get a 21 on a split, but not a blackjack (they’re not going to pay you 3:2 on a 10 card over a split ace).

            1. That is true. You won’t get the 3:2 odds and if the dealer hits 21 you push rather than win.

        2. Only when you’re a canary in the coal mine.

  32. “You don’t worry about [blank]. You let me worry about [blank].”


    “[Blank]? [Blank]?!? You’re not looking at the big picture!”

    1. Scruffy votes his 40,000 shares for the mysterious stranger.

  33. You know something, man, I know something that you don’t know. That’s right, jack. The man is clear in his mind, but his soul is mad. Oh yeah. He’s dying, I think. He hates all this, he hates it! But … the man’s … uh … he reads poetry out loud, alright? … And a voice! A voice. … He likes you because you’re still alive. He’s got plans for you. Nah, nah, I’m not going to help you, you’re going to help him, man. You’re going to help him. I mean, what are they going to say, man, when he’s gone, huh? Because he dies, when it dies, man, when it dies, he dies. What are they going to say about him? What, are they going to say, he was a kind man, he was a wise man, he had plans, he had wisdom? Bullsh-t, man! Am I going to be the one, that’s going to set them straight? Look at me: wrong! … You!”

  34. Can Democrats take positive steps to accomodate a diversity of media asset reintermediation units through problem escalation flows toward the high-impact critical success factors on key issues they need to provide the framework for a robust dynamic butterfly market transformation in the health care business space to create new rings in the value chain going forward?

    The country waits.

    1. Only if they achieve certain synergies between the industry and political units involved in the forward-looking actions.

  35. Healthcare reform is never doomed. No matter how many Presidents fail it, be it Bill Clinton, Barack Obama, Hillary Clinton, there will be an endless stream of politicians who think that this time they can do it.

    Remember, when they’re pillorying you for your own good, they’ll never stop.

  36. OK, Sugarfree and John:

    At the end of the day, Congress must think outside the box to create a paradigm shift by doubling down on game-changing legislation to create impactful synergies going forward to proactively enable a quantum leap in our healthcare system.

    The inside-the-beltway silverbacks want to shift blame for push back on the ground to the astroturf teabaggers in flyover country running interference for vested interests.

    1. Careful RC, the AP may slap you with a copyright claim suit for encroaching on their formula. That reads like every other story.

    2. RC,

      You need to send that into the WAPO, how could you not win their pundit contest with that?

    3. That’s only because we’re the only country in the industrialized world without one and our market failure.

    4. EXTERNALITIES!!!!!!!!!!11!

    5. That said, the ultimate ramifications of ongoing developments remain to be seen.

  37. Oh shit. Our health care system is about to be Snowed under, as Snowe says she’s going to vote for the latest effort.

    1. The way those two senators from Maine keep claiming to be Republicans you’d think it was still 1936.

  38. If “Reform” implies a change for the better then no matter what this gang of clowns passes Health-Care Reform is indeed Doomed.

    Of course to speak of “Reform” suggests that someone can actually identify what, if anything, is wrong and can come up with something to fix whatever that is.

  39. HaHa
    I knew Snowe would crack. Social engineering is in her blood.

  40. With a single Republican vote, this will now be lauded as a bipartisan bill, opposed only by extremists.

    1. The news story I just read about Snowe’s decision referred to it as a bi-partisan effort. The question is how hard will the media work to give this traction. I am curious how much Snowe was influenced by her constituents. I wonder if other R’s will feel a similar urge now that one has broken ranks?

      1. how hard will the media work to give this traction?

        I don’t know, but the staff at MSNBC just creamed their jeans.

  41. I can’t imagine how any other republican could consider Snowe as cover to vote against the party line. She needs to just defect and get it over with.

  42. We’re up shit crick without a leg to stand on.

  43. You know an expression we ‘let go by the wayside’ that we really should have retained? Mugwump.

    You know, a fence-sitter. Got his mug on one side and his wump on the other.

    Too bad that one lost currency about 120 years ago or so.

    1. Good one, Jonas. I never knew what mugwump meant. Now that I do, I love it.

    2. What about carpetbagger or scalawag?

      1. What about Know-Nothing?

  44. “Know-Nothing” is not exactly a characterization which distinguishes one Congressidiot from another; we need teams, dammit.

  45. a single person earning $26,500 would pay $2,300 for health insurance, but if his income rises to $32,400, his premium rises to $3,700. This yields an implicit marginal rate rate of 24 percent.

    You get somewhat different numbers at other income levels. Typically, however, the implicit marginal tax rates are around 20 percent. Those figures for marginal tax rates are, of course, added on top of those already imposed by existing income and payroll taxes,http://artmarketer.blogspot.com/

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