Obamacare

Democrats Claim Leaked Health Care Messaging Memo Is A Hoax

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Earlier today, Politico posted a leaked Democratic messaging memo, since removed, that seems to admit what I've noted previously: that Democrats plan to pass a "doc fix" (an expensive, unfunded change in doctors' Medicare reimbursements) later in the year, that the fix will wipe out reform's alleged deficit reductions, that the deal is being used to buy doctor support, and that party members and staffers are under orders not talk about this because it would undercut their message that health reform is fiscally responsible.

If Democrats were actually caught admitting all of this, it would likely be pretty damaging. Democrats, however, are claiming the memo is a GOP hoax.

I can't verify whether or not it's a genuine Democratic memo, but the fact that neither the Politico item nor the memo itself identify an author or source is somewhat suspicious. Politico is attempting to verify the veracity of the document now, but I wouldn't be surprised if it's never confirmed either way—or if it is, but not until long after the larger legislative debate is settled.

Update: Post has been edited for clarification.

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  1. They have to do the Doc fix. If they don’t all Medicare docs will leave the business — they’re leaving no in droves and this will exacerbate the cost side when demand (further) exceeds supply.

    Supply and Demand, it’s the Law.

    1. You are assuming the supporters of Obamacare actually give a damn about the elderly. They do not. All they care about is power. That is what it is about. They do not care about supply and demand. They do not care about people having access to medical care. They do not care about the elderly or the poor. They care about power and nothing more.

      1. Accepting your assertion, what would someone who cared about keeping power do? Piss off a large, well-organized voting block? Or pass on an unfunded liability to people who are not yet born and therefore can’t vote?

        1. Many of the have been born and some have reached voting age. They (18-30 yr. olds) voted overwhelmingly for Obama.

          Oh to be young, idealistic and foolishly gullible again. *sigh*

        2. Repealing an entitlement is much more difficult than passing it. If it ever becomes law they will have yet one more goody to hold over the sheeple.

          1. Reading all this, neither can i! I really do not think I can guess whether it was a new hoax or not! However I do agree with your suspicion that the politico item as well as the memo does not recognize the author as well as the source and that is certainly something which someone can place their bet upon as a hoax. We anyway can come to a conclusion that this issue is seriously going to threaten the Democrats!

      2. PIRS has looked into the supporter’s souls like Bush did Putin.

        1. PIRS has looked into the supporter’s souls

          All it takes is the briefest of glances at what they are doing to know exactly what is in their souls.

          1. Sorry, that is nuts. Their actions can be explained by a host of motives, none of which you can prove.

            1. Ever hear of Occam’s Razor?

              1. Yes, though I don’t remember hearing about how it applied to this.

                1. OK, so I have to point out how hilarious it is to point to Occam’s Razor here. The simplest explanation of the supporters of Obamacare are the ones they state are their motivations. It explains their behavior and is simpler in that you don’t have to suppose hidden agendas you cannot ever prove.

                  So we both have heard of Occam’s Razor. But only one of us understands the concept.

                  A little bit of knowledge (having heard of Occam’s Razor but not grasping it) is worse than none at all (never hearing of it) it seems.

                  1. “It explains their behavior and is simpler in that you don’t have to suppose hidden agendas you cannot ever prove.”

                    No, it does NOT explain their behavior at all. Why all the deal making? Why have meetings behind closed doors? If everything was on the up and up why would you not have a clean bill that had no deals and was available to everyone who wanted to read it from the begining?

                    1. I think the simpler explanation is a history making speaker of the house (first woman to hold the post), a history making President, (first black man, or close to it), wants to pass historic legislation.

                      They want a legacy to attach to the history they’ve made. As the first, they feel they have something to prove.

                    2. If they weren’t schmucks they would realize the the way to make a legacy is finding a way to cut the 12 Trillion dollar debt not use vodoo math to justify a multi-billion dollar entitlement program.

        2. No one with a decent soul would threaten to throw someone into a cage for NOT buying heatlth insurance.

        3. MNG has looked into world history like Stevie Wonder hits bullseyes.

      3. I wonder what opponents of health care give a damn about. Do they have some sort of fetish for vastly overpaying for an inferior product, risk taking for no benefit, and ensuring that millions of people suffer?

        1. I have a fetish for “solutions” that don’t suck worse than the problem they are trying to solve.

          It would also be nice if the proposed solution empowered patients and doctors (the essential part of the healthcare system), rather than politicians, lawyers, bureaucrats, union leaders, large businesses, pill pushers, and insurance companies (the peripheral players who fucked the system up in the first place).

          1. How are people going to be any less “empowered” than they are now? It won’t change which doctors you can see when.

            Of course, our vaunted system is actually very poor at this measure. Only in America do you find “networks” that create all sorts of hassles.

            1. Do you know what a mandate is? That’s how.

              1. You mean people won’t be able to avoid buying insurance until they get sick? Oh, cry me a river. No one should have that “power” in the first place.

        2. Do you honestly believe this is going to fix any of that?

          1. Yes, actually. The bill eliminates some of the worst risks that make our health care so inferior (the fact that you can lose it when you most need it!). And of course, it will eliminate most cases of people being uninsured.

            1. “””The bill eliminates some of the worst risks that make our health care so inferior (the fact that you can lose it when you most need it!). “””

              Inferior is not a word I would use to describe our health care. It’s the best in the world and if you really need it, you don’t lose it. A hospital is required to treat you regardless of payment. That has it’s own problems of course.

              Our health care has some issues but it’s not in such a bad condition that it needs the major overhaul they are proposing. It needs small fixes over time.

              1. The only people who think our health care system is “the best in the world” have their heads so far up Rush Limbaugh’s heiney that….errr, I’ll let you use your imagination.

                You don’t lose it, eh?

                http://www.nytimes.com//2010/03/21/opinion/21kristof.html

                Our system is terrible at prevention, our wait times are mediocre, the chances that you will get screwed by your insurance company is extreme and our prices are horrendous. However, IF you have good insurance AND you managed not to get @#$##ed by your insurance company AND you live in a decent neighborhood, you get “sick care” that is on par with other rich nations.

                How does this make us #1?

                1. You’re #1 at being a spoiled brat.

            2. You’re like a little child.

        3. I care about my government telling me that I have to buy a product from a private company OR ELSE.

          I think most sane people, those who are actually paying for this monstrosity (and not those who are already free-loading) feel about the same.

  2. Peter:

    Do you doubt for one moment that scheduled Medicare cuts will not take place?

    1. No, I don’t. I’ve noted this many times previously. What I don’t know, though, is whether or not the memo is real. Edited the post to clarify this.

  3. Regardless of whether the memo is a forgery, it is still true that passing the doc fix without other cuts would wipe out all of the alleged savings in the health reform bill.

  4. doctors will always take medicaid and medicare. They really have little choice in a poor economy.

    1. Wrong, Mr. Herring. Many doctors don’t take Medicaid now, and many more will eliminate or limit their Medicaid practices under this bill, as it will increase the number of Medicaid patients and force the states to cut reimbursement rates.

      1. If you lose $$ per Medicaid patient, this being a bad economy won’t lead you to take them.

        1. I know physicians who take medicaid and medicare for altruistic reasons and some who jump in when the economy slows and they have less patients. This phenomenon is typical in the ob field.

          1. You might want to check with Walgreen.

            1. My plan just dropped all medicaid in the upstate NY region. But I suppose docs might just bill the state directly.

            2. CVS and Rite Aid have an excellent business opportunity but the likelihood is that they are heading in the direction of Blockbuster. Wal-mart and Costco will take over most of the market share.

              1. Sure, if only CVS and Rite Aid like operating at a loss too.

                1. Rite Aid will survive…it sells booze!!!

    2. I spoke with my doctor about this. He’s got some colleagues who are already going to a cash-only business, with no Medicare or Medicaid patients. And no HMOs, either.

      1. A shockingly high percentage of the best doctors in NYC do this already. By “best” I mean doctors who are on lists in magazines etc.

        1. This kind of stuff I don’t buy. There will be plenty of doctors willing to take the government money stuff.

          Funny they said the same kind of thing about student loans. Banks used to bitch that they were such a hassle because of conditions, they barely made any money from them, don’t push us or we will drop these things we don’t like them as it is, yada, yada, yada.

          And then when the government started to administer them directly those same banks howled like forlorn wolves on a cold, winter night…

          1. This kind of stuff I don’t buy. There will be plenty of doctors willing to take the government money stuff.

            Wrong again, MNG, at least for Medicaid. In many, many places, there is already a major problem getting access for Medicaid patients. Growing the Medicaid rolls while cutting reimbursement will make the problem worse.

            1. Yes, there is a problem: overpaid doctors make more money gaming the private system than they make with Medicaid.

              Boo bleeping hoo.

              As I have shown many times around here, doctors are overpaid relative to other professionals and their international peers.

              1. And why are they overpaid? Could it be licensing mandated by government allowing a small group to control the number of doctors?

                I know more than one person has made that case rather convincingly here. Anecdotally one of my in-laws is a physician and he seems to agree.

                1. Yes, it is largely because of government-mandated restrictions on the number of doctors. Did I ever claim otherwise?

                  The problem is not licensing, but that the AMA restricts the number of people who can obtain licenses, and this has the weight of law.

                  1. Which points to one solution–some deregulation of the medical profession.

                    1. Like tort reform, this problem is only a tiny fraction of the whole. The real problem is adverse selection, which makes the individual market for health insurance utterly disfunctional. Fortunately, few of us have to deal with it. Unfortunately, this implies that few know how FUBAR’d it is, and why we need to have better regulations to address its problems.

                    2. Unfortunately, we live in a democracy, so the regulations would (in the ideal case, where the people or their representatives make rules in good faith) emerge from a group of people that don’t even know that the system is messed up in the first place, much less in what ways or how to fix it without creating more problems.

                      In the more realistic scenario, the regulations are passed with the guidance of people who are knowledgeable about the industry – i.e., people who have a vested interest in maintaining the FUBAR’d aspects of the system, but who think they could gain even more advantage with a few extra regulations.

                    3. Actually, the technical details of the legislation should arise out of public health researchers and economists based on real data, commented on by the public (including “special interests”) and be ultimately be chosen by elected representatives. That’s sort of what we have now, except that Republicans like to skip step one and let the lobbiests in step two do the writing.

              2. Chad, I hope you get a brain tumor and have to settle for a surgeon who lives in a studio apartment.

    3. Not if they have to treat the patients at a loss, or at wages too low to be worth their time. My wife already refuses to take several low-paying forms of government insurance.

  5. Its truthy, no doubt about it. Props to Politico for pulling it pending verification.

    That said, the memo (from whatever source) just acknowledges the obvious. Of course the Dems don’t want to talk about the details of the CBO memo. Of course the Dems have to remove the doc fix to keep it under a trillion. This is hardly news.

  6. neither the Politico item nor the memo itself identify an author or source is somewhat suspicious.

    This is undoubtedly the work of some evil, faceless corporation.

    I blame SCOTUS.

    1. An evil, faceless political or labor corporation.

  7. Seriously? They’re making us choose between which party is less trustworthy?

    That’s just dirty pool.

  8. but the fact that neither the Politico item nor the memo itself identify an author or source is somewhat suspicious.

    Why? If a Dem leaked it, would he or she want his or her name attached to it?

    1. No, but you would to say it came from Democratic leadership, or a Democratic committee, or a Democratic consulting firm, or a House Democratic office, or even just “Democratic sources” or, well, something that indicates the type of person, if not the exact individual, who wrote it.

  9. That was the first line of defense during ClimateGate also.

  10. We all know it’s true whether the memo is legitimate or not. But it kind of strikes me as similar to the whole ‘birther’ thing. Obama’s policies are so misguided that nobody should’ve voted him whether he’s technically qualified for the post or not. What the democrats say right out in the open (on the health insurance issue) is bad enough. There’s really no need for any secret conspiracy.

    1. Oh, and I should point out that I’m not criticizing Mr. Suderman for posting this; it seems like a newsworthy story to me. I’m criticizing anyone whose position on the issue would be changed by the existence of the memo.

      1. Thanks for making the point that I wanted to make. Now I don’t have to go through the trouble of trying to communicate with other humans.

  11. If it’s a hoax, it’s the best kind of hoax: completely believable.

  12. The memo is fake but accurate.

  13. Why would the GOP put out a fake memo during the weekend news black hole? I’d have done it Monday.

    1. Monday is too late; Bela Pelosi has already decided that this sucker is getting through by hook or by crook on Sunday.

      1. I meant the most recent Monday, not next Monday.

    2. The vote is slated for Sunday.

  14. Occam’s razor. Which is the simplist explination that Republicans risked their credibility faking a memo and did it well enough to fool Politico (a pretty nonpartisan website) or that the thing is real and the Democrats are denying it for damage control? Make Bohner and company are running a black ops, but that seems unlikely. How would they expect that to work? It would be revealed as a fake pretty quickly and just make things worse. That doesn’t make any sense. What does is that the memo is real and the Democrats are denying to muddy the water.

    1. Who could have seen that John would assume the facts are in line with his partisan proclivities? The funniest line in his post is ” that Republicans risked their credibility “. That’s a hoot.

      1. And who is on here muddying the water assuming it is a fake? None other than our favorite DNC hack. What a surprise. Again, you stay on those evil Republicans just like you did back when you were telling us how they were wiping their asses with the Constitution trying to end the filibuster. You go MNG.

        1. Ah, poor, predictable John.

          Please provide any evidence where I said the document is a fake.

          1. Since I did not assume it was a fake you can cue John in about two more minutes (spent combing this thread and not finding what he assumed) to come on here and move the goalposts.

            “Well MNG you might not have said it was a fake but you were nonetheless muddying the waters [which simly means pointing out that without confirming evidence either way assuming anything about the document is damned stupid].”

      2. “Laugh while you can monkey boy.”

        The recent three elections showed that the Republicans have more credibility than the Democrats now.

        1. Man, I love that quote.

  15. “This is an unethical underhanded dirty trick by Republicans to try and distract from important debate on health care reform,” the senior Democratic leadership aide said.

    Of course it is; and trotting out small children to recite woeful anecdotes is nothing but honorable.

    1. Seriously, does anyone believe the Republicans in Congress are competant enough to come up with such a believable fake? And even if they were, what do they gain by the fake? If there is no way to verify it, and there by definition wouldn’t be if it were a fake, how does releasing it via a legitimate news source accomplish anything?

      1. “what do they gain by the fake”

        Er, giving red meat to partisan rubes like you who will trumpet this on blogs all over the nation to try to discredit their opponents?

        Oh and look, it’s already working!

        1. But if it is a fake it will be quickly established that it is a fake and it will make things worse for them.

          But you may have a point. You were all over the Republicans back when they were trying to get rid of the filibuster and wiping their asses with the Constitution as you said. So, it is no surprise you are all over this one.

          1. “But if it is a fake it will be quickly established that it is a fake and it will make things worse for them.”

            Nah, there are plenty of rubes in their base, such as yourself, who will never acknowledge it as a fake.

            1. There are plenty of rubes who will never believe those East Anglia emails are fakes, either.

              Oh wait, they’re real. They just don’t matter…

        2. So, MNG, do you deny that the doc fix is going to be passed later this year?

      2. Intention matters to some people, especially people on the fence.

        It’s the difference between
        1) going to into a confessional and swearing passionately and sincerely that you’ll never murder another stripper, and then being good for a while, and then accidentally running into a hot stripper and things get out of hand and you black out and… what’s all this blood? where am I? oh god, I’ve got to hide the body under the mattress…

        and

        2) telling the parole board “yes sirs, I have learned my lesson and accepted Jesus in my heart and I will walk the straight and narrow and never murder another stripper again, now may I please go free”, with your fingers crossed behind your back and a list of strip clubs in your pocket.

        1. 1) going to into a confessional and swearing passionately and sincerely that you’ll never murder another stripper, and then being good for a while, and then accidentally running into a hot stripper and things get out of hand and you black out and… what’s all this blood? where am I? oh god, I’ve got to hide the body under the mattress…

          Actually, getting rid of the body on a Guy Fawkes bonfire might work better….

    2. Yeah, I never really got pissed about this whole debate until that point. I guess I should’ve seen it coming.

  16. Update from HotAir.com
    Update (Ed): When Politico went live with this article, I had confirmed with two people I know on the Hill that they had seen this being passed around. Did it come from Democrats, or from Republicans? I can’t answer that, but I did confirm with two sources that it exists.

  17. I know physicians who take medicaid and medicare for altruistic reasons

    and they shift the cost onto people with more money and/or better insurance.

    When everybody’s insurance coverage has been equalized, where will the costs be shifted?

    1. Illegal aliens, the Chinese, millionaire wife swappers, hoarders, speculators, sex offenders, smokers, drug users, fat people, and all other enemies of the people.

      1. Can I swap for a millionaire wife?

    2. Those doctors must have an awful lot of market power if they’re able to shift costs like that. Wouldn’t other doctors be able to undercut them by simply not taking the medicare/medicaid patients?

      1. That’s what’s been happening.

        1. What’s been happening? Cost shifting? How do you know? Basic economics would tell you that a seller in a competitive market can’t shift costs. Unless you’re saying that the provider market isn’t competitive, which would undercut the argument for more private insurance.

          1. Doctors leaving Medicaid. See various posts above.

            1. Oh ok. I believe that. What I don’t believe is that a provider with no market power can cost-shift from medicaid patients to privately insured patients. The rational thing for a provider with no market power to do when faced with below market medicaid rates is to not accept medicaid patients.

          2. Easy, you upcode a few doctors visits here and there, you do a few extra tests, schedule an extra follow-up that probably isn’t necessary… There are a million ways that doctors chisel away at insurance companies, and nearly as many ways for the insurance companies to chisel back. This happens on both sides with each screaming “fraud” and “breach of contract” back and forth at each other.

      2. It wouldn’t matter since most people don’t directly pay for their doctors. You just pay your insurance co-pay. Whatever the cost is above the co-pay is your insurance company’s problem. As a result, charging less by not taking medicare patients doesn’t bring you any business since your customers don’t see the savings.

        1. Your insurance company would see the savings. Surely they are going to stand for cost-shifting when they set up their provider networks and negotiate provider rates.

          1. aren’t going to stand, that is

            1. WE try…but the hospitals and physician practices are large and have a great deal of negotiating pwer. Additionally, they play the insurance companies are bad-guys thing to the hilt. I’ve seen negotiations carried out in local newspapers and those papers employ people with a worldview not too different from Tony. Do you think the insurers get a fair hearing?

              By the way, you are just referencing the unit cost negotiations. You aren’t dealing with the upcoding, churning, etc. There are plenty of ways to get more from an insurance company even if you sign on to a low rate increase.

          2. The insurance companies pass the cost back to you. People will pay more to have access to more doctors. Look at any insurance plan and the higher the cost of the insurance, the more doctors take it and the more choice you have.

            1. So you’re saying that people and employers don’t shop for insurance based on price?

              1. But price isn’t the only factor. My insurance has different price levels. And one of the things the higher priced insurance gets you is access to more doctors. The insurance companies pass the higher costs onto the insured in the form of higher premiums to be on plans to see those doctors. People are willing to pay higher prices to have more choice.

                1. Ok, I understand that. How does this mean that cost-shifting can happen in a competitive provider and insurance market?

                  1. If we had a free market in health care you would be right. Since we dont, lots of things dont work correctly.

        2. Well the fact is Insurance companies only pay every doctor a certain amount for each procedure, so its not about jacking the price up, its irrelevant. It’s all about doing more services per insured patient to squeeze as much cash as possible out of the insurer.

      3. It doesn’t work like that, adam. Most private pay is from third party payers, who generally offer take-it-or-leave-it rates.

        Medicaid doesn’t cover costs. Here in Texas, Medicaid pays around, say, 30% of costs. Lots of doctors don’t take it. If you take Medicaid, its because you are either altruistic, or work for a nonprofit so taking it doesn’t hurt your income.

        1. It doesn’t work like what? Private insurance companies set up networks. They pay different rates to different providers in those networks based on negotiations. Some providers form groups to do the negotiation, but it isn’t take it or leave.

          The only credible way that providers could cost shift is if they have enormous market power.

          1. the short answer is fraud – see my reply above. god I hate threaded comments.

          2. The only credible way that providers could cost shift is if they have enormous market power.

            adam, you are positing massive and pervasive violations of the anti-trust laws here. Most “markets” are serviced by hundreds if not thousands of independent physicians, and at least a few hospitals. Are they all colluding?

            The cost-shifting happens because the unreimbursed cost of Medicaid (and Medicare, and charity care) is essentially built into the cost base of providers. When the insurers set rates for a market, they pretty much set one rate for everybody, which has to be high enough to cover the cost base for the market generally.

            Trust me, adam. I’ve done this for a living for nearly 20 years, and its apparent you have no idea how this works.

            1. I don’t trust you because what you describe is completely at odds with published reports on how private insurers and providers set rates, including one by Uwe Reinhart of the NJ market and another by the Massachusetts AG’s office. The rates most certainly aren’t the same thoughout a region. In fact, the same insurer pays different hospitals widely varying rates. Those rates can differ by as much as 200%.

    3. Our children and grandchildren, of course.

    4. They will all quit being doctors and move into a cave where they will meet a beautiful woman, realize how wonderful selfishness is, and carve the word “ego” on a rock.

    5. “””and they shift the cost onto people with more money and/or better insurance.”””

      Not necessarily. You can increase your rate, but a provider may be bound to the contracted rate they have with the insurance company. The insurance plan I had last year paid 80% of the provider rate, which is pretty damn good. It became too expensive and my job dropped it for a plan that pays the provider 140% of Medicaid. Plenty of doctors do take it, albeit less than the previous.

  18. Post has been edited for clarification clarity.

  19. The perpetrator of that hoax felt giddy at the thought that it just might work.

    1. Why do you assume it is a hoax?

  20. Hold on. Its waaaaaay too soon for Pelosi to call this a hoax. That’s an accusation she has to prove. There’s no way at this point to know no Dem at all is responsible for it, even if it is a low level grunt on a staff or w/ a Dem consulting firm (which would give them an almost reasonable “you can’t hold us to what that low-level nitwit wrote” defense). You can deny this is ‘official’, but you can’t say the GOP did this w/o proof, which she evidently doesn’t have.

    1. You can’t be serious!!

    1. I don’t see how it is a fake. It is probably from some low level operative. But, I really don’t see how the Republicans would have gone to such an elaborate hoax. At least not until I see some evidence of that.

      1. But with no evidence of the alternative either you rush into a lover’s embrace.

        hack, hack

        Sorry, bit of a cough…

        1. The evidence is the document itself. The document speaks for itself. It appears to be a Democratic memorandum. Until there is some proof that it is not, you take the document on its face.

          But you are not hack. I am sure in your mind it is just another example of the “Republicans wiping their ass with the Constitution” like back when they were thinking about the nuclear optiion right there Mr. Nice Guy?

          Seriously MNG, how can you call anyone a hack? I guess shame is not something you are cursed with.

          1. You’re a pretty big rube if you think that the document purporting to be a Democratic memo means a presumption that it is. This is Washington dude.

            And I explained to you the filibuster thing. The filibuster was over a SCOTUS nominee. It was the nominee, a GOP nominee, that I was concerned with. The filibuster is not in the Constitution, everyone knows that, so it of course makes no sense to say that in overriding the filibuster anyone would be “wiping their ass on the Constitution.”

            Look, why don’t you just admit it, you assumed something about me with no evidence and you were wrong. Hey, you’re doing it again about this document!

            1. Whatever MNG. Your own words revealed you to be the hack everyone knows you are. You thought the filibuster was essential to Democracy when the Democrats were using it and now think it is horrible. Any chance of you ever being considered anything but a hack ended when you came out against the filibuster now that the Dems are in charge.

              What evidence do you have that it is fake? Why would it be fake? Is it your position that there is no way it can be real? You just don’t like what it says so you muddy the waters by claiming it was fake. You don’t have any more evidence that it is fake than I have that it is real, except of course I have the document which speaks for itself. You just claim it must be a fake because you are Democratic hack and that is what you do.

              1. “You thought the filibuster was essential to Democracy when the Democrats were using it and now think it is horrible”

                Again, John, please provide any evidence of this you have. I’ve explained why the quote you reference is not evidence of that. If you dispute my explanation then provide your reasoning.

                You’re just wrong and I called you on it. And your embarrassed.

                It’s OK. You’re actually wrong far more than that John 😉

              2. Oh mercy, did you just, in an argument over whether a document is a fake or not, point to what the document purports as evidence it is not a fake? John, you are a regular comedian dude!

                See, I’m not saying it is a fake or not. Because there is no evidence either way right now. You are the one caught with your pants down assuming again. The document may be a Dem memo. It may not be. That is my position. Your position is that it should be presumed not to be a fake because of what the document in question purports. And that is hilarious reasoning sport.

            2. BTW John I’m not even sure the “nuclear option” discussed at the time was a move to remove the filibuster per se. I seem to remember it was just the proposal to override the filibuster re: SCOTUS nominations.

              None of this should be so fantastic. One of the leading liberals of Constitutional Law, Sandy Levinson, has been arguing, advocating and writing about ending the filibuster for the reasons I gave for a long time, during both Dem and GOP majorities. It really is a quite common position among liberals John.

          2. “”The evidence is the document itself. The document speaks for itself. “”

            Are you kidding? I bet you didn’t say that about the CBS Bush Guard memo.

        2. The memo is consistent w/ their previous behavior. MNG, what is your prediction concerning the Dems and the “Dr fix”?

          1. I don’t know what the Democrats are going to to vis-a-vis any of this. If I were them I would have dropped this bill alltogether, and they haven’t, so I obviously can’t predict what they are going to do. I won’t “look into their souls” and guess what they are planning.

            1. “If I were them I’d…” and predicting their behavior are two different things. You should know that.

              1. Are’nt you a good Austrian in good standing? And you are trying to predict people’s behavior? Someone needs to re-read Mises Human Action…

                1. I don’t recall Mises ever saying that no individual human behavior can ever be predicted under any circumstances. Did he ever write that, for example, Mrs. Mises could slit his throat one night while they were sleeping, because humans are so unpredictable?

                  Or did he merely say “elites” can’t predict ALL human behavior w/ enough accuracy for your dreams of a centrally controlled society to ever work?

        3. In a court of law, the party claiming forgery must carry the burden of proof it is a forgery.

  21. You can quibble about who wrote what when, but does anybody seriously believe the “doc fix” got stripped out by accident?

    1. No one with the intelligence and integrity greater than Ezra Klein. They took the numbers they needed and reverse engineered the plan to meet CBO requirements for reconciliation. The plan is then to put back in all the spending later. The whole process is, as you I am sure know, a fraud.

    2. MNG believes it. Are you saying he is wrong?

      1. Wrong and a left wing dumbass.

      2. Oh lord, what exactly are you saying I believe today John? I’m quite on record here as opposing this health care bill from the start.

        1. Will you two just kiss already?

        2. What DO you support, MNG? Surely not the status quo, or anything like it.

          1. There are parts of Obamacare that I support, and these parts should have been brought up individually for, dare I say it, “up or down votes.”

            I worry over any bill that tries to be as “comprehensive” as this one. I drive by a government work crew which has been working to fix the same exit ramp for two year now. They strike me as amazingly incompetent. Reading Bureaucracy by Mises in grad school made quite an impression on me. Because government agencies lack a profit motive there are only very tenuous disciplining mechanisms for such agencies, therefore they will be sloppily run. Mises grants that certain functions must be done by the government and that we cannot expect them to be done that well. I’m sorry but I cannot accept health care being put into that category. Obamacare does that, hence I oppose it and always have.

            I’m not trying to “fake” anyone out here. I’ve heard single payer explained by some people in ways that made me think that in theory it would not be awful. But I just don’t see our goverment administering it well, I see it administering it worse than my private insurance does. Hence my hesitation in support…

            1. MNG: The bureacracy in our current system is far worse than it is in other countries, precisely because we have hundreds of little bureacracies instead of one big one into which resources can be focused for the sake of streamlining the process. We spend absurd amounts on overhead and paperwork – indeed, much of the reason that we overpay relative to everyone else is the profit, paperwork and advertising needs of the private insurance sector insurance system.

              Of course, this bill doesn’t not fix this, and leaves us with fundamentally the same system we have now. The major changes are a group of three policies which only work when implemented together: community rating, mandates, and subsidies. This is stupid-man’s version of simply doing single-payer, but it more or less achieves the same effect of tamping down on adverse selection in the individual market. The subsidies are largely paid for by putting an additional tax on the capital gains of the rich (boo hoo, Buffet and the hedgies will have to pay 18% now….cry whine pout) and a tax on gold-plated plans. Not perfect, but better than what we have.

              If I were king for a day, I would scrap this bill and pass the *Republican* dream bill. It is clear that the private system is driving off the cliff, and accepting their crazy ideas would only send it off sooner. Then, when all hell breaks loose, the Democrats would take over and implement single payer once and for all.

              I think the core of your argument is that the government is too bureacratic to do this well. I invite you to look at other nations, and how little they spend on overhead and how little paperwork is involved in going to the doctor or making appointments. Or indeed, just check our Medicare, Medicaid and VA systems, which are better than our own private sector. The proof really lies in the pudding on this one.

        3. Yeah, you are on record just like you were on record about how great the filibuster is, until it wasn’t. Shut the fuck up you hack.

          1. Already explained that many times, you no response, you are the hack buddy.

            But by all means check into it. I’ve been skeptical of Obamacare from the get-go, for the reasons stated. I guess in theory I’m not opposed to many parts of it, but there is no way I can be convinced that our government can administer such a behemoth without disaster.

  22. How does this mean that cost-shifting can happen in a competitive provider and insurance market?

    Who said it was a competitive market?

    1. That may be true. If it isn’t a competitive though, then doesn’t that undercut the argument for private insurance as a cost-control solution?

      1. Not at all, we would just have to create a situation where private insurance can exist.

        Doing nothing doesnt do THAT either. We need reform, just in the opposite direction.

  23. http://www.youtube.com/watch?v=0NMqAVJNxco

    Watch the squirming in this video. My God that man is a scumbag. They don’t call them Congress Critters for nothing.

  24. then doesn’t that undercut the argument for private insurance as a cost-control solution?

    I’m not sure who is arguing that.

    I believe (further) socialization of the insurance market will have no beneficial effect on costs.

    I want to see the link between employment and insurance broken, and I want to see supply side changes to the market. Whatever they fuck they are doing in Washington, they are most certainly not increasing the supply of medical services.

    1. +1,000,000

  25. They will all quit being doctors and move into a cave where they will meet a beautiful woman, realize how wonderful selfishness is, and carve the word “ego” on a rock.

    And they will quietly mind their own business, until they are pressganged into providing free unlimited medical care for the sniffling little children. They must be enslaved, for the good of the Tribe. For the Haves must serve the Have-nots; those who know must serve those who know nothing.

    1. Social Justice demand that unequal actions and decisions reap equal rewards!

      Social Justice try to explain this to normal Justice, but she is blind! Social Justice say “Why you put murderers in prison, but let others roam the streets free? Fairness means treat all equal! Everyone go to jail!” Then Social Justice hold down normal Justice and make compulsory love, like in jail!

      1. One can almost smell the straw here!

  26. unlimited medical care for the sniffling little children.

    No, just MNG’s children.

  27. MNG, I can tell, has very little contact with doctors.

    This abomination will amp up all the things they hate about practicing medicine – the paperwork, the micromanaging by bureaucrats, the transformation of medicine into a volume-based assembly-line – while cutting their pay.

    But none will move up their retirement date, or find something else to do. Not one. Nope. Not gonna happen.

    1. This abomination will amp up all the things they hate about practicing medicine – the paperwork, the micromanaging by bureaucrats, the transformation of medicine into a volume-based assembly-line – while cutting their pay.

      Citation, please.

      1. You really should read more.

      2. Brainy Smurf…

        As a physician, I can tell you personally that RC is spot on.

        Paperwork is ungodly, especially for state and federal payment providers and their condescending paternalistic attitude (especially when they refuse to cover a procedure. Yes, Chad Medicare/Caid practices recission. And worse than private insurance).

        The worst I see is the “volume based assembly line” cookie cutter approach to medicine; you want caring and individualized care, then get the damn government out of my office and suite.

        Your snotty Brainy Smurf-ist attitude regarding how much YOU think I should make (I am a specialist, I’m sure that’s even more of a sin in your twisted mind) really mother fucking offends me to no end.

        If other countries provide better care, and your righteous indignation is pacified by a physician making what you think is appropriate then buy a ticket and go.

        You probably worship St. Kenneth Feinberg too, statist shitbag.

        1. Yes, our paperwork is “ungodly”, because unlike every other civilized nation on earth, we don’t have universal coverage.

          But Sean said that the bills before congress will “amp it up”. I am asking for proof…or hell, even evidence, that paperwork will be increased.

          And if you are a specialist, you are wildly overpaid. Quit whining about your loans, as anybody who passed Algebra I in high school can figure out how to amortize the loan and estimate how much additional pre-tax income you would need to pay them off. For example, a $250,000 loan at 7% over thirty years (your career) and at a 50% marginal tax rate would require ~$40,000 in additional annual income over what a comparitive person in a different field earns, for you to break even financially. Do you think you earn merely $40k more than, say, scientists or lawyers (who are happy to make $100,000/year nowadays)? Actually, I have argued many times that scientists make a good control group for doctors, as PhD+post-doc is about the same as med school+residency, except the loans which can easily be accounted for. Since scientists DO compete in the market, their salaries are probably a good indicator of what is fair for that level of talent and delayed graitification.

          It is patently obvious that your high salaries are maintained by the AMA, who gates the numbers of people entering each specialty in order to keep salaries that way. Far more people WANT to be specialists than are allowed to. Your salary has nothing to do with the market, and everything to do with a cartel. Quit whining and deal with it when we attempt to knock you off your pedastal.

          1. I truly can’t believe you spout this with a straight face.

            But Sean said that the bills before congress will “amp it up”. I am asking for proof…or hell, even evidence, that paperwork will be increased.

            See pre-Medicare/Medicaid paperwork amount v. post.

            I more than passed Algebra I adequately. TYVM.

            AMA (which I am not a member) does limit competition in the market place, and I argue against them having WAY too much say so in the licensing and admissions process.

            …because unlike every other civilized nation on earth, we don’t have universal coverage.

            Brainy Smurf, when you factor in small and very homogenized populations in these countries you tout as models. Even they (doctors) admit their models are unsustainable (and feel they are underpaid for what they do).

            Quit whining and deal with it when we attempt to knock you off your pedastal.

            Class envy does not become you Brainy Smurf.

            1. Explain why a small or homogenous population would affect per capita costs a whit. Do doctors charge based on skin color?

              I AM part of the professional class, and without a doubt, my college friends who went into medicine are all in the top fifth of our peer group income-wise twenty years later. Note that my friends were virtually all straight-A honors-college types, and with only a trivial number of exceptions, are successful at whatever they have chosen to do. The statistics easily confirm it: US doctors are overpaid, by about a fifth to a third, and this needs to stop. We can’t afford it.

              1. I hope you get cancer and have to settle for an oncologist who can’t pay back his student loans.

              2. European states (and Japan et al.) are spending more than they have to subsidize care.

                These countries also do not pay for their own defense and other functions of government.

                Most European states, Japan et al. are able to do so because homogenized populations are “easier” to treat as the pathologies that manifest are predictable and thus manageable.
                Smaller populations are easier to coerce and force to buy into the system.

                Manageable until the weight of entitlements envelopes the system thus becoming unsustainable without austerity measures.

                Because these countries do not see the logical conclusion of such policies, they are ultimately doomed to see these until too late.

                Hence, Greece.

                QFT.

  28. “MNG, I can tell, has very little contact with doctors.”

    I’m amazingly healthy 🙂

    RC, I oppose Obamacare. Did from the start.

    1. You oppose Obamacare. You will just do anything to defend Democrats. You are worse than Joe MNG. At least he was honest about who he was. You are the worst. You are a total leftist hack. But then insult everyone’s intelligence by pretending that you are not. Yeah, I am a partisan but at least I am honest about it.

      1. John
        Why do you find it so hard to concieve of a person who finds Obamacare to be wrong substantively, but who simply cannot agree that the deem and pass use is any more wrong than the filibuster use? I think it’s because of your high level of hackitude. You assume everyone must be the partisan you are. Certainly I must be for everything the Dems are for just like you are for everything the GOP is for. It’s “unpossible” to you that someone might feel such little devotion to one of the two major parties that they find some of their tactics acceptable but much of their proposals to be wrong…

        What a sad, little person you must be….

  29. Politico is ex-Washington Post people. They aren’t going to like being scammed. Since their creditability is on the line, we’re going to find out the origin of the memo.

  30. I don’t think MNG is liberal. I think he just has a major crush on Pelosi or Reid, or maybe just a majority of the Democratic party. He defends them harder than the “rubes” he accuses of bashing them.

    1. Maybe Pelosi gave him a blow job once. I hate MNG worse than I ever hated Joe. At least Joe was honest about who he was. MNG is such an insecure piece of shit he can’t even admit his own beliefs.

      1. I’ve got no hate, but I do get some serious lols from MNG, Tony, and Chad.

    2. MNG is liberal. Try process of elimination — conservative? No. Libertarian? No. Espouses support for the vast majority of liberal causes? Bingo.

      1. He doesn’t vote with any party but looks at the issues.

    3. It’s hilarious to think I have it for Pelosi/Reid. Was it just a week ago that I said that no matter what side of the aisle one falls on any sane person mut admit that Pelosi’s run as Speaker has been a disaster? And I think I added that the only thing more obvious is Reid’s pathetic leadership. There’s a search thingee up in the corner for the fanatics to test this out.

      I’ve said this many times but I’ll say it again, I guess I am a liberal when it is said and done. From arguing with you guys it seems I tend to agree more with the side you guys call “liberal” than the shit you are peddling. But interestingly I find myself disagreeing with people who identify as liberals quite a bit. As I’ve said here before the Democratic Party often doesn’t get my vote: my votes for Buchanan and Perot for President are two of my proudest votes. I’ve voted for, and even campaigned for, a GOP senator (the recently retired great statesman John Warner, that’s John not Mark ;)), but never voted for a GOP Presidential candidate. I have voted for the Dem candidate for President (Clinton once, Gore and Obama), but I can say easily that if McCain had run against Gore or Clinton I would have voted for him (I voted Obama because I beleived the GOP must be turned out at the time, if McCain ran against him in 12 he would have my vote, I admire the man).

      Frankly I don’t care what my ideology is. However, I don’t pretend to be a libertarian under some fool idea that I am swaying folks here (I think a lot of our right-leaning folks do this on a regular basis). That’s an insult to the people here, and a silly waste of time. I come here to debate, not win conversions.

      1. Frankly I don’t care what my ideology is. However, I don’t pretend to be a libertarian under some fool idea that I am swaying folks here (I think a lot of our right-leaning folks do this on a regular basis).

        So you do care what your ideology is? Saying you don’t care after spending an entire post qualifying what your ideology is or isn’t is lol. See what I mean.

        It seems like you come here more recently to get digs in on people who you don’t agree with. Which is fine and there’s certainly sport in that, but don’t call it debate when it’s just shit throwing.

        1. *Saying you don’t care what your ideology is.*

          The inner non-typing retard got loose again.

      2. You are on record as opposing the health care bill, and seem to have an issue with the use of what are widely seen as “procedural tricks” – so why are you not loudly decrying the proposed uses of reconcilliation and deem & pass? After all, you are fairly anti-republican and a majoritarian, so the answer for you should be simple: subject the bill to an up-and-down vote, and hope that it fails. That you choose to adopt neither position is what leads people to believe that you are a hack.

        Do you really find that so unfair a charge?

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