Monday, March 22, 2010

Obama's Grand Legacy: "Health Care Reform, at Last "

Well, President Obama did it. We finally will have health care for every American, allowing us to join other developed countries in achieving a basic element of a civilized society.

It always struck me that having over 30 million uninsured Americans simply belied a supposedly Christian nation. As Martin Luther King, Jr. stated: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

I am not an expert in health care law. So, I defer to the editorial comments of the day to sum up the nature of this momentous day:

NY TIMES

WALL STREET JOURNAL

MINNEAPOLIS STAR-TRIBUNE

ST. LOUIS POST DISPATCH

CHICAGO TRIBUNE

I think that list covers the water front in terms of the thinking about the bill from across the spectrum.

I just want to add an economic perspective. This bill empowers people. This bill protects people. Children will be healthier in America because of this bill. Given the increasing importance of human capital and ideas to economic growth (and the fact that ideas and human ingenuity generate increasing rather than diminishing returns), this bill is bound to spur more innovation and growth by upgrading our human resources. Moreover, human capital will be able to move to its highest and best use in accordance with free market principles because of this bill, particularly the elimination of preexisting conditions as a basis for denying coverage. Finally, this addition to our social safety net will encourage risk taking and entrepreneurial behavior. In short, this bill is a victory for capitalism and a victory for macroeconomic growth. The nation that empowers its people to achieve maximum economic productivity will be the most prosperous nation. This bill is a step in that direction.

So, aside from the very powerful social justice basis for supporting this bill (as stated by Dr. King), this bill also benefits from a sound vision of macroeconomic growth.

68 comments:

  1. A huge historic vote. That the Democrats in Congress had the steel backbone to make this happen despite hundreds of millions of dollars of lobbying influence in opposition is amazing. Finally!

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  2. This bill doesn't matter, it's just an extension of the leftist fantasy. The existing entitlements are unsustainable, with unfunded liabilities in excess of 100 TRILLION dollars. All this bill does is hasten the day of reckoning. The country is bankrupt. Enjoy it while you can, your children and grandchildren will pay for it with a much lower standard of living.

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  3. There is nothing socialistic about this bill. Just look at the stock market. It is up 50 points right now. Earlier it rocked past 10,800. So the market verdict is decisively in favor of my reasoning and against your mindless right wing dogma.

    Inside the market, that basic message is amplified when one looks at the health care sector. The biggest health care exchange traded mutual fund trades under the symbol XLV. It is up over 1%, after soaring on the open.

    You right wing ideologues need to bone up on real capitalism and real socialism. Capitalism thrives when people are empowered because ideas drive growth. Socialism involves government ownership of the means of production.

    Basically, the bill gives big pharma and health insurance companies 30 million new customers. That is an excellent step towards a more powerful market development.

    Under your definition of socialism, public funded education is socialist. That is a real stretch.

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  4. Way to go Jim DeMint!

    http://www.youtube.com/watch?v=j4a9iVRb0l4&feature=related

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  5. Doctors, Hospitals and Pharmacies already opting out of the "more powerful market development":

    Dr. Sahouri informed her a few months later that he could no longer see her because, like a growing number of doctors, he had stopped taking patients with Medicaid.

    Dr. Sahouri said that his reimbursements from Medicaid were so low — often no more than $25 per office visit — that he was losing money every time a patient walked in his exam room.

    The final insult, he said, came when Michigan cut those payments by 8 percent last year to help close a gaping budget shortfall.

    “My office manager was telling me to do this for a long time, and I resisted,” Dr. Sahouri said. “But after a while you realize that we’re really losing money on seeing those patients, not even breaking even. We were starting to lose more and more money, month after month.”

    New York Times


    The renowned Mayo Clinic is no longer accepting some Medicare and Medicaid patients, raising new questions about whether it is too selective to serve as a model for health-care reform.

    Washington Post


    Effective April 16, Walgreens drugstores across the state won't take any new Medicaid patients, saying that filling their prescriptions is a money-losing proposition — the latest development in an ongoing dispute over Medicaid reimbursement.

    Walgreens follows Bartell Drugs, which stopped taking new Medicaid patients last month at all 57 of its stores in Washington, though it still fills Medicaid prescriptions for existing customers at all but 15 of those stores.

    Seattle Times

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  6. New England Journal of Medicine - 1 out of 3 physicians to leave medicine if Obamacare ultimately becomes law

    From a survey of physicians conducted by The Medicus Firm in December 2009, and appearing in the latest issue of the New England Journal of Medicine:

    "If health reform passes without the public option, 7.4% of physicians stated that they would quit practicing medicine, unless they were nearing retirement, in which case an additional 21.8% of the responsdents said they would retire early, bringing the total loss of physician workforce to nearly one-third of physicians leaving medicine.

    "What many people may not realize is that health reform could impact physician supply in such a way that the quality of healthcare could suffer," states Jim Stone, Managing Partner at The Medicus Firm's Dallas office. "Based on the physicians' responses to the survey, health reform could significantly intensify the effects of the physician shortage. Depending upon which version of the health reform bill passes, the reality is that there may not be enough doctors to provide quality medical care to all of these newly insured people."

    Over 50% of physicians who responded predict that health reform would cause the quality of medical care to deteriorate in America. When asked how health reform could affect the quality of medical care, 40.7% stated it would "decline or worsen somewhat," while another 14.4% stated that the quality of medical care would "decline or worsen dramatically". If a public option is implemented as part of health reform, 64.1% of physicians predict that the quality of medical care in general will decline."

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  7. The courts will decide whether the Democrats have the power to compel individuals to purchase a product from a private company as a condition of citizenship.

    But even the New York Times isn't buying insurance mandates as this article reveals: How an Insurance Mandate Could Leave Many Worse Off

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  8. The courts will decide whether the Democrats have the power to compel individuals to purchase a product from a private company as a condition of citizenship.

    But even the New York Times isn't buying insurance mandates as this article reveals: How an Insurance Mandate Could Leave Many Worse Off

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  9. I believe it all depends on the article everyone is reading because I have read many articles that express the same views in which you are stating and many articles that assert the complete opposite. Many articles and reports that I have read state that More efficient health care will lower the burden of health insurance premiums for firms, and in turn allow them to hire more workers.

    And of course, many articles and surveys note that not everyone agrees that the new Health Care Reform will lower healthcare costs. For example, according to a survey published by the Society for Human Resource Management, a full 71 percent of employees think that the new Reform will raise their costs, not reduce them.

    Supposedly, the $875 billion bill now headed to Obama’s desk is projected to cut the federal deficit by $118 billion over the next 10 years, according to the nonpartisan Congressional Budget Office. It will subsidize insurance for a family of four making up to about $88,000 annually, or 400 percent of the federal poverty level.

    I know many people are outraged, but are those people the uninsured? If they were the uninsured, would they feel differently? Just a thought.

    I am always impartial, but I feel that congress should do what needs to be done to create economic value, jobs, etc. The current party believes the Health Care Bill will do so. There is a lot of talk about challenging the constitutionality of this Bill in regards to State Sovereignty. The arguments in those cases will be exceedingly interesting. Only time will tell whether passing this Bill was a good move or a bad move.

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  10. I agree that this was a historic occasion and that America was behind the curve "in achieving a basic element of a civilized society." There was similar opposition to the Medicaid bill back when it was passed.

    Actually, one would think that the people who are opposed to the new health care bill would appreciate it more since it will actually benefit them more than Medicaid does. We are all paying for Medicaid every time we get paid but only a portion of our society is able to use it. This new bill will benefit everyone in one way or another. Not only in the economic ways that Mr. Ramirez pointed out but in that it extends the age that young people are able to be on their parent's insurance, and insures that if you have a pre-existing condition you will still be able to get insurance. We may not need that now but you never know what lies ahead for you or your family.

    People are so quick to talk about our Christian values and society but then are adamant about not helping out others who are less fortunate...doesn't sound like the "love thy neighbor" approach to me.

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  11. People are so quick to talk about our Christian values and society but then are adamant about not helping out others who are less fortunate...doesn't sound like the "love thy neighbor" approach to me.

    Charity is something you do with your own money, not someone else's. Christ never instructed us to steal from one man to benefit another.

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  12. I share the sentiment of Mr. Ramirez. I would like to add a couple more thoughts.

    I think what people are forgetting about this historic bill is that our entire health care system will not be overhauled overnight. This entire process will take a number of years to be fully implemented. Naturally, if all these doctors decide to quit their high-paying, prestigious careers, and if the hospitals suddenly become inundated with 30+ million Americans seeking treatment for every ailment, certainly we will all experience much longer waits to see a physician. However, in all honesty, I don't think most of us will be all that affected. And the upside, of course, is so many Americans in the lower income brackets are given the opportunity to receive quality health care.

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  13. President Obama’s health care reform was a major hurdle. I believe that passing the bill will have a positive effect on the health of hundreds of thousands of Americans. Considering that health care reform had not been discussed in Congress since 1995 and hundreds of thousands of lives continue to be lost because of a lack of adequate health care, I believe that reform was long overdue.
    In the news recently politicians have been bashing the health care reform bill with negativity and skepticism; however, I feel that many Americans are being misguided. The bill has a lot of positivity to it: such as being able to stay on ones parents’ health insurance plans until the age of twenty-six. How many college students do you know that live without health insurance after age twenty-one because of strict limitations placed on their parents’ policies? Another positive component of the bill is that individuals who are slightly above the poverty line will be eligible to receive Medicaid benefits. I believe this is beneficial because a single mother struggling to pay household expenses as well as other costs associated with raising a family and living in general doesn’t have enough money for private insurance. They make enough to tread water but such expenses would place weights at their feet; only pulling them under further. Without insurance these families which make-up a substantial part of our population have went without health insurance for years. These families as a whole have been unable to see a doctor and rely solely on emergency rooms for medical care. This is unfair and expensive. When it all boils down to it if there are a handful of people who are pissed then a far greater number of people are being helped.

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  14. I think it is natural for people to be anxious about the long term consequences of this bill specifically the economic consequences (maybe benefits...I can be open minded). I also think that blind acceptance of this bill or any bill for that matter is setting Americans up for a loss of freedom in favor of government control.

    I must admit I do not know enough about economics to intelligently comment on this issue. I just know that I am worried about the consequences of a bill with such a large price tag in such a difficult time.

    Luckily, I am a student and don't make much money. I'm not looking forward to the higher taxes once I enter the job market.

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  15. The bill has a lot of positivity to it: such as being able to stay on ones parents’ health insurance plans until the age of twenty-six.

    Yes, you need never grow up.

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  16. This bill will not help anyone. The Democrats lied to get a favorable CBO score. The truth is that this bill will ad significantly to the country's debt. When the country takes on debt it is simply looting future generations who will spend ever more of their working lives to satisfy these obligations. This is a form of slavery.

    The country is on the road to fiscal ruin. That is not an opinion, it's a mathematical certainty. The unfunded liabilities associated with our current entitlement programs - before Obamacare - were over 100 trillion dollars. To put that into perspective, all of our national assets - every house, factory, office building , car - everything - are valued at about 73 trillion. The foundation of the Democrats new health care system is built on sand.

    When the fantasy ends, and the collapse comes, the most vulnerable will be the hardest hit. Their misery, and the generations spent paying off the massive debt incurred, will be Barrack Obama's legacy.

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  17. I want to clarify the citation to the NEJM. The source is not the NEJM.

    http://www.nejmjobs.org/rpt/health-reform-may-reduce-physician-workforce.aspx

    Indeed, as you might suspect the entire use of this so-called survey is "dubious" according to Media Matters, a not for profit organization dedicated to ferreting out conservative inaccuracies:

    http://mediamatters.org/blog/201003170036

    I do not always have time to monitor the veracity of sources posted in the comments to this blog. But, I do strive to at least maintain some allegiance to the truth, and not allow either left or right propaganda to infect real thinking. That is why I posted a selection of editorials that included conservative voices like the Wall Street Journal. In egregious circumstances this type of post is necessary.

    Here is the actual survey write up:

    http://www.nejmjobs.org/content/rpt/pdf/marApr_10.pdf

    Note, that this was an email survey, with a low response rate (around 55%).

    http://www.themedicusfirm.com/pages/survey

    Finally, the survey was obviously conducted before the health care bill was finalized. But, without a public option, 93% of respondents stated they would not leave medicine before retirement:

    "How do you think the passage of health reform WITHOUT a public option would affect your professional/practice plans, if at all?

    * No change: 70%
    * I would try to retire early: 22%
    * I would try to leave medical practice even if not near retirement age: 8%
    * I would go back into practicing medicine (if non-clinical or semi-retired now): 1%"

    Everyone wants to retire early, I suppose.

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  18. "In short, this bill is a victory for capitalism and a victory for macroeconomic growth."

    Health insurance is not a right; it is a business. The health insurance market is a product of free market capitalism. Supply and demand work to regulate the insurance market, just as they do for any other commodities available under the United States model of capitalism. To say that a government take-over of health insurance is a "victory for capitalism" is wrong.

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  19. Laissez faire capitalism is a failure everywhere and always throughout human history. Name a successful laissez faire economy! There is not one.

    Of course government must intervene in markets to secure capitalism. Dogma will never get one to the right answer.

    Instead, you must think: is this government program an appropriate intervention?

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  20. Laissez faire capitalism is a failure everywhere and always throughout human history. Name a successful laissez faire economy!

    Hong Kong, prior to the Chinese takeover.

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  21. Media Matters, a not for profit organization dedicated to ferreting out conservative inaccuracies ...

    Media Matters was founded by David Brock and is run by Eric Burns and John Podesta, a former Clinton operative. It is financed by George Soros, the Tides Foundation and other left-wing or "progressive" groups. On January 14, 2008, the Canada Free Press identified the Treasurer of Media Matters, Rachel Pritzker Hunter, as a Board member of Democracy Alliance (another Soros front which helps to fund Media Matters). A generous donor to Democratic candidates and causes, Hunter in recent years has given money to the presidential campaigns of Sherrod Brown, John Kerry, Howard Dean. Their specialty is distortion not "truth".

    "I want to clarify the citation to the NEJM. The source is not the NEJM."

    No one said that it was. Read carefully, "appearing in the latest issue of The New England Journal of Medicine".

    The source of the poll, The Medicus Firm, was linked to as well a NEJM disclaimer. There was no effort to deceive.

    According to Medicus,"A total of 1,195 physicians from various specialties and career levels in locations nationally completed the survey." This is a statistically significant sample and not as you would have it, "... an email survey, with a low response rate." One would assume that the NEJM would not have printed the results if they did not find the survey significant.

    Unfortunately for Media Matters, and you, a separate poll conducted by IDB/TIPP has confirmed the findings of the Medicus poll. 45% Of Doctors Would Consider Quitting If Congress Passes Health Care Overhaul, IBD

    It should also be pointed out that President Obama and the Democrats publically trumpeted AMA support for the bill without mentioning that the AMA represents only 18% of physicians.

    I do not always have time to monitor the veracity of sources posted in rebuttal to the comments to this blog. In egregious circumstances though this type of monitoring may be necessary.

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  22. Jane Hamsher writing at the left-wing Huffington Post, breaks the bad news to her fellow travelers: Fact Sheet: The Truth About the Health Care Bill, The Huffington Post

    - The bill will leave tens of millions uninsured.

    - This bill is almost identical to the plan written by AHIP, the insurance company trade association, in 2009. The original Senate Finance Committee bill was authored by a former Wellpoint vice president. Since Congress released the first of its health care bills on October 30, 2009, health care stocks have risen 28.35%.

    - The bill will not bring down premiums significantly ...

    - The excise tax will result in employers switching to plans with higher co-pays and fewer covered services. Older, less healthy employees with employer-based health care will be forced to pay much more in out-of-pocket expenses than they do now.

    Read it all.

    I'm not sure if Media Matters has weighed in on Jane or not. Since their mission is to protect us from those evil conservatives, probably not.

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  23. Professor Ramirez is my esteemed colleague at Loyola University, and I believe he is right on point when he says "the bill is a victory for capitalism and a victory for economic growth." I'd like to follow up on Professor Ramirez's last observation. Subjecting the health-insurance companies to reasonable regulations (while at the same time handing them tens of millions of new customers), is a far cry from a "government takeover of health insurance." In the aftermath of the Great Depression, Franklin Delano Roosevelt recognized that, if capitalism was to survive in this country, government would need to temper the harshness of its impact on the most vulnerable members of our society. Some of the cries against a system of Social Security back then were as vehement as many of the current denouncements of the new health care legislation. Consistent with the FDR model, this bill actually rescues the current capitalist system of private health insurance by bringing the most vulnerable (the currently uninsured) into the system. In due time, many in the health-insurance industry will come to revere the courageous President and the brave political party that somehow managed to save the American system of private health insurance.

    Neil Williams

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  24. You are still misleading.

    It is not from the New England Journal of Medicine. It is "Recruiting Physicians Today."

    Switching polls is cute, but I did not comment on your new poll. It is hardly worth it because it mixes in "early retirement."

    Big news there: people are thinking about early retirement.

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  25. RE HONG KONG:

    "In fact, of course, the reality was very different from the myth of complete laissez-faire. The government’s programs of public housing, land reclamation, and infrastructure investment were ambitious. New industrial towns were built to house immigrants, provide employment and aid industry. The government subsidized industry indirectly through this public housing, which restrained rises in the cost of living that would have threatened Hong Kong’s labor-cost advantage in manufacturing. The government also pursued an ambitious public education program, creating over 300,000 new primary school places between 1954 and 1961. By 1966, 99.8% of school-age children were attending primary school, although free universal primary school was not provided until 1971. Secondary school provision was expanded in the 1970s, and from 1978 the government offered compulsory free education for all children up to the age of 15. The hand of government was much lighter on international trade and finance. Exchange controls were limited to a few imposed by the U.K., and there were no controls on international flows of capital. Government expenditure even fell from 7.5% of GDP in the 1960s to 6.5% in the 1970s. In the same decades, British government spending as a percent of GDP rose from 17% to 20%."

    http://eh.net/encyclopedia/article/schenk.HongKong

    And yes, 92% of Hong Kong's people get health care at PUBLIC institutions!

    http://www.asiasentinel.com/index.php?option=com_content&task=view&id=2354&Itemid=204

    Hong Kong has long had universal health care.

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  26. "Subjecting the health-insurance companies to reasonable regulations (while at the same time handing them tens of millions of new customers), is a far cry from a "government takeover of health insurance."

    The government will be determining what insurance policies insurers can offer and that we, as private citizens, must buy. They will establish how much profit insurers are allowed to make. They will determine the rate of reimbursement for physicians and where those physicians will be allowed to practice if they accept college loan subsidies. And the list goes on and on.

    Jonah Goldberg tears the mask off:

    “Insurance companies are now heavily regulated government contractors. Way to get big business out of Washington! They will clear a small, government-approved profit on top of their government-approved fees. Then, when healthcare costs rise — and they will — Democrats will insist, yet again, that the profit motive is to blame and out from this Obamacare Trojan horse will pour another army of liberals demanding a more honest version of single-payer ...The Obama administration has turned the insurance industry into the Blackwater of socialized medicine ... The endgame was to get the young and healthy to buy more expensive insurance than they need or want. "Expanding the risk pool" and "spreading out the risk" by mandating -- i.e., forcing -- young people to buy insurance is just market-based spin for socialist ends.

    L.A. Times

    "In the aftermath of the Great Depression, Franklin Delano Roosevelt recognized that, if capitalism was to survive in this country, government would need to temper the harshness of its impact on the most vulnerable members of our society."

    There has never been a system that provided great opportunity or material wealth to the "most vulnerable of our society" than capitalism. Any claim to the contrary is a lie. The "FDR saved capitalism" is a fiction of the left. I suggest you read Amity Shlaes book, The Forgotten Man for a less hagiographic account of FDR's success at fighting the Great Depression and "saving capitalism".

    "Some of the cries against a system of Social Security back then were as vehement as many of the current denouncements of the new health care legislation."

    Let's be clear, Social Security was set up as a Ponzi scheme. And, like all Ponzi schemes, everything is fine as long as there are more people contributing than drawing benefits. When the program began the ratio was 44:1, today it is 3:1 and the system is already operating in the red.

    Would you invest your grand parent's and parent's retirement money with Bernie Madoff knowing that he was running a Ponzi scheme? That is exactly what FDR and the Democrats did with Social Security. And that is what LBJ and the Democrats did with Medicare. Further, they demagogue every effort to rationalize these programs and put them on a sustainable footing. Now these programs are bankrupt, just as millions approach retirement. The left's only recourse is to steal the necessary funds from our children and grand children. That's not caring or compassionate, it's evil.

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  27. Continued ...

    "Consistent with the FDR model, this bill actually rescues the current capitalist system of private health insurance by bringing the most vulnerable (the currently uninsured) into the system."

    The left has consistently misrepresented who the uninsured are and the treatment they actually receive from the system:

    - More than 17 million of the uninsured make at least $50,000 per year, 8.4 million make $50,000 to $74,999 per year and 9.1 million make $75,000 or higher.

    - The National Center for Policy Analysis estimates that uninsured people get about $1,500 of free health care per year, $6,000 per family of four.

    - The Urban Institute found that 25 percent of the uninsured already qualify for government health insurance programs; even the liberal Kaiser Family Foundation puts the number of uninsured Americans who don't qualify for government programs and make less than $50,000 a year between 8.2 million and 13.9 million.

    Who Are the Uninsured?, Michael D. Tanner, CATO Institute

    We do not need a massive new government program to provide for those who are truly in need. The purpose of this health care bill is to establish an entrenched unionized bureaucracy capable of generating 100's of millions of dollars in political contributions and beholden to the Democrat Party for it's very existence.

    "In due time, many in the health-insurance industry will come to revere the courageous President and the brave political party that somehow managed to save the American system of private health insurance."

    What is it with you leftists, you always believe that we need you to "rescue" us? Can you really be that full of yourselves? Do you spend your days imagining that you are saving the world? We've seen how you "rescued" Cuba and how you're "rescuing" Venezuela. No thanks.

    And another thing, if the health care bill is so wonderful and the President so courageous, then why do the people who wrote the bill want to be exempted?

    Exempted From Obamacare: Senior Staff Who Wrote the Bill, The New Ledger

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  28. If your argument is that there can be no public education under a laissez-faire system, that's wrong. Laissez-faire would simply deny the government a monopoly on education, as it would deny the state a monopoly in any part of economic life.

    Hong Kong prior to the Chinese take over in 1997 did not have "universal health care". Starting in 1993, they had a two tiered system consisting of a form of government provided indigent care paid for by the sale of land, not taxes. And while under the law no one could be denied care for lack of means, most Hong Kongers carried private insurance policies.

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  29. You are still misleading. It is not from the New England Journal of Medicine. It is "Recruiting Physicians Today."

    No, I am not. I'll say it a third time, the article was printed in the NEJM and conducted by the Medicus Firm. Is that sufficient, or will it take a fourth and fifth time before it soaks in?

    Switching polls is cute, but I did not comment on your new poll. It is hardly worth it because it mixes in "early retirement."

    I didn't "switch" polls, I presented the results of a different poll that supported the findings of the first. Both surveys used large, statistically significant samples to reach their conclusions.

    Big news there: people are thinking about early retirement.

    Those "people thinking about early retirement" represent a very large portion of the country's primary care physicians and they are considering retirement because the health care bill negatively impacts the practice of their profession. The nation already has too few primary care physicians and it will take years to train more, provided we can convince the smartest students to sacrifice their personal potential to the whims of the state. The current wait to see a primary care physician in Massachusetts, which passed a health care bill very similar to this one years ago, is 44 days. In Canada and the UK the average is 110 days. I'm sure that long waits to see a physician will endear Obama and the Democrats to the American people. Massachusetts also has the highest health care insurance premiums in the country. Go figure.

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  30. Courageous President exempts himself from requirements under health care bill.

    “It’s pretty unbelievable that the President and his closest advisors remain untouched by the reforms they pushed for the rest of the country. In other words, President Obama’s health care reform won’t apply to President Obama.

    Last December, the effort to apply any new law to administration political leaders was rejected by the Senate Majority Leader. But there’s no justification for the double standard, and I’ll continue to work to establish fairness.

    It’s only fair and logical that top administration officials, who fought so hard for passage of this overhaul of America’s health care system, experience it themselves. If it’s as good as promised, they’ll know it first-hand. If there are problems, they’ll be able to really understand them, as they should.”

    Senator Grassley proposes to end special exemptions in health care bill

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  31. Karen Lander:

    It is remarkable. A significant reform to healthcare passed despite almost maniacal opposition. How did that happen? I was able to catch some of an NPR story today - credit for passage of the bill was given to the Obama administration's negotiation skill. The negotiation process was not derailed by tantrums (of either side). (sorry no link - I just caught a snippet of the story)

    Aside from my personal satisfaction with having healthcare reform law in place, I am even more pleased about the negotiation process which allowed the bill to pass. Neither political extreme prevailed. But folks on the edges were free to voice it, march it, and our representatives were able to vote it. Remarkable. It is democracy in action. And, I agree with Professor Ramirez about the economic boost. The markets seemed to really like this bill. Plus, the economic boost will not begin and end with the thirty million new customers the health care insurance companies will gain. There will be tons of work for lawyers fighting the legal battles to come in the states. I hope there will be plenty of skilled negotiators holding to the middle road.

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  32. Now that President Obama has signed the legislation into law, most voters want to see it repealed ... The latest Rasmussen Reports national telephone survey, conducted on the first two nights after the president signed the bill, shows that 55% favor repealing the legislation ... Republicans overwhelmingly favor repeal while most Democrats are opposed. Among those not affiliated with either major party, 59% favor repeal, and 35% are against it.

    Rasmussen

    The poll finds that 62 percent want Congressional Republicans to keep challenging the bill, while 33 percent say they should not do so. Nearly nine in ten Republicans and two in three independents want the GOP to keep challenging. Even 41 percent of Democrats support continued challenges.

    CBSNews

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  33. IT WAS A MOMENTOUS DAY!

    Not one day in anyone’s life is an uneventful day, no day without profound meaning, no matter how dull and boring it might seem, no matter whether you are a seamstress or a queen, a shoeshine boy or a movie star, a renowned philosopher or a Down’s syndrome child.

    Because in every day of your life, there are opportunities to perform little kindnesses for others, both by conscious acts of will and unconscious example.

    Each smallest act of kindness – even just words of hope when they are needed, the remembrance of a birthday, a compliment that engenders a smile – reverberates across great distances and spans of time, affecting lives unknown to the one whose generous spirit was the source of this good echo, because kindness is passed on and grows each time it’s passed, until a simple courtesy becomes an act of selfless courage years later and far away.

    Likewise, each small meanness, each thoughtless expression of hatred, each envious and bitter act, regardless of how petty, can inspire others, and is therefore the seed that ultimately produces evil fruit, poisoning people whom you have never met and never will.

    All human lives are so profoundly and intricately entwined – those dead, those living, those generations yet to come – that the fate of all is the fate of each, and the hope of humanity rests in every heart and in every pair of hands.

    Therefore, after every failure, we are obliged to strive again for success, and when faced with the end of one thing, we must build something new and better in the ashes, just as from pain and grief, we must weave hope, for each of us is a thread critical to the strength – the very survival – of the human tapestry.

    Every hour in every life contains such often-unrecognized potential to affect the world that the great days for which we, in our dissatisfaction, so often yearn are already with us; all great days and thrilling possibilities are combined always in THIS MOMENTOUS DAY!

    Excerpt from Dean Koontz’s book, “From the Corner of His Eye”.

    It embodies the idea of how the smallest of acts can have such a profound effect on each of our lives.

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  34. I urge every reader of this blog to look at the Actual March/April issue of "Recruiting Physcians Today" and decide if someone is trying to pass it off as "The New England Journal of Medicine."

    Here is the link: http://www.nejmjobs.org/content/rpt/pdf/marApr_10.pdf

    While you are there, decide for yourself whether the original comment was a fair summary of the email poll, or whether they used numbers from p. 3 that related to public option plans rather than the plan as passed. The 46% number comes from a question relating to a public option plan.

    Finally, as to my central point that this plan is a victory for capitalism and a victory for the economy: I note the stock market is up over 2.5% since Monday morning, the first trading day after the healthcare vote. That is over 250 points on the Dow.

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  35. As much as I find healthcare passing through Congress a victory, I can't help but think about what Congress does to give us reasons to need healthcare now more than ever. The subsidies that the government throws at the corn industry fuels low prices of fast food, junk food, and high fructose corn syrup. It is also what meat packers feed their livestock. If Congress could subsidize fresh products, then maybe Americans on a budget could make a healthy choice in the grocery store and not flock to the value menu because it is all they can afford. People who can't afford the produce aisle go straight for the corn products...and these are the same people who can’t afford healthcare. They are hit twice. Now that they have a better chance at healthcare, Congress needs to focus on ways to help them avoid having to use it.

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  36. Finally, as to my central point that this plan is a victory for capitalism and a victory for the economy: I note the stock market is up over 2.5% since Monday morning, the first trading day after the healthcare vote. That is over 250 points on the Dow.

    Pointing to day to day fluctuations in the stock market as evidence of support for Obama's health care plan seems, well, desperate. And while it's true that the industries who helped write this bill behind closed doors and pumped millions into the pockets of Democrats to secure it's passage are hoping that their largesse will pay off, you can hardly call that "capitalism". It would be better described as corporatism or cronyism. Hurrah, a victory for seedy back room deals, bribes and consensus destroying legislative gimmicks. Pathetic.

    Meanwhile, how are the businesses who weren't allowed a seat at the table and who didn't give the Democrats payoffs doing?:

    Even before President Obama signed the bill on Tuesday, Caterpillar said it would cost the company at least $100 million more in the first year alone. Medical device maker Medtronic warned that new taxes on its products could force it to lay off a thousand workers. Now Verizon joins the roll of businesses staring at adverse consequences ...

    WSJ

    Farm equipment maker Deere & Co expects after-tax expenses to rise by $150 million this year as a result of the healthcare reform law President Barack Obama signed this week ... Most of the higher expense will come in Deere's second quarter, the company said on Thursday. The expense was not included in the company's earlier 2010 forecast, which called for net income of about $1.3 billion.

    Weekly Standard

    Of course, it's early days and $400 million in losses is chump change to an administration that robs future generations of trillions in a single piece of legislation, but I'm sure that Joe Biden is right, "This is a big f***ing deal."

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  37. Desperate? Right, just ignore the verdict from free markets. You are a rather selective fan of laissez faire.

    As opposed to a stubborn and ridiculous insistence that the poll you initially was published in the NEJM? Whatever!

    I do agree with you an one important point. (And yes it really is no big deal to agree with you when you are right as you occasionally are.

    I too am concerned that special interests prevented real reform--that is a public option or a single payer system.

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  38. Desperate? Right, just ignore the verdict from free markets. You are a rather selective fan of laissez faire.

    I don't ignore free markets, I just don't believe that you can divine anything from their daily fluctuations. It will take weeks, perhaps months, before the markets can determine the full impact of a bill that even the politicians who forced it upon us hadn't read before voting.

    It is interesting that someone who supports a "public option or a single payer system" pays any attention to free markets at all. But, hey, delude yourself any way you choose. ObamaCare will turn out to far more expensive than promised - by orders of magnitude - and it will result in substandard medical care. The bankruptcy of Social Security, Medicare and ultimately this ridiculous POS is a mathematical certainty. The socialist welfare state is doomed. Soon, the American people will get the bill for Obama's profligacy. The young people who chanted his name at campaign rallies will be forced to confront the reality that Obama and the Democrats have mortgaged their futures, and that they will spend all of their working lives paying for his recklessness. Further, they will pass the burden on, like a baton, to their children and grandchildren. As Margaret Thatcher said, "The problem with socialism is that eventually you run out of other people's money."

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  39. The passing of the Health Care Reform bill is not only historical, it is overdue. How can we consider ourselves Leaders of the Free World when we do the least to protect the health of our citizens? It amazes me the responses to this bill, "It’s unconstitutional to force people to have health insurance (be healthy)?" If this is the case it should be unconstitutional to force citizens to have car insurance. Every American doesn't have a car, but we all American, Mexican, African, etc have our health. In the event that we are sick, or even worse contagious, one persons bad health can spread to affect many (ie. Swine Flu, Bird Flu, AIDS) Yes it will be an extra expense but is it not worth it? Providing citizens with healthcare is as constitutional as it comes, after all we were granted the right to LIFE! Life is only maintained with good HEALTH.

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  40. Krystal Johnson,

    Yours is a very noble impulse. None of us wants to see those who are truly in need go without medical care. But that is not what this bill is about. Addressing the needs of those unable to care for themselves would have been a straight forward and relatively inexpensive affair, and it would have inspired bipartisan effort and support. This bill is about something larger and more insidious.

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  41. The conversation on this posting seems to be driven entirely by rhetoric. I am not an economist and I have not read the health care bill from back to front in order to be able to comment on the long term financial impacts of this bill. I don't know the ins and outs of the bill and how it will impact the quality of health care in the future. What I do know and what no one seems to have mentioned anywhere in these postings, is that regardless of what this bill does, it surely has to be better than what we have now, which is a system that allows people to go bankrupt from being sick.
    I don't believe that anyone who has commented on here has gone without insurance. If you had you would not be saying the things you do. As someone who has personally been affected by being sick and being uninsured I can tell you that your quality of life is seriously impacted when you don't have medical insurance. Being uninsured the only thing worse than the fear of getting sick, is actually getting sick. While trying to deal with illness you are forced to worry about bills and how you will pay for your treatment. It is a fortune that I wish on no one.

    I suppose that those who are speaking out about this bill don't care that there are people with no insurance. They are afraid that the quality of their health care is going to suffer as a result. I don't think that this is supported by any sort of empirical data. Further where is your compassion? Would you not suffer a little so that others don't suffer completely?

    Also as to this being a "socialist" takeover, where is the support for this claim? The government is not taking over hospitals and insurers.

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  42. The significance of this health care reform will likely not be realized for a number of years. Heath care issues have plagued our country for centuries and no one seemed to have a workable solution. Here 30 million uninsured people will now have access to health care and individuals will not face the fear and worry of sickness –and financial ruin when/if they become sick. People avoid care and treatment that they desperately need because they do not have insurance. Once they are critically ill, when prevention could have solved their problem, they end up in the emergency rooms. Reform was needed and it was needed immediately.
    My concern with the proposed reform however is how the states will pay for the mandated reform. Many states have struggled to meet their Medicaid financial responsibilities for years and under this reform - and now their mandates have been increased. States with large Medicaid populations have been cutting Medicaid services to meet their budget requirements. Granted the federal government will be covering and subsidizing these new program participants initially, but this will be phased out after four years. Then what? The states with lower Medicaid recipients have surplus dollars currently, but states with high Medicaid populations will be in increasingly worse situations. It will be interesting to see what representatives propose as changes to this reform plan and if the Republican law suits being mounted by the states have any impact on agreements going forward

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  43. The conversation on this posting seems to be driven entirely by rhetoric. I am not an economist and I have not read the health care bill from back to front in order to be able to comment on the long term financial impacts of this bill.

    In other words, your comment is based entirely on rhetoric.

    ... it surely has to be better than what we have now, which is a system that allows people to go bankrupt from being sick.

    Leaving aside for a moment that the studies linking most bankruptcies to medical expenses are seriously flawed, this bill will not prevent sick people from going bankrupt. The government will not cover your expenses while you are sick and unable to work. You will still have to worry about bills, and you will have to keep up on your mandated insurance premiums. So, very little changes in that regard. The fact is that people living in countries with single-payer socialized health care still go bankrupt and lose their homes when confronted with the challenges of a major illness.

    I suppose that those who are speaking out about this bill don't care that there are people with no insurance ... where is your compassion? Would you not suffer a little so that others don't suffer completely?

    If this is true, than why does almost every state have some sort of indigent care plan and high risk insurance pool? Why do we have Medicare and SCHIP? We spend hundreds billions every year so that "others don't suffer completely." And those programs, meant to help people, are defrauded out of tens of billions. When a government program provides subsidies to families making 400 percent of poverty - $88,000 a year - it is not about helping people in need. It is about creating a sense of dependency and buying votes. Where is the limit to your greed and sense of entitlement?
    It really is a strange person who mortgages his children's and grandchildren's futures so that he can provide benefits to people who can more than afford to take care of themselves, in the hope of buying their political support, and then calls it "compassion".

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  44. I believe that the health care bill, like all things, has both good and bad aspects about it. Yes, a lot of people are going to be helped, however, this will be at the expense of others whether it be taxpayers, those already insured, etc. I am also interested about the bill's take on the elimination of pre-existing conditions as a basis for coverage. I think this is a good thing in some regards because now individuals with legitimate ailments will be able to receive coverage without "jumping through hoops" per say. However, this also opens the door for people coming forward with health problems that may not even have an adequate medical solution thus creating overcrowding in an already crowded health care system. Either way, I believe it will be awhile before we see the full benefits and consequences of adopting this bill.

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  45. I can honestly say that I am appalled by some of these blog postings. It seems that some people have missed the point of the health care reform. The purpose of this bill is to HELP ALL AMERICANS. It’s easy for many of us to oppose this bill when we currently have health insurance. But, what do you say to that child who has a pre-existing condition or mother who simply can’t afford insurance? Many Americans live a life oblivious to not having such a privilege. As such, we grow insensitive to others who desperately need our help. Furthermore, I find it hilarious that many of the postings which highly criticize the health care reform are anonymous. It makes me wonder whether you would even have the audacity to tell a child with a pre-existing condition that the price of this reform is more important than potentially saving his or her life.

    For those who are concerned with the price tag of this reform let’s review the logic. Many of you can support a war that has cost this country trillions of dollars and killed thousands of people, but oppose a bill that will promote life. Something is wrong with this picture. Clearly, your moral compass is broken. Economically, I do agree that this bill will expose many people to the health care system and ultimately improve the economic growth of this industry.

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  46. I definitely agree with MLK when he said the injustice in healthcare was inhumane. The new health care bill gives hope to Americans, but specifically to middle and lower class Americans who often run into obstacles when trying to afford healthcare.
    I do believe that this bill will uplift society and restore hope in America, which many citizens have lost over the past decade. Many critics of the bill are individuals who have never been sick and unable to pay for, people who have always had medical coverage. It's saddening to hear so many critcs attack such a positive bill. In reality, the healthcare bill may affect our economy; however, there is no value that can be placed on saving lives and promoting a healthy America. The result of this bill will be healthier citizens. Citizens who probably would have died because they couldn't afford healthcare. In 2010, it is truly sad to know that there are still some Americans who are so involved with their "world," they fail to look at reality, and reality is "our world." The world that we all live in consists of people who aren't wealthy, people who don't have insurance, people who are struggling. This bill addresses some of the needs of the people in "our world." At this point, its time for Congress to continue to pass legislation that will positively impact "our world."

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  47. GERMAINE ANTHONY AUSTINMarch 29, 2010 at 11:28 AM

    Well it's about time. I'm very happy to be alive during this monumental moment. I was beginning to think that America would never be able to pass a Healthcare Bill. I've seen many different people fight past health care bill proposals at every different angle. Some people didn't think certain contents of the bill was constitutional, some didn't like how it was being funded and some thought we should take years to think about the bill and its contents, before we even try to pass one. Democrats fought, republicans fought, health care companies fought but they forgot about the people they should be fighting for, the American people. Instead they decided to fight and kill a bill for their own personal reasons. It doesn't make sense for millions of people in America to be uninsured. Then you had a stipulation on health care plans some companies call, preexisting conditions. A stipulation that came from greed and the driving philosophy of the business, to make a profit. Stipulations like the preexisting condition makes people lose hope in healthcare companies. They would rather not have health care and try to save money. Why pay hundreds of dollars every month, only to have your health care company drop your coverage for failing to disclose a condition you didn't know existed?

    I'm very happy that Health care reform was finally achieved. In addition, I hope the system places some checks and balances on the amount of money wasted in healthcare each year. It doesn't make any sense to spend 2.2 billion dollars in healthcare each year only to lose 1.1 billion to carelessness. This is how our past health care system operated. However, I don't find it surprising that people are still upset and are trying to fight the Bill even after its passage; I guess you can't please everyone. At the end of the day, the optimal decision will be made at the margin and whether we like it or not, the concept of, opportunity cost, exists.

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  48. GERMAINE ANTHONY AUSTINMarch 29, 2010 at 11:31 AM

    Well it's about time. I'm very happy to be alive during this monumental moment. I was beginning to think that America would never be able to pass a Healthcare Bill. I've seen many different people fight past health care bill proposals at every different angle. Some people didn't think certain contents of the bill was constitutional, some didn't like how it was being funded and some thought we should take years to think about the bill and its contents, before we even try to pass one. Democrats fought, republicans fought, health care companies fought but they forgot about the people they should be fighting for, the American people. Instead they decided to fight and kill a bill for their own personal reasons. It doesn't make sense for millions of people in America to be uninsured. Then you had a stipulation on health care plans some companies call, preexisting conditions. A stipulation that came from greed and the driving philosophy of the business, to make a profit. Stipulations like the preexisting condition makes people lose hope in healthcare companies. They would rather not have health care and try to save money. Why pay hundreds of dollars every month, only to have your health care company drop your coverage for failing to disclose a condition you didn't know existed?

    I'm very happy that Health care reform was finally achieved. In addition, I hope the system places some checks and balances on the amount of money wasted in healthcare each year. It doesn't make any sense to spend 2.2 billion dollars in healthcare each year only to lose 1.1 billion to carelessness. This is how our past health care system operated. However, I don't find it surprising that people are still upset and are trying to fight the Bill even after its passage; I guess you can't please everyone. At the end of the day, the optimal decision will be made at the margin and whether we like it or not, the concept of, opportunity cost, exists.

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  49. I find it hilarious that many of the postings which highly criticize the health care reform are anonymous. It makes me wonder whether you would even have the audacity to tell a child with a pre-existing condition that the price of this reform is more important than potentially saving his or her life.

    Before this bill was signed, no child needing care was ever turned away from a hospital, period. First, the law required that hospitals treat anyone in need, regardless of their ability to pay. Second, we had a program, SCHIP, that specifically covered the health care needs of children. So, save your moral preening for someone who doesn't know the facts.

    Many of you can support a war that has cost this country trillions of dollars and killed thousands of people, but oppose a bill that will promote life. Something is wrong with this picture. Clearly, your moral compass is broken.

    The war, saved hundreds of thousands of lives. Further, it liberated millions from sadistic tyranny. Your claim, that it cost trillions of dollars, is just gibberish. I would argue that anyone who thought that allowing hundreds of thousands of Iraqi children to die of hunger and disease, not to mention the thousands of adults who were tortured and executed, in order to maintain a sanctions regime that seemed designed only to make certain U.N. officials rich at their expense, is the one with the broken moral compass.

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  50. ... health care companies fought but they forgot about the people they should be fighting for, the American people. Instead they decided to fight and kill a bill for their own personal reasons.

    Health care companies did not fight this bill, they wrote large parts of it. Big Business Goes Big for Health Care Reform, Reason

    Then you had a stipulation on health care plans some companies call, preexisting conditions. A stipulation that came from greed and the driving philosophy of the business, to make a profit.

    Preexisting conditions clauses did not come from greed, but from common sense. The cost of insuring an event with a 100 percent certainty of occurrence, is the actual cost of the event plus administrative and other costs, plus a profit. In other words, it would cost more than the event itself. If they charged any less, they would be putting their other policy holders at risk of not having their claims met when they arose. Try starting a company that sells fire insurance to people after their houses have burned down for the same price as those whose houses are still standing and see how long you're in business.

    And profit, by the way, drives innovation. We have CT scanners, MRI machines, cutting edge drug therapies and the like, not because of charity, but because people were trying to make a profit. The U.S. leads the world in medical innovation because companies here have been able to make a profit. It's greedy capitalists who create the machines and therapies that save people's lives, not community organizers.

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  51. If this bill is so wonderful and necessary to saving children's lives, then why don't the benefits start immediately? Why wait until 2014? What about all those children that are supposedly suffering and dying for lack of care?

    If it's so wonderful, why did Nancy Pelosi and Harry Reid have to bribe members of their own party to pass it? Why was it necessary to resort to consensus destroying legislative tricks and gimmicks to get it passed? Why did the people who wrote the bill seek to exclude themselves from it's provisions? Why did the Democrats have to manipulate the CBO scoring in an effort to mislead the American people about it's true cost? Why does it call for the collection of 10 years of taxes to fund 6 years of benefits?

    This isn't a "monumental moment", it's a travesty.

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  52. Its sad that you have to resort to untrue right wing talking points about the spending in the health care bill. It is true that most of the bill takes until 2014 to be implemented. It does raise moderate amounts of money before spending it - but that is called fiscal responsibility - not an effort to mislead the American people. (A clear graph about spending can be found here http://voices.washingtonpost.com/ezra-klein/2010/03/what_does_the_health-care_refo.html) The bill saves the American taxpayer over 1 trillion over the next 20 years. That is the most aggressive move to lower the debt since Clinton's budget in 1994.

    The reason that the Democrats had to resort to parliamentary tactics is the unprecedented obstruction by the Republicans - if they would have allowed a majority vote in the Senate like the Constitution provides for there would have been no need for tactics.

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  53. Its sad that you have to resort to untrue right wing talking points about the spending in the health care bill. It does raise moderate amounts of money before spending it - but that is called fiscal responsibility - not an effort to mislead the American people.

    In fact, it's you who, like the Democrats, must resort to mistruths about the costs of this bill. The CBO scored this bill, absent the gimmicks used by Democrats, at $2.3 trillion over the next two decades. There are no savings. Not now, not 20 years from now

    ... if they would have allowed a majority vote in the Senate like the Constitution provides for there would have been no need for tactics.

    I'm sure that is just what you will say when it's repealed using the same tactics.

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  54. Its sad that you have to resort to untrue right wing talking points about the spending in the health care bill.

    Douglas Holtz-Eakin, who was the director of the Congressional Budget Office from 2003 to 2005, explains all the gimmicks that the Democrats used to achieve the CBO score for ObamaCare:

    The Real Arithmetic of Health Care Reform, The New York Times

    "In reality, if you strip out all the gimmicks and budgetary games and rework the calculus, a wholly different picture emerges: The health care reform legislation would raise, not lower, federal deficits, by $562 billion."

    If I'm a liar, he is too.

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  55. I am elated to know that healthcare reform has been finally passed. This is truly a day to be celebrated here in a country that is considered to be the land of the free! The new healthcare reform will provide great opportunities for ALL Americans. The Children’s Defense Fund released a story about a young boy who died because he had a major issue with his tooth, that would typically cost no more than a hundred dollars to fix. Unfortunately, his family didn’t have the money and to my dismay the young man passed away. Children are sometimes at a disadvantage and it is sad to see them affected by not having insurance. And now all American citizens will be able to gain access to healthcare. Some would argue that there are some serious drawbacks to universal healthcare, but I am in favor of saying that the positives definitely out way any type of concerns. I know there are some logistics as to how the system will work, but by being a little patient and a little time I am sure that most of the concerns will be ironed out.

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  56. If I'm a liar, he is too.

    Its pretty funny that you quote DHE to back up your point and yet refer to him as the former head of the CBO to bolster your point, but then refuse to accept the actual CBO report which says that this bill will reduce the deficit and begin to slow the rise in health care costs. While one can always criticize the CBO, the fact is that in previous health care bills, such as Medicare part D, the CBO has seriously UNDERESTIMATED the savings in the bill. DHE on the other hand as the economic adviser to candidate McCain told him that the "fundamentals of the economy are strong" during the greatest financial collapse in 80 years. You need to do a better job cherry-picking your wingnut welfare propaganda.

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  57. Its pretty funny that you quote DHE to back up your point and yet refer to him as the former head of the CBO to bolster your point ...

    Read the article, that is how the New York Time's refers to him. Probably because he actually is the former head of the CBO. I assume that puts him in a position to know how the scoring process works, as opposed to some blow hard from "HipHopLaw" who doesn't have a clue.

    ... but then refuse to accept the actual CBO report which says that this bill will reduce the deficit and begin to slow the rise in health care costs.

    Yeah, yeah, I guess that no matter how clearly a point is made - in this case, that the Democrats gamed the scoring process - there will always be some people to dense to follow along.

    While one can always criticize the CBO, the fact is that in previous health care bills, such as Medicare part D, the CBO has seriously UNDERESTIMATED the savings in the bill.

    Actually, they UNDERESTIMATED the COST. Medicare part D, like this health care bill, created a new entitlement and so was never expected to save money. It would have been a lie to suggest otherwise. Just like it's a lie to suggest that this bill will save money. In order to believe that the government will add 20+ million people to the health care rolls, using massive government subsidies, and that will actually result in a savings, you would also have to believe in the tooth fairy. But, then again, that's probably why you're a leftist - you'll believe anything the left tells you.

    Here's the link to a paper produced by the CBO, under Holtz-Eakin, explaining the reasons for the increased cost estimates for Medicare part D. Of course, you may not want to read it as it bolsters the case that he actually was the head of the CBO.

    DHE on the other hand as the economic adviser to candidate McCain told him that the "fundamentals of the economy are strong" during the greatest financial collapse in 80 years. You need to do a better job cherry-picking your wingnut welfare propaganda.

    Yeah, yeah and Barrack Obama told us that the "stimulus" would create jobs and that his mortgage program would aid homeowners. He told us that he would never support health care mandates, or raise taxes on anyone making less than $250,000. He said that the health care negotiations would be held on C-Span and that he would exclude lobbyists from his administration.

    Enjoy your Kool-Aid.

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  58. First of all I don't see whats so complicated about how you take Republican CBO director's word as gospel, but the current CBO director's actual findings as partisan democratic spin. I'll trust the guy who actually has to respond to Republicans in Congress and the entire permanent staff of the CBO rather than a guy who shilled for McCain and is setting up his own right wing think tank.

    Second, whats so hard about understanding that you can spend money on one thing in a bill, but save money on another? Where there were savings on programs in Medicare Part D the savings were underestimated. It is the same in this bill. This bill spends money, about 90 billion a year, but it cuts existing spending and raises revenue through excise taxes on health care plans that adds up to over 100 billion in total savings in 10 years and over a trillion in 20 years. Businesses spend money to save money in the long run all the time. You buy a machine that is more efficient it costs money to buy it but it saves you money in the long run. Here you spend money to cover people but make health care more efficient and raise revenue to cover the rest. Its not complicated.

    As for what Obama promised, he promised a health care bill and he got one.




    Obama said he'd pass health care in his first term and he did.

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  59. In a letter to Ryan, the CBO estimates that if the Medicare cuts were used to help shore up the effectively bankrupt Medicare trust fund instead, then the Democrats health care bill would run $260 billion in deficits over the next decade.

    Earlier CBO estimates also assume that future lawmakers would actually enact some of the unpopular measures, such as the Medicare cuts and the "Cadillac tax." These are crucial to Democrats' claims that the bill will reduce deficits even more -- by $1.2 trillion -- in the second decade. But in the letter, the CBO says that without the changes, deficits would actually increase -- by a quarter of a percent of GDP, or $600 billion -- in the second decade.

    CBO Confirms That Without Accounting Gimmicks, Obamacare Adds to Deficits, The American Spectator

    Both the Medicare cuts and the "Cadillac tax" - which would primarily effect union health benefits - will be almost impossible for the Democrats to enact, that's why the effective date was moved out to 2014. By counting the savings today and pushing the cuts out into the future, they hoped to deceive Americans about the true cost of the bill. Add those back in and you've got red ink as far as the eye can see. That's not me or some "Republican CBO Director" that's saying it, it's Douglas W. Elmendorf, the current CBO Director.

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  60. Nice point, if you take all of the cost controls out of the bill - it won't save money. What a shock. I'm also glad that we can agree the Elmendorf and the CBO are the appropriate authority here.

    Will the future taxes be enacted? Maybe not, although it is certainly more likely if Republicans grow up in the interim. In addition cost controls have consistently been one of the goals of health reform as outlined by the President. Does this bill go far enough in cutting costs? No. Not even close. But Republicans didn't negotiate for better cost controls, they wanted Waterloo. So instead of having a centrist bill, Obama had to cater to the unions who don't want the excise tax. This is a good law that begins to tackle the serious problem of health care inflation and solves some of the serious insurance problems like pre-existing conditions.

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  61. Although there has been great opposition to the healthcare bill, it is quite obvious that the majority of America feels it is necessary. Unfortunately, a number of Americans are not in a financial position to fund the astronomical medical fees that accompany healthcare. Yes, by law, hospitals cannot turn away a sick child, but if it has gone to a point where that child is brought to an emergency room because of an ailment, more then likely, the parent or caretaker cannot afford doctor visits and therefore, will have a hard time finding funds to satisfy the debt of going to an emergency room, or even fighting the battle of having debt covered by a government aid. Let's be realistic and not delusional. Just because Medicaid, Medicare, and the such are in place does not mean that most people that need it are able to use it! True, there are those that abuse the system, but we cannot let one bad apple spoil the bunch.

    I would like to specifically address two of Annonymous' comments.
    1. "Charity is something you do with your own money, not someone else's. Christ never instructed us to steal from one man to benefit another."
    You sound ridiculous. Taxes are collected for the wellbeing of the Nation, therefore it is OUR money. It was voted on to use in a particular manner. If you were to try to argue that you do not approve of your insignificant portion being used for the healthcare bill, you would likely get laughed at by the court. One should not be so selfish. I am sure it is your hope that when you are in a time of need, there will be others to donate time, money, etc to you. No one is a position to consistently be self sufficient in every aspect of life. Your time of need has or will come and you too will be in search of "charity". Additionally, how is this stealing? Is it really any different then taxes being used for public schools, the war, the roads...?

    2. "You need not grow up". The sarcastic response to a comment mentioning that children can remain on a parent's health insurance until the age of 26.
    This encourages students to continue in higher education. Most professional jobs require years of schooling and sometimes experience before making a substantial income. At times, that schooling does not offer the opportunity for employment to earn an adequate income. Young adults often must choose between school and work to make ends meet at a specific time in life. When one must choose to work instead of completing school, life sometimes gets in the way of continuing school. Stunting the growth of our youth and young adults will only stunt the growth of our economy. You complain of doctors wanting to retire once the bill is enforced. Why not encourage the youth to pursue medical school since they will be guaranteed health care under their parent's insurance (and not have to worry about keeping a full time job) so that they can take care of the millions of Americans that will now be able to seek medical care!?

    Ms. Styons made a great point about the people who need health insurance are the same people who cannot afford to live a healthy lifestyle, specifically a healthy eating lifestyle. These people are stuck in a vicious cycle. How can they prevent the need for health care by living a healthy lifestyle if they cannot afford the "healthy food". It's a lose lose situation and something must be done.

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  62. Nice point, if you take all of the cost controls out of the bill - it won't save money. What a shock.

    Yeah, and if you count measures that have not been enacted as cost controls and double count "savings", you get a bill that reduces the deficit.

    Unfortunately, the credit ratings agencies and the bond markets are not as easily fooled as your average leftist. The U.S. in now paying more than some private corporations to borrow money and the credit ratings agencies are warning of a downgrade to our debt. Maybe they need to hang out in faculty lounges more often.

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  63. Now that this pig has passed, left-wing "journalists" feel freer to examine it's true cost. What they find isn't pretty:

    The official projections for health-care reform, which show it greatly reducing the number of uninsured and also reducing the budget deficit, are simply not credible. There are three basic issues.

    1.The cost and revenue projections rely on unrealistic assumptions and accounting tricks. If you make some adjustments for these, the cost of the plan is much higher.

    2.The so-called “individual mandate” isn’t really a mandate at all. Under the new system, many young and healthy people will still have a strong incentive to go uninsured.

    3.Once the reforms are up and running, some employers will have a big incentive to end their group coverage plans and dump their employees onto the taxpayer-subsidized individual plans, greatly adding to their cost.

    Read it all, if you think that your world view can stand it.

    Obamacare By The Numbers, The New Yorker

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  64. Well this all has been very interesting.

    I just want to make two small points.

    First, the market was up again this week. So in the last 2 weeks the market has been consistently positive. This is a total rebuke of far right wing rhetoric regarding some kind of imagined "socialist" takeover.

    Second, here is the table of contents for the most recent issue of of NEJM: http://content.nejm.org/current.dtl

    Even the most far right wing wacko must admit there sim[ply is no such poll in the NEJM. They just made it up folks.

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  65. What courage Congress has shown! I don't understand how anyone can deny the importance and necessity for Health Care Reform. How can you deny your adult children continued coverage on your insurance plan while they pursue higher education? Or would you prefer that your elderly parents, church members, or neighbors not be given a rebate immediately to help cover the cost of their spiraling prescription drugs? Most participants on this blog have some financial astuteness and can appreciate that if the Government miraculously found Billions to bail out the Banks, it can find a little less to bail out Americans who are striving to live healthy productive lives.

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  66. I am truly for the health care bill and for the economic, social, and humanistic benefits it provides. However, my only contention is the procedural aspect used to pass the bill. Our great nation is deeply rooted in the Constitution and the checks and balances it provides. In my opinion, the step taken to pass the bill is a true mockery of those checks and balances. I have had several discussions on how Congress has the authority to pass this bill and I have been told through the commerce clause or the tax and spending clause, however it doesn’t seem to add up.

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  67. Even though I support Health Care Reform I do have concerns. There is already a lack of health care workers in hospitals. Expanding health care access to everybody might make this shortage more evident. The end result could be a deficiency in the quality of care provided to each patient. Hopefully this economy gets better so we can afford to have more health care workers to keep the level of care up for everybody.

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  68. This bill is long overdue. the biggest issue I have with this bill is that it took so long to pass. The republicans oppossed to the bill continued to give reasons why this bill was so terrible. However, why didn't they come up with a new one that was better instead of fighting for the status quo. Furthermore, this bill will inspire macroeconomic growth because now everyone can go see a doctor or go to a hospital which will create a greater demand for doctors, nurses, hospitals, etc. Just the building of hospitals creates many construction jobs, people to work in the hospitals in the non medical areas. Also, the American taxpayer will no longer be paying hospital bills for those who can afford healthcare but choose not to get it. Again, let me make it clear, I'm not saying I had a problem with indigent people whose simply could not afford healthcare, I'm taking about people who had the financial resources to get healthcare and chose not to. This plan also makes healthcare affordable to indigent people. Its a win for the American people for the most part. Those people concerned with future rises in taxes due to this bill I say this. As taxpayers we were already paying the hospital bills for millions of people without healthcare. Their bills were most likely a lot higher because instead of these people treating problems early or getting preventive care, they would be rushed to the hospital for expensive treatment. I could continue speculating on all the benefits we as a nation will recieve from this bill. I am not saying it was perfect by any stretch of the imagination, but its the best we could come up with. When we balance that with the previous status que, I think there is no question that having the healthcare reform pass was a better move than not passing it.

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