February 7, 2011

Mitch Daniels in the WSJ: "Unless you're in favor of a fully nationalized health-care system, the president's health-care reform law is a massive mistake.."

The Indiana Governor (and potential GOP presidential candidate) ponders what the states can do if the law is not repealed or judicially voided. The states cannot be commandeered to run the program, so there is leverage to bargain. These are the conditions that 21 governors have proposed to the Secretary of Health and Services:
• We are given the flexibility to decide which insurers are permitted to offer their products.

• All the law's expensive benefit mandates are waived, so that our citizens aren't forced to buy benefits they don't need and have a range of choice that includes more affordable plans.

• The law's provisions discriminating against consumer-driven plans, such as health savings accounts, are waived.

• We are given the freedom to move Medicaid beneficiaries into the exchange, or to utilize new approaches to the traditional program, instead of herding hundreds of thousands more people into today's broken Medicaid system.

• Our state is reimbursed the true, full cost of the administrative burden to be imposed upon us, based on the estimate of an auditor independent of HHS.

• A trustworthy projection is commissioned, by a research organization independent of the department, of how many people are likely to wind up in the exchange, given the large incentives for employers to save money by off-loading their workers.

Obviously, this is a very different system than the one the legislation intends....
That's a GOP proposal on how to tweak health care reform, which is what Obama and others have said they need. With the prospect of 21 states dropping out of the enforcement regime, there should be real pressure to work with them and try to draw them back in.

On the other hand, you really are in favor of a fully nationalized health-care system, then you might celebrate the states failure to go along with the attempt to include them. And if what happens is, as Daniels predicts, "first-rate operational catastrophe," then that sets up the collapse into the only workable fix a fully nationalized health-care system.

56 comments:

Scott M said...

then that sets up the collapse into the only workable fix a fully nationalized health-care system.

While I'm a tad loathe to cite drama-queen Beck, this is pretty much exactly what he said they were doing when they passed health care to begin with. I know this only because I was out to get lunch one day and was flipping through the Sirius stations in search of Raw Dog. I feel the disclaimer is necessary :)

AJ Lynch said...

Obamacare is Romneycare. I don't think Massachusetts is too happy with RomneyCare. But I thought the states were supposed to experiment with stuff and the other states would adopt the successful experiments. Obamacare adopted the failed experiment.

Larry J said...

then that sets up the collapse into the only workable fix a fully nationalized health-care system.

That sounds like a false option. Given that the government's 40+ year experience with attempting to manage health care (Medicare and Medicaid) is what got us into this mess, how is it the only option to ObamaCare even more government controlled health care? They've never proven the ability to do a good job with the programs they have, so why is it assumed they could do a good job controlling everything? That's stupid. Another alternative is to phase out or radically downscope the existing government controlled health care programs.

george said...

So it sounds like the states are saying that you can pass your reformation but you can go pound sand if you think we are actually going to participate in it. The administration has already been effectively told the same thing by private companies who have been given waivers.

Us small business guys are making no preparations to comply. It really isn't possible. This fact has already been acknowledged by the repeal of the 1099 provision.

The day they try to enforce the rest of this crap is the day we shut our doors permanently. My business has already made preparations to get rid of half of our employees and the rest will go if this thing ever gets off the ground.

European countries don't have high systemic unemployment for no reason.

MadisonMan said...

It looks like Federalism at work.

PETER V. BELLA said...

What would happen if a state just snubbed their nose at the so called reform and refused to participate?

SGT Ted said...

Democrats will continue to deny that Republicans have a plan so that the State Run Media can use it as an unchallenged talking point. The usual assortment of leftwingers will parrot it.

Journo-Losers.

Jana said...

@Scott M: Beck wasn't the only one to point this out. Such conservative luminaries as Jan Schakowsky and Barney Frank affirmed that the destruction of private health insurance was the ultimate goal of health reform.

In any case, after closely watching the mess of the last two years, I have trouble imagining the scenario in which nationalized health care passes. I'm not saying it couldn't happen, but replicating the favorable political milieu (for Democrats) again any time soon would be a feat.

edutcher said...

I have a feeling that somewhere John C Calhoun is smiling. This sounds a bit like nullification.

But Daniels is right about one thing. The system as laid out in ZeroCare would collapse. What The Zero really wants is single-payer.

Lisa said...

I would prefer a nationalized health care system like what Israel has.

Health care should not be for profit.

Jana said...

@Lisa: Yeah, health care should be non-profit. Those non-profit government concerns like education are producing top quality outcomes. Let's replicate those raging successes in the health care industry!

Robert Cook said...

"Given that the government's 40+ year experience with attempting to manage health care (Medicare and Medicaid) is what got us into this mess...."

Um, no.

Our health care mess has nothing to do with our Medicare/Medicaid programs, and in fact those programs have been successful in alleviating the difficulties of the aged and indigent in obtaining necessary but costly medical care.

Robert Cook said...

By the way, Mitch Daniels to the contrary, I am in favor of a nationalized health-care system, yet I vehemently believe Obama's Romney-like HCR is a massive mistake.

Lisa said...

Jana,

Actually, our schools are doing a good job. Sadly, if one breaks down performance by race, our students are doing quite well within their own racial groups.

And again, having lived in Israel where there is a nationalized health care system, where health care is not for profit, yes, it clearly is a better choice.

Health care as it stands in the U.S. is untenable. Insurance companies and for-profit medical centers eye on profits has sent medical costs soaring. It isn't working now... why not try something that is working elsewhere?

Carol said...

"how is it the only option to ObamaCare even more government controlled health care?"

Desperate men often double-down, and kick the can down the road.

Maguro said...

Health care should not be for profit.

Why not?

MadisonMan said...

What would happen if a state just snubbed their nose at the so called reform and refused to participate?

My guess? A bill would stop payment on a lot of things to the state unless they participated. It's the tried and true method of forcing State participation in Federal Govt programs.

Hoosier Daddy said...

Our health care mess has nothing to do with our Medicare/Medicaid programs

Our health care mess is a result of transferring more and more of the financial responsibility for all medical care to a third party (insurance, Medicare, Medicaid).

Robert Cook said...

"Those non-profit government concerns like education are producing top quality outcomes."

They have in the past, and still are in many areas of the country.

For many years our public education system was admired by the world and was a true boon to our citizenry. That we presently see ineffective public education in school districts around the nation--though not all school districts--does not invalidate effective public education as worthy and achievable.

Hoosier Daddy said...

Health care should not be for profit.

There are three basic things that are required for survival: Food, clothing and shelter. If the argument is that health care should be provided for free on humanitarian grounds, then logic dictates that groceries, clothing and housing should all be provided on a non-profit basis.

Scott M said...

but replicating the favorable political milieu (for Democrats) again any time soon would be a feat.

This is very true.

Health care should not be for profit.

It's skill-based. Like anything skill-based, there are going to be really shitty providers and really exceptional providers. If you want to keep the exceptional skill in that field, how do you reward their expertise versus shitty providers?

Hoosier Daddy said...

For many years our public education system was admired by the world and was a true boon to our citizenry.

So what happened to diminish our public education in the eyes of the world?

It certainly isn't a lack of dollars.

AllenS said...

Yeah, food should be non-profit. Why do we pay endless amounts of our hard earned money to farmers?

Scott M said...

I am in favor of a nationalized health-care system, yet I vehemently believe Obama's Romney-like HCR is a massive mistake.

After you wave that magic wand, RC, are you going to let me opt out completely and rely on my own HSA and catastrophic insurance?

Scott M said...

And again, having lived in Israel where there is a nationalized health care system, where health care is not for profit, yes, it clearly is a better choice.

Propped up by foreign aid and dealing with a drop-in-the-bucket population by comparison. Next realistic idea, please.

mccullough said...

It would be nice to see Obama and Daniels debate this in Oct. 2012.

Daniels is just the guy to clean up the mess Obama and W. have created.

LarryTheOlder said...

Off topic:

Governor Daniels surprises Sugar Ray Leonard-

Sugar Ray Leonard

Hoosier Daddy said...

dealing with a drop-in-the-bucket population by comparison.

Excellent point. Its possible that people don't realize that we are a nation of 300+ million whereas Israel is about 6-7 million. Sweden, another nation consistently touted for its great health care is about 9.3 million.

Again, rising health care costs are not unique to the US but in developed Europe as well. France and Germany (two more lauded programs)are both contemplating raising taxes to compensate for rising costs. Couple that with an aging demographic and there you go.

Consider how much we spend on illness that is entirely preventable. Obesity just for starters is contributes directly to heart disease and Type 2 diabetes. When I was growing up in the 70s and 80s, you had the occassional tubby kid. Now, its an epidemic.

Pogo said...

Oh, so now the left wants a debate on socialized health care.

Fire, aim, ready.

MadisonMan said...

Daniels is just the guy to clean up the mess Obama and W. have created.

Daniels will have a hard time getting through the Republican Party Primaries. Not socially conservative enough.

Hoosier Daddy said...

Daniels will have a hard time getting through the Republican Party Primaries. Not socially conservative enough.

Suffice it to say that if 2 years from now unemployments remains unchanged (or God forbid worse) and the debt continues to balloon, I'll wager that God, Guns and Abortion will be taking a backseat to the economy.

That of course assumes he doesn't face a real crisis.

Bender said...

Nationalized health care is a matter of social justice!

We need a truce on these issues. Rather than allowing such things to distract us from the really important things, we need to have a truce, to simply acquiesce and permit solidification of the status quo. No more fighting on social issues!! TRUCE!

Bender said...

Daniels -- "We have no choice but to prepare for the very real possibility that the law takes effect in 2014 . . . what could be done to reshape it in the direction of freedom and genuine cost control?"

In other words, Daniels opposes ObamaCare, but he's not willing to fight all that hard against it. With this emphasis on reshaping the law and working with it, he proves himself here all too willing to surrender and give in.

Nullification?? What a piss-poor understanding that we might see echoes of nullification here. The only thing that Daniels is willing to nullify here is his spine.

Hagar said...

Maybe we want to establish a social welfare program of medical care for the indigent; sort of like the Veterans Administration, but for civilians, and fi we decide we can afford it, let us do so.

For the rest of us, the Government should get clear out of the business - either medical care or medical insurance - except for investigating and prosecuting criminal malpractice and financial fraud schemes, as it is obliged to do for any other industry.

How things work in Israel and why, I do not know, but I suspect it is similar to the Scandinavian countries - at least the way things were a generation or more ago - in being a small country, with everybody more or less related and knowing more about everybody else's business than they should. There is also the patriotic aspect and the feeling of "being in the same boat."

None of this applies to the United States, which is a large country with a very heterogeneous population, and no one feels particularly responsible for his neighbor's welfare. Government money is manna from heaven. Taxpayers' money is everybody's money, which is the same as nobody's money, and it would be positively sinful for you not to grab as much of it for yourself as you can.

This is just the way the world is, and no amount of wishful thinking is going to change it.

Scott M said...

Taxpayers' money is everybody's money, which is the same as nobody's money

This only holds if you feel zero duty to be a responsible citizen of this country. Most, I argue, would disagree and hold that taxpayers' money is everyone's money, hard-earned for the most part. It should be husbanded and carefully spent with the most bang for the buck because it's one-half of a social construct/contract everyone agrees to be a part of.

Hagar said...

Spoken like a true Democrat, and I am sure the Great Pumpkin will have something nice for you, come Halloween.

But people just are not built that way, and whatever they say, it is not the way they will act.

Hagar said...

In fact, is not the Government already estimating $50-60 billion annually in outright fraud from the existing Medicare/Medicaid programs and implicitly declaring itself powerless to do anything about it?

You add "Obamacare" to that, and just the potential fraud figure will be something else, and that will again be dwarfed by the cost of more or less legitimate demands for first class and then some treatment for just minor ailments and injuries.

Scott M said...

Spoken like a true Democrat

Me? LOL, you either haven't been around long enough, or don't read my posts. Either way, no skin off my teeth. Most people I know that live center-right, or even right (without extreme-ing it all the way to anarchy) agree to pay some taxes on some services. To say those funds are "nobody's" money flies in the face of both the actual facts and common sense.

Hagar said...

Have you noticed what happened to the couple of trillion the Fed and the Treasury "created" and gave to their cousins on Wall St. to "stabilize the system"?

Scott M said...

Have you noticed what happened to the couple of trillion the Fed and the Treasury "created" and gave to their cousins on Wall St. to "stabilize the system"?

Shredded up for parakeet cage liner?

Hoosier Daddy said...

Most, I argue, would disagree and hold that taxpayers' money is everyone's money, hard-earned for the most part.

Problem is, its not everyone's money. The problem is almost half the wage earners pay zero or nominal income tax while the upper income earners foot well over half of the total federal income tax bill.

When so few are actually paying the bills, its no wonder we have what amounts to an aristocracy.

Scott M said...

When so few are actually paying the bills, its no wonder we have what amounts to an aristocracy.

Good point. Let me clarify by amending my "everyone's" to "everyone that pays taxes". You can milquetoast that down to sales tax only if you like, but I'm primarily referring to income taxes.

Hagar said...

The problem is that a taxpayer in Yoknapatawpha County can see and understand his and his neighbors' interest in proposed improvements, may agree to finance
some, with conditions, and will watch to see that those conditions are complied with.

In the world's largest economy with 300 million plus citizens, even Bill Gates does not amount to that much, and the rest of us nothing at all, so "we are not really hurting anyone if we just grab what we can of what's floating by. No one will even notice it!"

Scott M said...

Hagar

You're basically describing the mentality of a crowd of people that just watched an armored car wreck. Yes, a mass of people will flock to grab as much money as possible. Some will instead check to see if the guards are okay. Still others will collect money and return it to the bank it belongs to.

Not everyone flocks.

Hagar said...

And the first ones will prosper, and the last ones will feel foolish, and at the next armored car wreck they see, they will go to grabbing too. And that's just the way it is.

Scott M said...

And that's just the way it is.

That's not the way everyone is. You'll have the same three groups on the second crash even among people that have seen one before.

Nihilism is unbecoming.

Hagar said...

Any program contingent on people somehow being inveigled into acting otherwise than people do, is doomed to failure.

That is the besetting of all utopian social schemes.

Scott M said...

Any program contingent on people somehow being inveigled into acting otherwise than people do, is doomed to failure.

The US military, indeed any military worth a spit, is predicated on the suppression of individual needs for the needs of the unit. What part of Star Trek 2 didn't you understand?





























KAAAAAAAAAAAAHN!

AJ Lynch said...

I look forward to the govt forcing Pinch Sulzberger to give each of us a free subscription to the New York Times.

Paul said...

What I really don't like is how all the UNIONS and Obama's corporation friends get a pass on this 'health care' while everyone else is supposed to foot the bill.

Yea it stinks.

Imagine if Bush had done this with his oil friends.

Bruce Hayden said...

Health care as it stands in the U.S. is untenable. Insurance companies and for-profit medical centers eye on profits has sent medical costs soaring. It isn't working now... why not try something that is working elsewhere?

Well.... No

The untenable part is really the provision of the same level of health care to those who don't work for it as those who do. You assume your answer if you start from the premise that most of us are suffering.

The idea that for-profit companies are the problem is, again, ludicrous. Your premise seems to be based somehow on the assumption that all that "profit" (which is not all that high) is the reason that we have financial problems, and that if we could somehow recover that, it could be used for providing care for those who don't or won't pay for their own health care and health care insurance.

But this is all based on the fallacy that the government can run the health care industry more efficiently. And, yes, the overhead is a bit lower with Medicare, etc. But that is partly because much of the overhead is hidden elsewhere in the budget. But what swamps all this is the rampant fraud in those programs. Far, far, more than any insurance company profit.

And that is part of why those government programs appear at first glance to be doing better than for-profit companies - because the government does little to combat the rampant fraud in those programs.

Finally, government run health insurance and health care has done miserably over the years. Yes, you can cherry pick countries where it has not done abysmally, but there are very good reasons why Canadians come here for their semi-elective surgeries, and the Brits have horrible survival rates for most types of cancer, at least in comparison to ours. Both of these are a result of the inherent rationing that inevitably becomes a part of government run health care (can you say "Death Panels"?)

Freeman Hunt said...

Everyone who knew anything about politics already knew that when the bill was being passed.

So we're planning to tweak it now?

For fark's sake, leave us alone. Repeal the poorly constructed Frankenstein bill. Go away, bureaucrats, go away.

MarkD said...

Sure, the Second Law of Thermodynamics shows that is what will happen when the current system collapses. A perfect substitute arises - the DMV on steroids.

I'm going to find a doctor who will take cash. The rich will go to India as medical tourists. The poor and illegals can take two aspirin and get in line.

If I had a habit that was the primary cause of lung cancer, I'd be, shall we say, more cautious about destroying the best healthcare in the world. Even now the kid who would have discovered the cure might be changing to a career in law.

AJ Lynch said...

I agree with Freeman. The Obamacare bill can't be fixed. Scrap it and leave us alone.

The problem is these career pols can't resist the urge to write new legislation- that is their solution for everything. Hence, we have Lindsay Gramnesty reviving immigration reform every 6 months or so.

PatCA said...

Attacking the monstrous bill from the flanks!

Well done, Sir Knights. Keep it up.

Timon said...

What exactly is the health care crisis? The only crisis I see is pols like Romney and Pelosi who think they have right to spend money their governments have not acquired by appropriate channels.