Healthcare Follies

It's awe-inspiring that the people who want to take over healthcare have trouble throwing pep rallies...

As Speaker Nancy Pelosi led her House Democrats down the Capitol steps Thursday morning for a health-care pep rally, the sound system began to crank out . . . wait, that's not U2's "Elevation," is it?

Alas, it was.

I need you to elevate me here

At the corner of your lips

At the orbit of your hips

Eclipse, you elevate my soul

I've lost all self-control . . .

Okay, you can stop blushing now.

Whenever politicians stage pep rallies to roll out the details of a new policy, the proceedings should be taken with a grain of salt. But Thursday's effort by House Democrats came with six 50-pound bags of salt -- ice-melting salt, to be specific -- placed on the bases of the six U.S. flags on the stage to keep them from toppling over in the wind and marring the event with unwanted visuals and ruinous metaphors.

The Democrats' preparations were elaborate. They chose a spot, on the West Front of the Capitol, near where Newt Gingrich announced his "Contract With America" 15 years ago. They had red, white and blue convention-style signs that, instead of displaying the names of states, offered messages such as "Expand coverage" and "Strengthen Medicare." They shared the stage with about 30 "real people," flown in from around the country, who could tell tales of health-care woe. One Capitol police officer, claiming that she was acting under instruction from Pelosi's office, even kept Republican staffers from entering the event.

But for all the precautions, policy pep rallies have a way of taking unwanted turns, and Thursday's did so almost immediately after Pelosi stepped to the microphone. "Nancy Pelosi, you'll burn in hell for this," said a voice, amplified by a bullhorn, from about 50 yards away.

"Thank you, insurance companies of America," Pelosi replied to the man. Actually, they were abortion protesters, and they were loud.

...Finally, police were able to silence the activists, who held a gruesome poster showing an aborted fetus and signs demanding "Kill the bill."

Pelosi and her lieutenants did an impressive job of putting together a health-care reform compromise that probably has enough support to pass. Her watered-down version of the "public option" -- leaving the government insurance plan to negotiate rates with providers rather than imposing Medicare rates -- meant that Thursday's rally included a few moderates from the "Blue Dog" coalition along with liberal Democrats.

But Pelosi's legislative finesse was not matched by her skills as a pep rally organizer. Only about 80 House Democrats, about a third of the caucus, were on the stage on the cool and gray morning. The others, Pelosi tried to explain to the crowd, "are in hearings, because the work of Congress does not stop just because we have an important message to give to you."

Another possible reason for the sparse attendance: Health care may be hugely important, but it's hard to get fired up about the nitty-gritty of policy. "The uninsured will have access to a temporary insurance program -- we're calling it a high-risk pool -- from the date of enactment until the exchange is available!" Democratic Whip Jim Clyburn (S.C.) told the rally.

A small number of people, many of them paid staffers standing off to the side, offered polite applause for the high-risk pool.

"From the date of enactment, we'll hinder price-gouging with sunshine requirements on insurance companies to disclose insurance rate increases!"

Light applause for rate-increase sunshine requirements.

You know, perhaps the lack of enthusiasm stems from the fact that most Americans don't know what's in the 1,990 page bill. Then again, most of Congress probably doesn't know either...

Congressional budget experts predicted the controversial government insurance option would probably cost consumers somewhat more than private coverage. At the same time, rank-and-file conservative Democrats sought additional information about the bill's overall impact on federal health care spending.

There was no official estimate on the total cost of the legislation, which ran to 1,990 pages. The Congressional Budget Office said the cost of additional coverage alone was slightly more than $1 trillion over a decade. But that omitted other items, including billions for disease prevention programs.

Yet another $230 billion or more in higher fees for doctors treating Medicare patients, included in an earlier version of the bill, was stripped out and will be voted on separately.

The measure "covers 96 percent of all Americans, and it puts affordable coverage in reach for millions of uninsured and underinsured families, lowering health care costs for all of us," boasted Speaker Nancy Pelosi, D-Calif., at a ceremony attended by dozens of Democratic lawmakers. She spoke on the steps of the Capitol, not far from where Obama issued his inaugural summons for Congress to act more than nine months ago.

Pelosi said the legislation would reduce federal deficits over the next decade by $104 billion, and congressional budget experts said it would probably reduce them even further over the following 10 years.

...One of the bill's major features is a new national insurance market, in which private companies could sell policies that meet federally mandated benefit levels, the government would offer competing coverage and consumers could shop for the policy that best met their needs.

In a bow to moderates, Democrats decided doctors, hospitals and other providers would be allowed to negotiate rates with the Health and Human Services Department for services provided in the government insurance option.

Liberals had favored a system in which fees would be dictated by the government, an approach that would have been less costly than what was settled on, and also would have moved closer to a purely government-run health care system than some Democrats favor.

The Congressional Budget Office said the result would be fees comparable to those doctors receive from private insurers. But for consumers, government-backed plans "would typically have premiums that are somewhat higher than the average premiums for private plans" sold in competition. As a result, it said enrollment would be only about 6 million.

I'm sure businesses that face high health care costs will continue to offer health care to their employees rather than paying a penalty at a lower cost. And I'm sure those employees won't feel bad about having to pay the higher costs for the public option. And I'm equally sure that the bill's cost isn't underestimated, because the estimated costs of government entitlement programs are always on the mark...

Beware of government estimates about the future cost of ObamaCare. When Medicare was being considered in the mid-1960s, the government projected that the outlays for the program 25 years down the road would be $10 billion. Instead, in 1990, 25 years later, the outlays were $107 billion. Government estimates were off by a factor of more than 10!

Medicaid, the other large medical program currently in effect, outdid Medicare. Medicaid outlays in 1968 were $1.8 billion. In 2007 they had risen to $190.6 billion, an increase in dollar terms of 105.9 times.

And that is only the Federal outlay number. There is a roughly equal Medicaid amount spent by the states due to federal mandates.

I'm sure I'll be able to explain the tremendous debt burden to my daughter by saying "Hope and Change" over and over. Then again, she's only two years old.