Why such a visceral reaction to the health care law?

Why do so many Americans have such a visceral reaction against the new health care law?   It seems to me like a bad law, poorly thought through and terrifyingly expensive, especially given our present deficits.  But I’m thinking that even if it were not so expensive and were not such a Rube Goldberg chain of complexities, that many of us would still be angry about the thing.

Is it that a  government-designed health care system makes us feel like wards of the state, dependent on the government for our health and thus our very lives?  Many of us don’t begrudge welfare to the truly needy, but recoil at the thought of being on welfare ourselves.  Does this new system put us, on some level, all on welfare?

Or is it that we don’t trust the government’s ability to run things effectively, and so are panicked at the thought that the government is now going to be in charge of our health?

Or is it that the health care law, perhaps coupled with the financial bailouts,  represents a repudiation of all that free market, new morning in America policy associated with the Reagan Revolution?  Are we perceiving this as a counter-revolution back to the welfare state ideology of LBJ and other Democratic social engineers?

Or what?  I know you can say something like “all of the above,” but I would find it helpful to know not just what you are thinking but what you are feeling, down in your gut.  I’m not looking for policy analysis but psychoanalysis.  (Not that you are psychos. . . You know what I mean!)  I would welcome hearing from tea partiers and also those of you who are all for the bill, whether this makes you feel better about America, or better about reversing the culture of conservatism that has reigned since Reagan, or whatever.

To stupak

Bart Stupak, the pro-life Democratic congressman from Michigan, went from a hero to a goat in a single moment.  With his blocking of the health care reform bill unless it included anti-abortion provisions, pro-lifers were thinking they too might be able to become Democrats after all.  But then came his press conference in which he agreed to accept the bill on the basis of a presidential executive order saying tax money will not be used to pay for abortions, something that can’t be enforced in the courts, can be changed at will, and doesn’t matter anyway since segregating money means as little as  putting it in your right pocket rather than your left.  So now BOTH pro-lifers AND pro-abortioners are mad at him.  The whole performance inspired Kathleen Parker, who is no right-winger, to coin a new word:

Stupak.

Etymology: Eponym for Rep. Bart Stupak.

Function: verb

1: In a legislative process, to obstruct passage of a proposed law on the basis of a moral principle (i.e., protecting the unborn), accumulating power in the process, then at a key moment surrendering in exchange for a fig leaf, the size of which varies according to the degree of emasculation of said legislator and/or as a reflection of just how stupid people are presumed to be. (Slang: backstabber.)

Poor Bart Stupak. The man tried to be a hero for the unborn, and then, when all the power of the moment was in his frail human hands, he dropped the baby. He genuflected when he should have dug in his heels and gave it up for a meaningless executive order.

Now, in the wake of his decision to vote for a health-care bill that expands public funding for abortion, he is vilified and will forever be remembered as the guy who Stupaked health-care reform and the pro-life movement. . . .

Stupak’s clumsy fall from grace is a lesson in human frailty. In a matter of hours, he went from representing the majority of Americans who don’t want public money spent on abortion to leading the army on the other side.

Something must have gone bump in the night.

Whatever it was, demonizing Stupak seems excessive and redundant given punishments to come. Already he has lost a speaking invitation to the Illinois Catholic Prayer Breakfast next month. His political future, otherwise, may have been foretold by a late-night anecdote.

After the Sunday vote, a group of Democrats, including Stupak, gathered in a pub to celebrate. In a biblical moment, New York Rep. Anthony Weiner was spotted planting a big kiss on Stupak’s cheek.

To a Catholic man well versed in the Gospel, this is not a comforting gesture.

via Kathleen Parker – Stupak’s fall from pro-life grace – washingtonpost.com.

Use the verb “stupak” in a sentence to bring up other examples of people standing up for principle only to cave when it mattered most.

“Gee, I hope this works”

Ruth Marcus BELIEVES in the new health care reform law.  But she points out that no one knows exactly what it will do:

If I were a member of Congress, my floor speech before casting a yes vote would have boiled down to:

Gee, I hope this works.

One of the astonishing aspects of the health-care debate is how little is actually known about the implications of a change this far-reaching. Everyone has a theory, and a model to match, but even some of the most fundamental questions remain the subject of debate.

On the most basic of all — does having health insurance lead to better health? — the evidence is solid but not unanimous. The Institute of Medicine, reviewing the literature in 2009, found that “the body of evidence on the health consequences of health insurance is stronger than ever before. . . . Simply stated: Health insurance coverage matters.”

But a study that same year by Richard Kronick, a former health-care adviser to President Bill Clinton, found “little evidence to suggest that extending insurance coverage to all adults would have a large effect on the number of deaths in the United States.” . . .

To take another example, one common assertion has been that the uninsured end up getting health care — just more expensive health care, in emergency rooms and when conditions have worsened, with the costs passed on to the rest of the population. The notion that the tab is being picked up one way or another makes intuitive sense.

A new National Bureau of Economic Research paper by Michael Anderson, Carlos Dobkin and Tal Gross questions this assumption. The researchers examined health-care consumption by 19-year-olds who had just been dropped from their parents’ coverage. They found that not having insurance resulted in a 40 percent reduction in emergency room visits — “contradicting the conventional wisdom that the uninsured are more likely to visit” the emergency room and a 61 percent drop in hospital admissions.

“Overall, these results suggest that an expansion in health insurance coverage would substantially increase the amount of care that currently uninsured individuals receive and require an increase in net expenditures,” the authors write. Emergency room visits could increase by 13 million annually, and hospital admissions by 3.8 million, they project. . . .

Will younger adults, who account for about half the population of uninsured non-elderly adults, sign up for coverage — or will they pay the fine instead? How will that decision affect premium levels and the adequacy of federal subsidies?

Will the expansion of coverage create a shortage of health-care providers and result in higher prices, or will, for example, higher Medicaid payments for primary-care doctors stem an exodus of doctors from the program? Will employers add coverage because workers facing the mandate to obtain insurance will press for it, or will they drop it because it will be cheaper to pay the penalty and let employees fend for themselves?

Will increased coverage of preventive care save money because diseases will be caught earlier — or will the added cost of widespread screening exceed the economic benefits? The Congressional Budget Office has concluded that, “for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.”

via Ruth Marcus – A generous dose of caution on health reform – washingtonpost.com.

We don’t even know the regular consequences of this new health care system.  Let alone the unintended consequences.

Obamacare is the law of the land

The President has signed the healthcare reform bill.  It is now the law.

How do you think this will shake out? Some conservatives feel glee, thinking they will now trounce the Democrats for pushing through this unpopular proposal. Democrats, though, are going on the offensive, launching a big PR campaign to win over the public.

Another view I’ve heard is that the public will actually like the provisions that go into effect early (see below). The big taxes and expense, the surge in insurance premiums, and the possible disruptions in health care won’t kick in until 2014 and so won’t trouble the current administration all that much. And once the system gets going, so the theory goes, Americans will become as dependent on it as they are Social Security and no one will dare tamper with it.

What do you think will happen?

What goes into effect now

The major parts of the new health care reform law won’t go into effect until 2014 or later, with some kicking in during 2012.  But some measures go into effect either now or in a few months:

Indoor tanning salons will charge customers a 10 percent tax beginning today in just one of the changes Americans will see as a result of the U.S. health-care overhaul signed into law by President Barack Obama.

Insurers will be required by September to begin providing health coverage to kids with pre-existing illnesses and allow parents to keep children younger than 26 on their plans as the clock has begun ticking on many of the law’s provisions. Medicare recipients will receive a $250 rebate for prescription drugs when they reach a coverage gap called the donut hole if the Senate passes and the president signs companion legislation approved March 21 by the U.S. House.

Within 90 days, the law will provide immediate access to high-risk insurance plans for people who can’t get insurance because of a pre-existing medical problem, Harris said. These high-risk pools will be funded by $5 billion in federal grants.

Companies led by Minnetonka, Minnesota-based UnitedHealth Group Inc., the largest health insurer, will be banned within six months from dropping a person’s coverage because of severe illness and from limiting lifetime or annual benefits.

Participants in Medicare, the U.S. government’s health coverage for those 65 and older, are expected get a $250 rebate toward prescription drugs once their benefits run out — a coverage gap know as the “doughnut hole.” The benefit is part of the package of amendments to the legislation now pending in the Senate. Drugmakers led by New York-based Pfizer Inc. will have to offer discounted drugs to Medicare recipients next year, according to an analysis of the legislation by the Kaiser Family Foundation, a nonprofit group based in Menlo Park, California. . . .

Insurers also will have to reveal how much of members’ premiums they spend on medical care, as opposed to executive salaries or other administrative costs. Next year, they’ll owe a rebate to customers if the insurers spend less than 80 percent on benefits for people in individual or small-group plans. . . .

The legislation also creates an Independent Payment Advisory Board to suggest cuts in spending by Medicare, the government health program for the elderly and disabled, that could threaten payments for drug and device-makers.

via Health-Care Overhaul Changes to Start Taking Effect This Year – Bloomberg.com.

The health care bill passed

In a straight up vote (not using the “deem and pass” dodge), the final tally was 219 for to 212 against. It took 216 to win.

The difference was the 6 pro-life Democrats who agreed to vote for the bill if the President would sign an executive order forbidding federal money in the program going to pay for abortion. (See post below.)

Now the Senate must pass some reconciliation elements, but since the House passed the Senate bill and since the President will sign it, this is essentially a done deal.

Did you watch the debate? What I saw was quite telling. What did it tell you?