The Politics of Accountability

Larry Elder: Republican Collectivism

I have been critical of big-government Republicans on this website, although markedly less than Democrats for a number of reasons, not the least of which is that Democrats have been in charge of Congress since the blog began, and won the White House only a month later. For those of you who say I "don't get on Republicans like I do Democrats" Libertarian columnist and author Larry Elder had a great piece on TownHall.com's website. The article was originally forwarded to me in an e-mail with the following quote, which I think merits inclusion:

"On every question of construction, carry ourselves back to the time when the Constitution was adopted, recollect the spirit manifested in the debates and instead of trying what meaning may be squeezed out of the text or invented against it, conform to the probable one in which it was passed."

 

Thomas Jefferson  

Here's the link and the article: 

http://townhall.com/columnists/LarryElder/2010/03/11/republican_collectivism?page=1

The most disturbing part of the ObamaCare debate is not about where Republicans and Democrats disagree, but where they agree.

Take this issue of those with pre-existing illnesses. Many Republicans actually support government action to prevent insurance companies from refusing to insure them. Ignoring the benefits of cost-lowering free market competition and the role of charity, many Republicans believe it acceptable to force an insurance company -- in business to insure against unknown risks -- to "insure" someone currently experiencing a known risk.

Sen. Tom Coburn, R-Okla., supports legislation to "eliminate pre-existing conditions" as a reason for a carrier to deny coverage. Sen. John Barrasso, R-Wyo., says government needs "to take care of things like pre-existing conditions so that that doesn't stop (people) from getting insurance." Sen. Chuck Grassley, R-Iowa, supports prohibiting "insurers from denying coverage to people with pre-existing medical conditions or charging higher premiums to people who are sick."

But this should not surprise anyone who observes the allegedly "fiscally conservative," "pro-free market," "limited government" party in action. From the acceptance of the New Deal to government bailouts of private industry, Republicans -- sooner or later -- go along.

Here are just a few recent examples. Republican President George W. Bush, for a time, worked with a Republican House and Senate. Bush promised and delivered a prescription benefits bill for seniors. It expanded Medicare, the popular under-funded entitlement program passed -- with Republican support, by the way -- in 1965. We like seniors. Seniors vote. So if they struggle with their drugs bills, why, by all means make someone else help pay them.

On the 10th anniversary of the Americans with Disabilities Act, signed into law by his father, Bush bragged about the law's importance and effectiveness. That such an assault on private employers engenders praise says much about the GOP's acceptance of federal government's command and control.

Like Hamlet, Bush agonized over whether to support federal funds for embryonic stem cell research. He never said, "Why are we asking government to spend taxpayer money on research that is -- or should be -- done by the private sector or nonprofits?"

No Child Left Behind ties federal dollars to local schools' performance. Where is the outrage about taxpayers in one state paying for education in another? What gives educrats in Washington, D.C., the skills, wisdom and competence to run schools in all 50 states? More importantly, what clause in the Constitution permits this? Presidential candidate Ronald Reagan campaigned to shut down the Department of Education. Reagan failed. Today any candidate making such promises gets a one-way ticket to Shutter Island.

The entire ObamaCare debate starts off in the wrong place -- with Republicans agreeing that "reform" is necessary, health care "costs too much" and that government must "make health care more affordable." But it is because of government -- laws, regulations and policies -- that users pay more for services and drugs than they otherwise would.

Licensing requirements restrict potential caregivers. A non-doctor field medic in Iraq or Afghanistan could not come home, hang up a shingle, and render basic care without facing prosecution. Despite our aging population, trade associations, along with laws and regulations, restrict the number of doctors. Insurance companies enjoy protected markets because laws restrict carriers from competing across state lines. The Food and Drug Administration increases the cost of drugs while delaying or keeping possibly beneficial drugs off the market.

Republicans ran for the exits when Bush attempted a partial privatization of Social Security. And they should encourage a full-throated deregulation/privatization of the health care industry. After airline deregulation, fares declined. After telephone deregulation, telecommunications companies started providing a numbing array of services -- along with better quality, lower prices and constant innovation.

Because government pays for nearly half of medical costs, we have a nation of government-provided-health-care dependents. Understandably, they want what they currently have or expect to have in the near future. But Medicare, Medicaid and Social Security are steadily gnawing away at the country's foundation. The bill is coming due.

In 1900, government at all levels -- federal, state and local -- took about 7 percent of America's income. Today it's almost 40 percent. And that doesn't include an estimated 10 percent cost in federal unfunded mandates imposed on states and private business. President Barack Obama and Democrats want to add more than 30 million people -- those without health insurance -- to the takers, with little or no concern about the effect on the givers.

Are Republicans sounding the alarm about government's present intrusion in health care and its counterproductive effect on quality, affordability and accessibility? Government, they should argue and persuade, grows at the expense of the productive. This eventually weakens the country by sapping the incentive of risk takers. This makes it harder -- not easier -- to help those we claim to care about.

A collectivist, whether an active or passive one, is still a collectivist. Having an "R" after the name provides no defense.

Did You Notice? Patriot Act Re-Authorized

Seems while everyone was caught up in the political theater that was the Health Care Summit between Congressional Democrats and Republicans, and moderated by President Obama, something else happened you might not have noticed. At one point, members of the summit broke to cast a vote to extend several major provisions of the Patriot Act. A friend texted me the news that night, but if you missed it, don't feel bad- so did the New York Times and virtually every major newspaper and news program in the country.

Our former President was berated by Democrats on Capitol Hill and the mainstream media for the Patriot Act, but nary a peep from the press this time around. Other than a few mentions of it in the blogosphere and predictable protestations from the ACLU (http://www.aclu.org/national-security/congress-reauthorizes-overbroad-patriot-act-provisions) - nada.

In fact, no mention from February 25th to three hours ago by any major newspaper that I could find online. Then, Washington Examiner columnist David Freddoso just published this piece on his blog with the paper pointing out that no one was reporting it:

http://www.washingtonexaminer.com/opinion/blogs/beltway-confidential/If-Obama-reauthorizes-the-PATRIOT-Act-and-the-New-York-Times-doesnt-cover-it-does-it-make-a-sound-87162077.html

If Obama reauthorizes the PATRIOT Act, and the New York Times doesn't cover it, does it make a sound?

By: David Freddoso
Online Opinion Editor
03/09/10 5:55 PM EST

Perhaps it was unfit to print. (Lnnihan / AP)

Like homelessness, threats to civil liberties suddenly disappear when Democrats inhabit the White House. Mark Hemingway noticed when the Congress quietly passed the reauthorization, and now Kevin Mooney at TimesCheck marks its signing by President Obama. Not that anyone else noticed:

President Obama has signed off on a one year extension of The Patriot Act that won overwhelming congressional approval just over a week ago; not that anyone reading The New York Times would know.

Throughout the Bush years, The Times editorialized vociferously against key provisions of the counter-terrorism law and gave wide latitude to critics from the American Civil Liberties Union and other left-leaning institutions.

A Nexis search shows that in both the 2004 and 2008 presidential campaigns The Times repeatedly called out the Bush Administration for using The Patriot Act as a tool to violate constitutional provisos.

Read more at the Washington Examiner: http://www.washingtonexaminer.com/opinion/blogs/beltway-confidential/If-Obama-reauthorizes-the-PATRIOT-Act-and-the-New-York-Times-doesnt-cover-it-does-it-make-a-sound-87162077.html#ixzz0hjx3bZb1

Health Care a Right? Wrong.

At the heart of the health care reform debate is this assertion that health care is a right. As I argued in my article on health care reform "(h)ealth care is not and cannot be, by definition, a Constitutional right."

(http://prasifkapolitics.typepad.com/the_politics_of_accountab/2009/08/a-solution-for-health-care-congress-and-the-free-market.html):

 

"The Founding Fathers believed that rights...were God-given, that we were endowed by our Creator with…unalienable rights.' Rights, as the Framers described them, could not be bestowed upon you by government, but only by government infringed. They wrote extensively about this understanding that rights were innate and natural; rights did not require legislation. It is your right to speak your mind or own a firearm or worship as you please- those are rights; if the government (meaning taxpayers) subsidizes your speech or worship, or purchases your firearm for you, that’s an entitlement.

 

So, if providing one person with health care requires the sacrifice of someone else- if it must be compelled by government redistribution of resources from one person to another- it isn’t a right in the sense that the Framers of our Constitution meant it, which is the only appropriate context here. You may feel 'entitled' to it, and you may argue that you deserve health care (even when it must be provided by someone else’s labor), but let’s get away from this Constitutional 'right to health care' nonsense."

 

 

Of course, a Constitutional argument will hardly deter the most ardent, far-left supporters of government-run health care. They don't stop at the Constitution- they deem health care to be a human right. The American people need to consider the broader implications of "health care as a right" (of any kind) beyond whatever makes it into the final bill.

 

The final version of this bill will be revealed at the end of this week and rushed to a vote the following week, before legislators break for Easter recess and return to their home districts to face their constituents. The House bill will contain some concessions aimed at getting so-called moderate Democrats on-board, especially Bart Stupak and his "gang of twelve" who are holding out to keep federal funding for abortion out of the bill. If the bill passes the House it will be rammed through the Senate using reconciliation.

 

But don't expect the "health care is a right" crowd to be satisfied with that. Consider the words of House Speaker Nancy Pelosi last week (http://www.foxnews.com/politics/2010/03/01/pelosi-new-health-care-ready-days/) concerning her expectations of the re-worked bill. "It will be a much smaller proposal than we had in the House bill because that's where we can gain consensus. But it will be big enough to put us on a path of affordable, quality health care for all Americans..."

 

 

"Put us on a path," she says. Translation: "We ain't done yet."

 

After all, if health care is a right, and if "quality health care for all Americans" is the end-game, where exactly will this "path" ultimately lead us? Here's a glimpse into the future of health care.

 

First, coverage must be universal. If health care is a human right, this means coverage for illegal aliens. Of course, that isn't in the bill; however, it isn't a coincidence that the week after the House passed its original health care reform bill, Democratic Representative Luis Gutierrez introduced an immigration bill that would "that would open a path to legal status for millions of illegal immigrants." (http://www.nytimes.com/2009/12/16/us/politics/16immig.html?_r=1). Gutierrez represents Illinois' 4th District- guess where that is?

 

Illegal immigrants won't be included in the final health care reform bill, but if the goal is to cover "all Americans" and then provide a "path (there's that word, again) to citizenship" for illegal immigrants, isn't that the same thing? And if the Left wants to do this, fine, but let's be honest about what providing care to millions of newly-minted citizens will do to access and costs- because this isn't in the bill the Congressional Budget Office scored.

 

Furthermore, "coverage for all" will eventually be mandated. This means the young and healthy will see their costs rise the most. Universal health care will not work otherwise; the care of the old, the sick, and the poor must be subsidized by the young, the healthy, and the wealthy. Although most current proposals for funding reform have focused on the wealthy, such as taxes on those with so-called "Cadillac" health plans, medical device manufacturers, and evil insurance companies, the proposal to require health insurance or force those who elect not to carry health insurance to pay a penalty is a sign of things to come.

 

Any health insurance program, public or private, which requires coverage of pre-existing conditions and regulates price increases will necessarily increase premiums on younger, healthier persons in its risk pool to subsidize the loss leaders in the pool. Fines for uninsured individuals and employers who do not provide coverage to their employees are not enough because such a program adversely selects against itself; the young and healthy need to be in the pool to prevent a "death spiral." Politicians aren't being honest about this aspect of reform, but former Clinton Labor Secretary Robert Reich had this to say about the hard truths of health care reform they would tell you if they were honest.

 

 

Did you get that? Reich, a liberal Democrat and a supporter of government-run health care, says these are the outcomes we can look forward to- 'higher costs for the young and healthy, less care for the elderly, and less innovation.' Makes you wonder what the American people are so worried about, doesn't it? Perhaps that's why Democrats are pushing one enormous bill rather than a measured, incremental, bi-partisan approach.

 

Another class of people who won't be permitted to opt-out of the current system will be the providers of health care themselves. There's been a lot of talk about the possibility that more and more physicians will refuse to treat Medicare patients if their reimbursement rates are cut (as has been proposed) to cover the cost of the health care overhaul. The so-called "doctor fix" may not happen immediately, but look for reimbursement rates for physicians treating any government health care recipient to gradually decline. And, since health care is a right, physicians can't be allowed to refuse treatment for anyone.

 

And what does that mean for the best specialists and facilities such as Cancer Treatment Centers of America, the Mayo Clinic, M.D. Anderson, etc., which boast better outcomes and higher survival rates? Health care is a right, isn't it? Do we allow one class of people more speech than others? More second amendment rights? If we have equal rights, shouldn't that mean equality of access and outcomes?

 

Perhaps health care facilities and providers will function much like our schools- all are required to contribute to public schools whether they send their children there or not. Would some be allowed, to purchase supplemental coverage or go outside the plan with their own dollars to be treated at a private hospital? Would the best facilites cater primarily to the wealthy and to federal employees who will not be subject to the strictures of the new health care reforms?

 

Lastly, since health care is a right, if anyone cannot afford care, it must be provided to them free of charge. This means those who can afford care will be forced to pay even more than they already do subsidizing those who can't.

 

Does all of this sound implausible? This is the Left's so-called "path." A right to health care means tax-payer subsidized access for all that no person can opt out of and no provider can decline, which will raise premiums for the young and healthy, increase taxes, reduce access to care for the elderly, drive up costs, discourage medical innovation, and increase the control the federal government has over our lives.

 

 

Let's put that to a vote and see who supports it. This bill may not get us there, but it's "big enough to put us on a path..."