Come for the Politics, Stay for the Pathologies



Monday, August 17, 2009

The Royal “We” is Me, Not Thee

At the Montana town hall, a man presented this concern to President Obama:  “You can't tell us how you're going to pay for this. The only way you're going to get that money is raise our taxes.” He was referring to Obama’s previous commitment of deficit neutrality on the healthcare bill. The President’s response?  "I can't cover another 47 million people for free. I can't do that.”

I,” Mr. President? “I can’t do that.” Firstly, we didn’t really ask you to do that. And secondly, what happened to “This isn’t about me?” But in fact, in your mind, it is all about you – candor rolls off your tongue accidentally when you go off prompter. You don’t like being crossed. That imperial pose that you struck so often on the campaign trail was not just a Hollywood affectation.

So what? Haven’t other presidents been imperial and egomaniacal? Probably, but the only one that comes to mind immediately is Richard Nixon. So take a note Mr. President: the American electorate doesn’t really like being treated as flotsam and jetsam. We kind of thought that your Royal “we” might include us from time to time, not just your inner circle of community organizers, Organizing for America.

Because many of us just don’t share your world view of government benevolence. We’re still capable of thinking rationally. And we tend to look at Medicare, Medicaid, Social Security, Amtrak and the US Postal Service and see how deeply dysfunctional and non-economically viable they are and are therefore unwilling to place health care in government’s maw as well.

We’ve read your lips and we don’t believe you. We don’t believe that we can keep our own doctor, that a “government option” won’t put private insurers out of business and that the government won’t be involved in rationing care. And we sure as hell don’t believe that government mandated end-of-life counseling is purely altruistic.

We actually know that expanding a Medicare-like health care system  will not solve the continual escalation of health care costs. We actually know that it’s a large part of the problem. First there’s the established fraud and waste in the system – which are legion and the government can’t seem to correct. Then there’s the Medicare reimbursement rates which are set significantly below the actual cost of delivering the service,  both the doctor’s and the hospital’s.  And yes, cost includes the  “P” word - profit. After years of training and a couple hundred thousand dollars in debt, trained specialists think they should be able to make a good living, which requires them to do better than just covering their costs.

We actually know that if  private insurance companies weren’t subsidizing the government’s Medicare system (not the other way around, Mr. President) it would have been bankrupt years, if not decades ago. So while we don’t especially like haggling with our own insurance companies over covered services or reimbursements, we surely prefer it to haggling with a government civil “servant” who  has a job for life whether they feel like helping us or not.

If you don’t understand basic economics at a micro level, let alone the macro level, you have no business writing legislation that will be imposed on the American people and the American economy.

The only  piece of legislation I’d like to see passed during this session: one that requires all new Senators and Representatives to pass an Econ 101 exam, and prohibits the election of any one in possession of a law degree.