The party of no?

H.R. 77: Health Care Incentive Act
Sponsor: Darrell E. Issa (CA-49)
Introduced: 2009-01-06
To provide for a credit for certain health care benefits in determining the minimum wage.

H.R. 109: America’s Affordable Health Care Act of 2009
Sponsor: Jeff Fortenberry (NE-1)
Introduced: 2009-01-06
To provide for the offering of Health Benefit Plans to individuals, to increase funding for State high risk health insurance pools, and to promote best practice protocols for State high risk pools.

H.R. 164: Seniors’ Health Care Freedom Act of 2009
Sponsor: Ron Paul (TX-14)
Introduced: 2009-01-06
To provide greater health care freedom for seniors.

H.R. 198: Health Care Tax Deduction Act of 2009
Sponsor: Cliff Stearns (FL-6)
Introduced: 2009-01-06
To amend the Internal Revenue Code of 1986 to allow a deduction for amounts paid for health insurance and prescription drug costs of individuals.

H.R. 270: TRICARE Continuity of Coverage for National Guard and Reserve Families Act of 2009
Sponsor: Robert E. Latta (OH-5)
Introduced: 2009-01-07
To amend title 10, United States Code, to provide for continuity of TRICARE Standard coverage for certain members of the Retired Reserve.

H.R. 321: SCHIP Plus Act of 2009
Sponsor: Jeff Fortenberry (NE-1)
Introduced: 2009-01-08
To amend title XXI of the Social Security Act to expand coverage options under the State Children’s Health Insurance Program (SCHIP) through premium assistance.

H.R. 464: More Children, More Choices Act of 2009
Sponsor: Tom Price (GA-6)
Introduced: 2009-01-13
To provide for a 5-year SCHIP reauthorization for coverage of low-income children, an expansion of child health care insurance coverage through tax fairness, and a health care Federalism initiative, and for other purposes.

H.R. 502: Health Care Freedom of Choice Act
Sponsor: Michele Bachmann (MN-6)
Introduced: 2009-01-14
To amend the Internal Revenue Code of 1986 to improve health care choice by providing for the tax deductibility of medical expenses by individuals.

H.R. 544: Flexible Health Savings Act of 2009
Sponsor: Edward R. Royce (CA-40)
Introduced: 2009-01-14
To amend the Internal Revenue Code of 1986 to allow amounts in a health flexible spending arrangement that are unused during a plan year to be carried over to subsequent plan years or deposited into certain health or retirement plans.

H.R. 917: [NO TITLE]
Sponsor: Brett Guthrie (KY-2)
Introduced: 2009-02-09
To increase the health benefits of dependents of members of the Armed Forces who die because of a combat-related injury.

H.R. 1086: Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2009
Sponsor: Phil Gingrey (GA-11)
Introduced: 2009-02-13
To improve patient access to health care services and provide improved medical care by reducing the excessive burden the liability system places on the health care delivery system.

H.R. 1118: Health Care Choices for Seniors Act
Sponsor: Marsha Blackburn (TN-7)
Introduced: 2009-02-23
To amend the Social Security Act to improve choices available to Medicare eligible seniors by permitting them to elect (instead of regular Medicare benefits) to receive a voucher for a health savings account, for premiums for a high deductible health insurance plan, or both and by suspending Medicare late enrollment penalties between ages 65 and 70.

H.R. 1441: Ryan Dant Health Care Opportunity Act of 2009
Sponsor: Kenny Marchant (TX-24)
Introduced: 2009-03-11
To amend title XIX of the Social Security Act to allow States to permit certain Medicaid eligible individuals who have extremely high annual lifelong orphan drug costs to continue on Medicaid notwithstanding increased income.

H.R. 1458: Comprehensive Immunosuppressive Drug Coverage for Kidney Transplant Patients Act of 2009
Sponsor: Dave Camp (MI-4)
Introduced: 2009-03-12
To amend title XVIII of the Social Security Act to provide continued entitlement to coverage for immunosuppressive drugs furnished to beneficiaries under the Medicare Program that have received a kidney transplant and whose entitlement to coverage would otherwise expire, and for other purposes.

H.R. 1468: Medical Justice Act of 2009
Sponsor: Michael C. Burgess (TX-26)
Introduced: 2009-03-12
To provide health care liability reform, and for other purposes.

H.R. 1658: Veterans Healthcare Commitment Act of 2009
Sponsor: Todd Tiahrt (KS-4)
Introduced: 2009-03-19
To amend title 38, United States Code, to prohibit the recovery by the United States of charges from a third party for hospital care or medical services furnished to a veteran for a service-connected disability.

H.R. 1891: Sunset of Life Protection Act of 2009
Sponsor: Rodney Alexander (LA-5)
Introduced: 2009-04-02
To amend the Internal Revenue Code of 1986 to allow an above-the-line deduction for half of an individual’s long-term care insurance premiums.

H.R. 2520: Patients’ Choice Act
Sponsor: Paul Ryan (WI-1)
Introduced: 2009-05-20
To provide comprehensive solutions for the health care system of the United States, and for other purposes.

S. 1099: Patients’ Choice Act
Sponsor: Tom Coburn (OK)
Introduced: 2009-05-20
A bill to provide comprehensive solutions for the health care system of the United States, and for other purposes.

H.R. 2607: Small Business Health Fairness Act of 2009
Sponsor: Sam Johnson (TX-3)
Introduced: 2009-05-21
To amend title I of the Employee Retirement Income Security Act of 1974 to improve access and choice for entrepreneurs with small businesses with respect to medical care for their employees.

H.R. 2692: CAH Designation Waiver Authority Act of 2009
Sponsor: Mac Thornberry (TX-13)
Introduced: 2009-06-03
To amend title XVIII of the Social Security Act to restore State authority to waive the 35-mile rule for designating critical access hospitals under the Medicare Program.

H.R. 2784: Partnership to Improve Seniors Access to Medicare Act
Sponsor: Mac Thornberry (TX-13)
Introduced: 2009-06-10
To establish a loan repayment program for qualifying physicians and nurse practitioners participating in the Medicare Program.

H.R. 2785: Health Care Paperwork Reduction and Fraud Prevention Act of 2009
Sponsor: Mac Thornberry (TX-13)
Introduced: 2009-06-10
To reduce the amount of paperwork and improve payment policies for health care services, to prevent fraud and abuse through health care provider education, and for other purposes.

H.R. 2786: Patient Fairness and Indigent Care Promotion Act of 2009
Sponsor: Mac Thornberry (TX-13)
Introduced: 2009-06-10
To amend the Internal Revenue Code of 1986 to improve the ability of medical professionals to practice medicine and provide quality care to patients by providing a tax deduction for patient bad debt.

H.R. 2787: Medical Liability Procedural Reform Act of 2009
Sponsor: Mac Thornberry (TX-13)
Introduced: 2009-06-10
To provide grants to States for health care tribunals, and for other purposes.

S. 1324: Health Care Freedom Act of 2009
Sponsor: Jim DeMint (SC)
Introduced: 2009-06-23
A bill to ensure that every American has a health insurance plan that they can afford, own, and keep.

H.R. 3141: Strengthening the Health Care Safety Net Act of 2009
Sponsor: John Sullivan (OK-1)
Introduced: 2009-07-09
To amend title XIX of the Social Security Act to provide for a DSH redistribution pool from unexpended Medicaid DSH allotments in order to increase Medicaid DSH allotments for low DSH States and to provide grants for health access networks serving the uninsured.

H.R. 3217: Health Care Choice Act of 2009
Sponsor: John B. Shadegg (AZ-3)
Introduced: 2009-07-14
To amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce.

H.R. 3218: Improving Health Care for All Americans Act
Sponsor: John B. Shadegg (AZ-3)
Introduced: 2009-07-14
To provide a refundable tax credit for medical costs, to expand access to health insurance coverage through individual membership associations (IMAs), and to assist in the establishment of high risk pools.

S. 1459: Health Care Choice Act of 2009
Sponsor: Jim DeMint (SC)
Introduced: 2009-07-16
A bill to amend the Public Health Service Act to provide for cooperative governing of individual health insurance coverage offered in interstate commerce.

H.R. 3356: Medicare Beneficiary Freedom to Choose Act of 2009
Sponsor: Sam Johnson (TX-3)
Introduced: 2009-07-28
To amend title XVIII of the Social Security Act to clarify the use of private contracts by Medicare beneficiaries for professional services and to allow individuals to choose to opt out of the Medicare part A benefits.

H.R. 3372: Health Care OverUse Reform Today Act (HealthCOURT Act)
Sponsor: Tom Price (GA-6)
Introduced: 2009-07-29
To establish Medicare performance-based quality measures, to establish an affirmative defense in medical malpractice actions based on compliance with best practices guidelines, and to provide grants to States for administrative health care tribunals.

H.R. 3400: Empowering Patients First Act
Sponsor: Tom Price (GA-6)
Introduced: 2009-07-30
To provide for incentives to encourage health insurance coverage, and for other purposes.

H.R. 3438: Access to Insurance for all Americans Act
Sponsor: Darrell E. Issa (CA-49)
Introduced: 2009-07-31
To amend title 5, United States Code, to establish a national health program administered by the Office of Personnel Management to offer Federal employee health benefits plans to individuals who are not Federal employees, and for other purposes.

H.R. 3454: Medicare Hospice Reform and Savings Act of 2009
Sponsor: John Sullivan (OK-1)
Introduced: 2009-07-31
To amend title XVIII of the Social Security Act to reform payments and coverage for hospice care under the Medicare Program.

H.R. 3478: Patient-Controlled Healthcare Protection Act of 2009
Sponsor: Louie Gohmert (TX-1)
Introduced: 2009-07-31
To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts, to provide payments for a health savings account and for a high deductible health plan instead of entitlement to benefits under Medicare, Medicaid, and SCHIP, to give more control and coverage to patients, to lower health care costs through increased price transparency, and to require immigrants to have a health savings account and high deductible health coverage at time of admission.

Cut. It. Out.

I hate to comment further on the Gates arrest. Even before the “beer summit” it was clear opinions were entrenched and opinions were at least reflective of attitudes toward race and authority as of the facts.

However I do have to take a moment to ask my fellow conservatives to not flog the idea this somehow proves Obama is a racist. It may be fair say the president exhibited a lack of judgment in his comments, or that his treatment of the incident was needlessly focused on race. To say the president “has a deep-seated hatred for white people or the white culture” is just asinine, though, and the talk of how “Obama’s mask slipped” are reminiscent of the hysterical accusations of “coded racism” that are targeted at Republicans.

If anything this incident was tragic precisely because Obama has largely avoided identity politics in his career; there are exceptions, but they are notable largely for their infrequency. He has also repeatedly spoken hard truths to the black communities about personal and familial responsibility. No one should be in such a rush to judge and label that they lose sight of virtue.

A teachable moment.

Our president spoke recently about the arrest and controversy surrounding the arrest of Professor Henry Louis Gates Jr.:

My hope is is that as a consequence of this event, this ends up being what’s called a teachable moment, where all of us, instead of pumping up the volume, spend a little more time listening to each other and try to focus on how we can generally improve relations between police officers and minority communities, and that instead of flinging accusations, we can all be a little more reflective in terms of what we can do to contribute to more unity.

Setting aside his unfortunate initial remarks, which themselves served to pump up the volume by flinging accusations, the president is right, though perhaps not in the sense he intended.

Reading Professor Gates’ account establishes several things – that his house had been vacant for some period of time; that he and his driver had been fiddling with the door and eventually forced their way in; that he admits refusing to cooperate several times; that he admits make accusations toward the officers.

More telling than retelling of the events, though, is his interpretation of them. We are told the emergency dispatch report is “the worst racial profiling I’ve ever heard of in my life”. We are told that he several times “realized that [he] was in danger”. We are told that the officer clearly “had a narrative in his head: A black man was inside someone’s house, probably a white person’s house, and this black man had broken and entered”.

Whether the arrest was justified is arguable, and it was possibly not wise even if justified. However the responding officer acted according to protocol, even by Mr. Gates’ account. As a single officer responding to report of an break in progress involving two men, it would appropriately cautious for Sgt. Crowley to establish identity before entering the premises. That he entered the premises without backup likely indicates he believed Mr. Gates was the lawful resident and simply wanted to confirm that fact.

There are lessons here about the danger of treating peace officers as adversaries and about the poisoning effects of presumed racism. Unfortunately those lessons are likely to be lost.

Fun with numbers.

Obama:

Our budget had a 10-year projection — and I just want everybody to be clear about this: If we had done nothing, if you had the same old budget as opposed to the changes we made in our budget, you’d have a $9.3 trillion deficit over the next 10 years. Because of the changes we’ve made it’s going to be $7.1 trillion. Now, that’s not good, but it’s $2.2 trillion less than it would have been if we had the same policies in place when we came in.

The Congressional Budget Office

From 2010 to 2019, the cumulative deficit under the President’s proposals would total $9.3 trillion, more than double the cumulative deficit projected under the current-law assumptions embodied in CBO’s baseline.

It appears likely the president persists in the tactic of including a perpetual “overseas contingency operation” (i.e. the Iraq war) as part of the baseline projection. His numbers have changed slightly since his budget projection was published, but his dishonesty hasn’t.

Taxes have consequences.

One of the more enduring fictions in politics is that particular groups can be taxed with impunity. Businesses are a font of unending profits that can be curtailed and individual effort remains constant in spite of diminishing returns. It’s an alluring but dangerous idea.

The truth is that businesses have limited revenues and every tax has a consequence. Jobs and compensation may be cut; prices may be raised; dividends may be reduced or eliminated; growth and innovation may stagnate. Like any other cost, taxes must be offset.

Nor is it reasonable to expect that individuals will endure increasingly punitive taxation without reaction. The extent to which a particular tax rate depresses initiative is arguable, but common sense tells us the smaller the carrot the less enthusiastic the donkey.

The health care legislation being debated turns a blind eye to these realities. It relies on the idea that de facto tax increases in the form of mandates won’t result in layoffs and wage reductions. It stands to exacerbate the shortage of health care professionals by reducing compensation and taxing the bejesus out of what’s left. Perhaps a different approach is called for.

Too much.

Even the best of sometimes succumb to impulse to treat those we disagree with less charitably than those we consider allies. As such, I try my best to restrain both my judgement and my comments.

Then there are times it just gets to be too much. From today’s presidential address:

This is what the debate in Congress is all about: Whether we’ll keep talking and tinkering and letting this problem fester as more families and businesses go under, and more Americans lose their coverage, or whether we’ll seize this opportunity – one we might not have again for generations – and finally pass health insurance reform this year, in 2009.

False urgency seems to be a hallmark of this administration. There is absolutely nothing restraining the legislature from introducing a new bill tomorrow or the next year or the next year of the next. One might posit that unified and overwhelming control of both chambers of congress presents a unique opportunity for reform, that neither explains nor justifies passing another omnibus bill without due deliberation.

Have we learned nothing from the so-called stimulus package, which we are now being told was never designed to have a profound short term effect?

The address contains a number of other questionable statements and arguments:

Now we know there are those who will oppose reform no matter what.

This rhetorical gem seems to be a favourite of the president. Throughout his campaign he presented himself as the only alternative to the status quo. During the stimulus debate, every detractor wanted to “sit by and do nothing.” In the budget debate, every opposing voice was in favour of “the very same policies that have led us to
a narrow prosperity and massive debt.”

Other people have ideas, Mr. President. Try listening to them.

First, the same folks who controlled the White House and Congress for the past eight years as we ran up record deficits will argue – believe it or not – that health reform will lead to record deficits.

Is it that difficult to believe? The official budget already projects record deficits and the initial analysis of H.R. 3200 concludes an additional $239 billion shortfall.

Under our proposals, if you like your doctor, you keep your doctor. If you like your current insurance, you keep that insurance. Period, end of story.

The bill establishes criteria for “qualified” plans. Unless your coverage meets the criteria, it doesn’t matter how much you like it. Non-qualified plans will be allowed to operate for a limited time but are barred from new enrolments or changes.

I don’t believe that government can or should run health care.

The statement seems incompatible with the inclusion of a government option for insurance, unless one takes it to mean exclusive operation. However, his own website states that “Obama Has Consistently Said That If We Were Starting From Scratch, He Would Support A Single Payer System, But Now We Need To Build On The System We Have.”

His web site is right. He has consistently and unequivocally stated that government can and should run health care, but “we’ve got all these legacy systems in place, and managing the transition, as well as adjusting the culture to a different system, would be difficult to pull off.”

The opponents of health insurance reform would have us do nothing. But think about what doing nothing, in the face of ever increasing costs, will do to you and your family.

Again with the “do nothing” canard. The opponents of this health insurance reform have consistently explored and offered alternative proposals for health care reform. They even introduced alternate legislation months before the current bill came to floor.

I would appreciate leaders willing to address ideas on their merits instead of acting as if they don’t exist.

With apologies to Tim Rice.

Listening to the ongoing speculation surrounding Sarah Palin, I can’t help but re-imagine the opening exchange between Molokov and the Russian in the musical Chess:

[MOLOKOV]
The woman’s utterly mad –
we’re watching a lunatic.

[THE RUSSIAN]
That’s the problem — she’s a brilliant lunatic.
You can’t tell which way she’ll jump.
Like her game, she’s impossible to analyze –
you can’t dissect her, predict her –
which of course means she’s not a lunatic at all.

[MOLOKOV]
What we’ve just seen’s a pathetic display
Of a woman beginning to crack.

She’s afraid!
She knows she isn’t the player she was –
And she won’t get it back.

[THE RUSSIAN]
Nonsense!
Why do the pundits always want to believe
third-rate propaganda?

At this point I’m not staking myself to any firm predictions about her future, but I do believe she stands to have a profound influence in the next election. Regardless of the uncertainty evident in polls since her announcement, she has considerable sway among party adherents. Her participation in campaign events in key districts could deliver much needed funding and break the pervasive enervation often characteristic of mid-term elections.

Science without reason, reason without humility.

Acting on faith and conjecture can be dangerous. Acting on incomplete facts can be too.

Climate change is real. It was real before man walked the earth and, if the planet outlives the species, it will be real long after we have taken our final step. An anthropogenic impact on the environment is likewise indisputable. We have a demonstratively real capacity for poisoning our air and water and soil.

There however remain serious questions about our broader understanding of global trends. Existing models have thus far failed to accurately model past trends or predict emerging ones. Puzzling temperature maps published by the Goddard Institute of Space Studies last year uncovered significant errors in their dataset, calling into question diligence exercised in vetting data from a broad net of reporting sources. Many of the proposed positive feedback mechanisms that account for large temperature shifts lack any empirical grounding.

This is what passes for “settled science”. Paul Krugman of the New York Times spoke of “the irresponsibility and immorality of climate-change denial” and accused those arguing against Waxman-Markey of “a form of treason”. Proponents of the anthropogenic global warming, such as Al Gore and David Miliband, often equivocate those that question their conclusions with flat-earthers, moon landing sceptics and occasionally holocaust deniers.

Perhaps most chilling in recent news was the leaked mail correspondence regarding an internal report expressing “concerns and reservations… significantly important to warrant a serious review of the science by EPA before any attempt is made to reach conclusions on the subject [of endangerment analysis]“. Al MacGartland, director of the National Center for Environmental Economics urged the authors to cease any external communication and concluded the comments would have “a very negative impact on [their] office.”

The rightful place of science is as a tool, not a religion. Numbers and graphs and models provide only the illusion of precision and certainty. Before we, as a nation, take drastic measures that will impact the lives of millions, create vast federal bureaucracies, handicap us in a global market and strong arm our trading partners with de facto protectionist measures we should demands answers. Critical analysis of the IPCC report. Investigation into the politicization of the EPA. Science bridled by reason, and reason concious of our limitations.

The presence of the doctor is the beginning of the cure.

The debate on health care seems dominated by cost.  How much, and where will it come from?  Important questions, particularly in the midst of a recession, but a more important question might be, “Where will they come from?”

Money makes the world go round, but it will not cause doctors and nurses to materialize out of thin air.  Extending coverage to forty million new patients and promoting broader preventative care might be a laudable goal but that doesn’t change the basic fact that increasing demand with a growing supply shortfall will have significant repercussions.  Costs will go up, availability will go down or both.

Any rational attempt to control costs and expand coverage needs to treat this a core issue, and yet it gets scant mention if acknowledged at all.  Why?

Exactly.

Interviewing with ABC’s George Stephanopoulos, Vice President Biden declared, “The truth is, we and everyone else misread the economy.”  Exactly.  Exactly.

The stimulus plan had broad support, if not the universal consensus claimed here by Biden and previously by President Obama.  The projections were prepared and endorsed by men and women at the top of their field.  Geniuses.  Nobel laureates.  And they were wrong.

Doubtless many will argue that the spending has had a net positive effect, that they just misjudged the baseline.  There may be some truth to that.  Others will argue the bulk of the stimulus hasn’t happened yet, that it was always a long game proposition.  That isn’t how it was sold, but it’s certainly how it’s played out so far.  Still others say the whole idea of a stimulus was misguided, or that it should have included more tax cuts, or that it was too large, or that it was too small.

The details don’t matter.  The bottom line is that incredibly smart, eminently qualified people aren’t omniscient, even in aggregate.  That strikes me as a powerful reason not to bet hundreds of billions that they are.