Campaign for the Court on Health Care

Back in late May, columnist George Will wrote about the treatment of Supreme Court chief justice John Roberts by progressives. He said, "They are waging an embarrassingly obvious campaign, hoping he will buckle beneath the pressure of their disapproval and declare Obamacare constitutional." Many others made a similar observation. Will concluded, "Such clumsy attempts to bend the chief justice are apt to reveal his spine of steel."

Oh, that he were correct! But no, it appears as if this campaign was successful, according to CBS:

But Roberts pays attention to media coverage. As chief justice, he is keenly aware of his leadership role on the court, and he also is sensitive to how the court is perceived by the public. 

There were countless news articles in May warning of damage to the court - and to Roberts' reputation - if the court were to strike down the mandate. Leading politicians, including the president himself, had expressed confidence the mandate would be upheld. 

Some even suggested that if Roberts struck down the mandate, it would prove he had been deceitful during his confirmation hearings, when he explained a philosophy of judicial restraint. 

It was around this time that it also became clear to the conservative justices that Roberts was, as one put it, "wobbly," the sources said.

The gist of this campaign was that a ruling against Obamacare would delegitimize the court, turning it into an ideological body. If the court didn't defer to the legislative branch, people would lose confidence in it forever. They sensed that Roberts' concern for the reputation of the court, evidenced by his pledge during his confirmation hearings to move towards greater agreement on the court, was his Achilles' heel. Never mind the fact that the court is far more popular than Congress, and Obamacare was an unpopular bill that passed only due to the employment of various types of chicanery. But it sounds like these arguments played at least some role in Roberts' ruling on Obamacare. Rush Limbaugh the other day compared this to the instructions jurors get from a judge about not reading news coverage of the case at hand. This is exactly why judges say that.

What really delegitimizes the court is ridiculous rulings, like the tortured reasoning that the individual mandate is not allowed under the Commerce Clause but is allowed under the taxing authority. Thus, the mandate is not permissible, but it is. And then there's the whole issue of whether it is a tax, or whether it isn't, which depends on who you ask and on what day of the week. This is reminiscent of the idea that one can find rights  that stem from "penumbras" and "emanations" from the Constitution.

What this ruling means is that, next time a big case comes up, the media will once again conduct a full-court press to tilt the ruling towards the desired liberal outcome. They will be joined by prominent Democratic Congressmen and Senators, and it will be disgusting and pathetic. But they know full well that it just might work.

 

Two Days, Two Town Halls

As I indicated yesterday, Texas Rep. Chet Edwards had a town hall meeting last night. I attended via the internet. You can read about the meeting here.

My observation was this: Edwards refuses to take much of a stand on anything. He makes statements that sound unequivocal, but are really meaningless. He says "I won't support a Canada-style health bill." Well, that's not what's being proposed (maybe it's the eventual goal, though). He also says "I won't vote for a bill with death panels." There aren't any of those in this bill (boards that regulate allowable treatments - maybe). So while it sounds like he's taking a stand against the more extreme Democratic ideas, he said nothing indicating he might actually vote against the bill.

Whenever questioners expressed opposition to government health care, he would lean on the Medicare crutch. "Oh, Medicare's popular. Who here wants to get rid of that?" He probably expected nobody would raise their hand, but people did, and he said he disagreed with those people. The fact is, though, that Medicare will go bankrupt in 10 years, and Medicare is consuming an ever-growing portion of the federal budget. He did not touch upon these problems.

As a final House vote approaches, people will have to keep the pressure on Edwards, and try to get some statement from him on his intentions. Edwards needs to take a stand on this.

Tele-Town Hall

My Congressman from my North Dakota days, Earl Pomeroy (I've been gone for 10 years, but he's still there), had a telephone town hall meeting on health care Monday night, and I got an e-mail about it, so I decided to listen in. I wanted to participate in this town hall craze that's been sweeping the nation.

Pomeroy is avoiding real town halls, but this was his 5th phone version. When I called in, I was asked for the secret password (health care), my name and hometown, and whether I support or oppose Obama's health care ideas. "Oppose," I replied. I was then given some bad jazz to listen to while waiting for the meeting to start.

Pomeroy said that the town halls happening around the country are a "full demonstration on American democracy" for the world to see, and that this issue is as complex and personally important as issues get. He said he's doing these meetings by phone so that he can reach more people and so citizens don't have to drive. He didn't say anything about avoiding getting yelled at.

Before taking questions, Pomeroy stated his general views on the subject. He said:

• We need to "provide certainty that people can get health insurance."
• We need to get rid of denials based on pre-existing conditions or ratings schemes.
• The North Dakota primary-care centered model is a good one (not sure what he's referring to here).
• He will not support a bill that covers illegal immigrants, funds abortions with tax dollars, or has death panels (the invocation of which he called absurb).

With that, he went to the callers. The way this meeting worked was, one could get in line to ask a question by pressing *1, then apparently calls were taken in that order (it didn't sound like any screening would be done).

Here were some highlights from the questions:

• The first question was, "When will you guys forget about getting GOP support?" Pomeroy said it was not yet time for that, and he cited his ND colleague Sen. Conrad's participation in the Finance Committee's gang of six that is negotiating a bill. He cited Conrad a lot during this meeting, almost as if Conrad was a sponsor of the town hall ("this next call brought to you by Senator Conrad!).

• Pomeroy said to the second caller that he supports the current employer-based system of insurance provision. I haven't heard a lot of people say that, but I guess it is the Democratic plan to tax employers that don't provide it. As I've stated, I think we need to move away from this model.

• He mentioned several times that ND has one of the lowest Medicare reimbursement rates in the nation, meaning that ND doctors get paid less than docs from other states for seeing Medicare patients. He brings that up in this article. To some extent, that makes sense, because ND has a lower cost of living. I'm not sure, on the whole, how big of a problem this is, but Pomeroy says if the eventual bill bases payments to doctors on the Medicare system, he'll oppose it.

• The illegal immigrant issue came up once or twice. A lot of people bring this up, but I think it's a minor issue, because anyone who goes to a hospital will get care, whether they are officially under the new system or not. This bill is not the place to address illegal immigration.

• His solution for how to pay for this bill: tax "Cadillac" health plans, tax people who make over $1 million per year, find savings in the system, and "bend the cost curve."

• He supports the idea of an insurance mandate, but he never said the word "mandate." The implication was obvious, though.

• There were a lot of callers from Bismarck, which was strange, because Bismarck is not the largest city in the state. It is the capital, though, so maybe you have more political types there.

• On the public option, he supports one if it's "fair and square," not if it has the aforementioned unbalanced payment rates, or if it has a stacked deck against private insurance.

After about an hour, I got bored and left the meeting. Since it was over the phone, I didn't even have to sneak out the back. I think it's hard to pin down how Pomeroy will end up voting, and I'm sure it depends on the final bill. But it also will depend on political considerations.

In other town hall news, Chet Edwards is having a town hall meeting here tonight. I could go, or just watch on the internet. We'll see how I feel. Either way, I'll file a report.

Motivations of the "Mobs"

Commentators and politicians are clearly taken aback by the level of emotion being displayed at these health care town hall meetings. Various explanations for this outpouring of interest abound, and some have been quite ridiculous, including claims that these people were sent here at the request of big business or that they are merely expressing racism. However, I think it is quite easy to understand why people are ticked off. I will tell you why in bullet point format:

• More so than almost any other legislation, this health care bill would impact virtually everybody, and in a big way. People get fired up about illegal immigrants or taxes, but even those issues don't have the potential impact of this one.

• People are tired of the way Washington operates. One-thousand-plus page bills are written, "debated," and voted on in a span of days, and people have almost no ability to learn about and then speak up about these issues in such a short time span. This is an especially acute problem after the bailouts were rushed through Congress earlier this year. Remember, if the Democrats had their way, this bill would already have been passed and signed.
  

• People are sick of politician-speak. President Obama says, "If you like your health plan, you can keep it." But people have every reason to suspect that this will be true for no more than a year or two, as the "public option" swallows everyone up as employers respond to incentives to drop health coverage for employees. In response to a question about government funding for abortions in its plan, Senator Arlen Specter said, "You can get a plan that doesn't pay for abortions, and someone else can get one that does." That's a ridiculous answer, because it clearly means that the government plan will pay for abortions. I also hear people like Rep. Chet Edwards in Texas say, "I will not support a Canada-style, single-payer plan." Sure, that sounds good, but it doesn't address whether or not he'll vote for the plan currently working its way through the House. People are tired of this obfuscation.

• People don't trust legislation to work like it is supposed to. The TARP bill wasn't intended to provide bailouts for auto makers, but it did. The stimulus bill wasn't supposed to pay for ridiculous pork projects, but it did. The Bush Medicare drug bill was supposed to cost X, but it cost much more. Health care reform will undoubtedly have similar unannounced consequences (I'm not sure if they will be unintended).

• People are sick of elitist politicians. Voters know Congress won't subject itself to whatever plan it passes, just like Congress doesn't use Social Security or commercial airlines.
  

For these reasons, I fully support citizens who yell at and boo their Congressmen. While the politicians may publicly dismiss these people, privately they know that the anger expressed at these meetings could also manifest itself next Election Day.

CraigCare

Obama's drive for health care reform seems to be floundering, which is good. Considering that Medicare is a fraud-riddled beast that threatens to swallow our entire federal budget in 10 years or so, I don't know how anyone can want the government to take over more of health care. And all the stories that come out of our neighbor to the north about long waits and denied treatments make the Democratic plan even more unpalatable.

Although Obama likes to set up the dichotomy of "my plan or nothing," there are other ideas out there. Here are my health care reform recommendations:

• Medical malpractice reform, to reduce frivolous lawsuits and the unnecessary procedures that doctors perform in order to avoid these lawsuits. This "defensive medicine" is estimated to increase medical costs by 10%. Texas has had good results from its medical tort reform.

• Allow people to buy health insurance across state lines. A lot of states impose ridiculous mandates on their health insurers, requiring them to cover acupuncture or in vitro fertilization for everyone. These mandates drive costs up. People shop nationwide for car insurance and mortgages, so why not health insurance?

• More use of "retail health clinics," like those located at CVS or Wal-mart. There, people can get quick, low-cost, walk-in service for minor ailments, usually from a nurse practitioner. These clinics reduce costs, free up emergency rooms, and expand access. Of course, doctors' groups oppose them.
  

• Tax employer-provided health insurance. There is currently not much of a link between the people that use health care and those that pay for it. People don't think about what procedures cost, because insurance will cover most or all of it. Similary, when people get insurance from their employer, they usually have no say in what plan they get. Taxing employer-provided insurance would push more people to get their own insurance, in which case they would buy the plan that is best for them, not for their employer. At my last job, my employer was definitely paying more for my insurance than I would have paid for a basic individual plan.

• Related to the above point, I'm not sure about offering tax credits for people to buy health insurance. It seems like offering such credits could cause inflation of premiums, cancelling out whatever good the credits do. Maybe these credits could be offered exclusively to the poor and/or the young.

• More use of Health Savings Accounts. These accounts allow people to have tax-free savings accounts to use to pay health costs, and are used in conjunction with high-deductible plans, which create incentives for people to shop around for health care and question the benefit and necessity of costly procedures.

• Much is made about the benefit of being in a group plan versus an individual plan for spreading risk around and decreasing costs. Currently, this is done by getting insurance at work. It seems like people could instead get insurance through other types of groups. For example, there are credit unions for people who work in certain fields or live in certain areas. Similar groups could be formed to get health insurance. People could also buy into plans through their college alumni association, for example.
  

Thoughts?