A blog I used to write was just a collection of quotes I liked.  Early one was this one:

"Smokers don’t impose health care costs on society; governments that insist on paying for smokers’ health care impose health care costs on society." — Sasha Volokh, from The Volokh Conspiracy blog

(This was done while the Volokh Conspiracy was still using Blogspot.  They’ve moved to their own domain and the old one has a completely different kind of blog on it, so sorry, no link to the original post.)

It is, of course, a more wordy version of "Guns don’t kill; people kill" saying, retasked to a new subject.  Sasha’s version was written in 2003.  Seven years later, it takes on a new meaning.

I was reminded of this quote when I read this post from Bruce McQuain.  He talks about the easy slide from Nanny State to Bully State, and how the opposition go the health care bill is and always was based on freedom, and what happens when government is given a bigger and bigger share of the freedom in this country, for whatever the good intention.  He quotes a report from the Institute for Public Affairs that lists a series of assumptions governments make when they take over health decisions.

Most of the health care burden is driven by disease that results from lifestyle decisions.

Most of the health care burden is therefore, in theory, preventable.

The cost of most lifestyle-related disease is not recovered from the individuals with such diseases or from the industries whose products contribute to these diseases.

Individual autonomy cannot be the paramount value in health care.

Individual choice as a basis for health is ‘too simplistic’.

Individual freedoms may have to give way to the coercive power of the State.

Interventions, including coercive actions, to change behaviour may proceed in the absence of evidence of their effectiveness.

Individuals have a clear responsibility to refrain from lifestyle decisions that lead to disease and, consequently, treatment can be denied to those who refuse to change their behaviour.

With the passage of the health care reform bill, we’ve already slipped about halfway down this particular slope.  Never mind smokers, Sasha, the official nationalization of this sector now means that all sorts of bad habits are guaranteed to affect everyone in the country because the government insists on it.

And this is different from insurance companies charging more for smokers or young drivers or people who sky dive.  Insurance companies can’t make these choices illegal; they can only charge you more for the higher risk you are asking them to take on.  The government, however, has far, far more power at hand.

It’s about freedom, and it’s being eroded away.

(Fake photo credit:  Chris Jamison)

So the health care "reform" bill passed last night, complete with payoffs, abortion funding and fake projections of "savings" required to try to pass it via reconciliation.  And in an entirely "unipartisan" manner.  (Even the New Deal had bipartisan support.)

So what does this mean for American politics?  Glad you asked.

• There is now a precedent for requiring Americans to buy something simply because they live here.  Automobile insurance is required in most states if you own a car.  Health insurance, however, is required, period.  Nice work if you can get it. 
• The phrase "pro-life Democrat", at least (but not limited to) as it described Washington politicians, is now known to be an oxymoron.  The executive order Obama promised the Stupak group isn’t worth the paper it’s printed on.  (See here, here and here, please.)  An EO only applies to the executive branch, can be rescinded on a whim, and legislation always trumps it.  And in spite of whatever pro-life record they may have had in the past, the entire Stupak group sold its collective souls, principles and the lives of future generations for something they must know is less a fig leaf and more tissue paper.  (More on this from Betsy Newmark.  This is just unfathomable.)
• Democrats can no longer legitimately complain about polarization or the lack of bipartisanship in Washington.  No doubt they will, mind you, but they’ve completely lost the moral authority on the issue.
• Gaming the CBO system for political gain, though I’m sure it’s been done before, has, by virtue of this massive bill, been raised to a new level of legitimacy.  A former CBO head wrote on Saturday that the numbers were so manipulated that what is claimed will be a reduction in the deficit of $138 billion is really more like an increase in the neighborhood of $562 billion.  The foundation for using the reconciliation process to pass this bill was that it reduced the deficit.  So the method used to pass the bill was based on a lie.  And this is not even including a $371 billion dollar Medicare bill that’s coming down the pike. 

Everything about this legislation — above and beyond the usual sausage-making that is the political process — is absolutely awful, regardless of its actual contents.  And its actual contents, once we have it, no matter how awful it turns out to be, is now with us for good.  (Barring a repeal, which is very hard to get the political will to do in Washington.)  If it’s an abject failure, or even it if just keeps the status quo at the cost of billions every year to run in place, it will not go away.  We’re stuck with this ball and chain.

And a parting "shot", if you will, from Michael Ramirez.  (Click for a larger version.)

The CBO numbers for the final final health care reform bill may look good (depending on your definition of "good"), but, as I’ve noted before, the numbers are gamed.  And now, here’s more sleight of hand going on.

Democrats are planning to introduce legislation later this spring that would permanently repeal annual Medicare cuts to doctors, but are warning lawmakers not to talk about it for fear that it will complicate their push to pass comprehensive health reform. The plans undercut the party’s message that reform lowers the deficit, according to a memo obtained by POLITICO.

Democrats removed the so-called doc fix from the reform legislation last year because its $371-billion price tag would have made it impossible for Democrats to claim that their bill reduces the deficit. Republicans have argued for months that by stripping the doc fix from the bill, Democrats were playing a shell game.

Remember, the CBO estimate is, for all intents and purposes, a minimum price.  As with all other big government programs, it will increase dramatically.

Remember that "lock box" that Social Security money was in?  Well government, as government is wont to do, has already raided it over the years, treating Social Security funds as its own private slush fund and left IOUs in there.

This year, for the first time since the 1980s, when Congress last overhauled Social Security, the retirement program is projected to pay out more in benefits than it collects in taxes — nearly $29 billion more.

Sounds like a good time to start tapping the nest egg. Too bad the federal government already spent that money over the years on other programs, preferring to borrow from Social Security rather than foreign creditors. In return, the Treasury Department issued a stack of IOUs — in the form of Treasury bonds — which are kept in a nondescript office building just down the street from Parkersburg’s municipal offices.

Now the government will have to borrow even more money, much of it abroad, to start paying back the IOUs, and the timing couldn’t be worse. The government is projected to post a record $1.5 trillion budget deficit this year, followed by trillion dollar deficits for years to come.

The BigGovernment website, noting this, says there are 2 choices on how to raise this money; taxes and borrowing.  Those are the one mandated by law, but there is another option; change the law and renege on the promise.  (I didn’t say it was a good option.)  No one wants to do any of that, but the combination of a promise made, irresponsible spending on all sorts of "good" programs, and a down economy have combined to create this mess.  And now we’re broke, and our children are going to have to pay the price for our excesses.

All this is foreseeable with health care reform as well.  The creeping socialism of Europe has led it to insolvency as well.  Will somebody please learn from history.  Recent history? 

And if you weren’t already realizing that the Democrats were gaming the numbers to make the costs look good, this report should (hopefully) jolt you into reality.

A new congressional report released Friday says the United States’ long-term fiscal woes are even worse than predicted by President Barack Obama’s grim budget submission last month.

The nonpartisan Congressional Budget Office predicts that Obama’s budget plans would generate deficits over the upcoming decade that would total $9.8 trillion. That’s $1.2 trillion more than predicted by the administration.

We’re broke, folks, and we’re issuing a credit card to our kids, and using it to fund our own out-of-control spending.  The money’s not there.  It’s gone.  It’s long past time to wake up to this fact before we follow Europe into the black hole.

It is better to empower the people to be more charitable by letting them keep their money in order to give it than to get the government in the health care business.  It is both cheaper and more moral. 

Will people fall through the cracks if this is left up to the people?  Yes.  And it will be the same for a government program.  Don’t let the "perfect" be the enemy of the "good", especially if the "perfect" is clearly known to be unobtainable. 

Trying to obtain that perfection via government will do 2 things.  First, it will not happen.  Second, it will give more power and money to a government already awash in both.  For those that already despise dealing with a more local insurance company, multiply that for dealing with the government.  (Including, yes, "death panels", just like they have in Canada, in behavior if not title.)

But will government involvement, if not perfect, be at least better than we have now?  Perhaps we could ask that cancer patient in Alberta (follow that link up there) who came to Minnesota to get lifesaving surgery.  Or you could read the article in the London Times about how the liberal Labour party hid the truth about patient neglect in their National Health Service.  If your measure of "success" is how many people have health insurance, then sure, it would be "better".  But if you factor in the quality of care, not so much.

Because our system isn’t perfect, don’t make a deal with the devil.  Our founding fathers felt government to be a necessary evil.  They were students of history that saw the natural tendency of government and tried to avoid those problems when they wrote the Constitution so that government’s power was limited.  We are "unwriting" those limits if we do this.

Nancy Pelosi:

You’ve heard about the controversies within the bill, the process about the bill, one or the other.  But I don’t know if you have heard that it is legislation for the future, not just about health care for America, but about a healthier America, where preventive care is not something that you have to pay a deductible for or out of pocket.  Prevention, prevention, prevention—it’s about diet, not diabetes. It’s going to be very, very exciting.

But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy.

Emphasis added (by Reason magazine), and it speaks for itself.  No matter what they tell you about the bill, they’re not telling you everything.  No matter what they say it’ll cost, they won’t say all of it.  "Trust us to overhaul the health care insurance industry, with a bill made with back-room deals with unions, and bribes for votes."

Yeah, right.  It’s huge and it’s shrouded, and it’s a classic carnival huckster method.  How can people actually fall for this?

I wrote last Friday about "3rd rails" in American politics; programs like Social Security and Medicare that, no matter how wasteful, politicians can’t substantially deal with.  The reason is that the government has made promises, people have reordered their lives around those promises, and thus any attempt to change the conditions of those promises is met with vehement opposition.

This, then, is related to the eternal life of government programs.  Part of the reason some of these programs live on is because the promises made and the responsibility to live up to them and honor them.  The problem is, we have to honor them even if doing so bankrupts us (or, more specifically, future generations).  We have to honor them even if the money could be spent more efficiently another way, getting the same job done only with better results.  We are already saddled with debt because of some of these huge programs, but are also saddled with current and future promised payments that we can’t afford now, and thus will have to tell our children to make good on.

Is that moral?

Some have said that it’s immoral not to take care of the elderly and infirmed, but by doing it on the backs of our children and grandchildren, is that really the more moral route?  With the health care reform bill, we are making promises that future generations must pay for.  And we are making promises that they may not be able to afford at all after this generation has already spent their inheritance on previous promises made.

And, as I noted previously, no matter what you hear from any politician on how much this or that program will cost, it will cost more.  History is strewn with so many examples of this that anyone believing these numbers is utterly ignorant, willfully or otherwise. 

Making promises binds us to honor them, which is a good thing.  But making promises with an inefficient bureaucracy binds us to a millstone that will continue to take us down with its unsustainable load, and we can’t afford that.

No government ever voluntarily reduces itself in size. So, governments’ programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this earth. — Ronald Reagan (click here for the audio clip)

I’d say with precious few exceptions, Reagan’s words express a truism for any government instituted by man. 

Given this, it simply doesn’t make sense to make huge changes to our health insurance system, putting so much under the purview of the government, all at once.  Once it’s there, no matter how poorly it work, those who benefit from the programs (or believe they do) will make up such a constituency that no politician will dare cross them.  It’ll become yet another 3rd rail that no one wants to touch.  The only option will be to throw good (borrowed) money after bad.

I can say this with confidence because that tracks with history.  It has happened time and time again, and there’s not one thing to indicate that if this doesn’t do what it claims to do, it’ll be scrapped.  Instead, there’s plenty of evidence to suggest that government, regardless of which party’s in charge, will constantly try to "fix it", usually by giving the federal government more control and taking that control and freedom away from the individual. 

The better way to do this is incrementally, but the same problems can plague even these smaller items unless these items increase public freedoms.  For example, allowing health insurance to be purchased across state line is something that would give individuals more choices and hence drive down costs.  When you can only by apples from one  vendor, he can charge what he likes, and it doesn’t matter how good his apples are; where else are you going to go?  When there are 20 vendors, competition ensues and vendors compete on cost and quality.  Allowing this would have immediate results, and the results could be determined to be good or bad.  Actually, I see no real downside to this particular proposal from the Republicans, but if there were, it’s easier to repeal a small law than a huge, intertwined, governmental system. 

[One might ask, doesn’t the proposed public option increase competition?  Well yes, but by 1 rather than by hundreds.  But the general problem with getting the government into the market is that the government makes the market’s rules as well and can undercut competition because it doesn’t have to pay its costs from charging for the service; it can tax everyone on the side, hiding its true price on your 1040 form.]

A massive overhaul of any industry is not something government should be doing.  That’s another reason why I oppose the Democrat’s health care reform bill.

As events continue to unfold while the health insurance reform bill comes either to a vote or a train wreck (or both), I want to hit on a few main reasons why I’m against the Democrats’ idea of "reform".  Today, it’s the money.

Obama has said that whatever he signs must be either deficit-neutral or indeed reduce it, and the claims are that this bill will do just that.  In fact, it’s one of the reasons Democrats say that using reconciliation — typically used for deficit reduction — is appropriate.  They point to the CBO numbers for the bill as coming in under $1 trillion for the first 10 years, while generating savings that would go beyond that.

But here’s the thing. 

First of all, they’re gaming the CBO system.  By putting off any real serious spending for 4 years or so, while collecting taxes in anticipation of the spending, the real cost of the program is hidden.  To find the real estimates, click here to hear Democratic Senator Max Baucus give a better number for it; $2.5 trillion.  The difference?  In his words; if you start counting from the year 2014.  Knowing that the CBO rules only look 10 years out from bill passage, Democrats have crafted the timetable to favor a low CBO number, and they trumpet this fake number on the talk shows.  At least we have Senate video to show that they do know better, but they’re just hoping their constituents aren’t paying attention (which it looks like they aren’t).

Second of all, government programs virtually always cost more than original estimates, whether this is because the first estimates were faulty or gamed, or whether folks like the giveaways so much they ask for more, or whether politicians buy votes by increasing benefits.  The "experts" who were estimating the cost of Medicare back in 1966 — when it cost $3 billion — said that by 1990 it would cost $12 billion, allowing for inflation.  Instead they were off by almost 9 times; it was $107 billion.  And in 2007, it was costing us $431 billion.  For just 1 year.  Even after cost cutting measure like reducing payments to doctors, which then causes some doctors to leave the Medicare market.  (Follow the link for other medical cost underestimating.)

So in order to get this past the American people, Democrats are massaging the data to fit the narrative, while knowing full well (if they have any knowledge of history at all) that they are low-balling by an order of magnitude or more. 

It’s not just the cost estimates; it’s the disingenuousness and outright lying that is going on that should give any supporter pause as to what it is they’ve bought into.

Should something as huge as the remaking of the healthcare system in America be done in such a "unipartisan" manner?  Ask Barack Obama.  That was then:

And this is now:

White House officials tell ABC News that in his remarks tomorrow President Obama will indicate a willingness to work with Republicans on some issue to get a health care reform bill passed but will suggest that if it is necessary, Democrats will use the controversial "reconciliation" rules requiring only 51 Senate votes to pass the "fix" to the Senate bill, as opposed to the 60 votes to stop a filibuster and proceed to a vote on a bill.

So then, it requires a "sizeable majority" so long as it doesn’t take too long.  Then all bets are off.  Gotcha.

There are those who say that our government is "us", so to speak, and thus if health care reform passes, it’s because we wanted it.  Well, except that a majority of us don’t.  This isn’t representative government.  Yes, the general idea did enamor more folks when it first hit Congress, but the more people know about it, the less they have wanted it.  With one exception, opposition to it has been over 50% since the middle of September, and peaked over 50% often before that. 

Most of us don’t want this monstrosity.  But Obama is more than willing to shove aside his principles of good governance, and do precisely what he accused Bush and Rove of, in order to get his way.  Representative government indeed.