Archive for March, 2010

Health Care Reform: Polls and Crazies in the News

Thursday, March 25th, 2010

Like many I’ve continued to watch coverage this week of health care reform. Just a few interesting articles and nuggets today.

CBS Poll: Most Want GOP to Keep Fighting
I had expected to see Obama get a slight bump following the passage of the health care bill this weekend. According to Gallup, the favorables jumped 4 points from 45% in favor of the bill before the vote to 49% in favor of the bill after the vote. And Obama’s job approval rating jumped to 51% from a low of 46% just about a week ago. In general, Gallup has tracked more favorably for health care reform than most other polls, and by a pretty good margin. RealClearPolitics does a great job of tracking multiple polls, and you can see here that Gallup tracked the favorables of the health care reform bill by 4-10 points higher than just about everybody else. So even if health care reform gets a similar bump in the other polls, it will still be seen as an unfavorable bill by most Americans.

But what I found more interesting was in a new CBS poll that found that 62% of those polled WANT the republicans to continue to challenge the health care bill.

CBS Poll Results

From CBS: “The poll finds that 62 percent want Congressional Republicans to keep challenging the bill, while 33 percent say they should not do so. Nearly nine in ten Republicans and two in three independents want the GOP to keep challenging. Even 41 percent of Democrats support continued challenges.”

Threats and Violence are Never Acceptable
Lots of media coverage of threats from health care reform opponents against democrats who voted for the legislation. This is just wrong. Though it’s interesting that Bart Stupak was receiving threats from the left when he had planned to vote against the bill, but it’s not until he receives threats from the right for voting for the bill that it becomes a news story.

There are crazies on both sides. I condemn the behavior of these extremists on the right just as I condemned the behavior of the extremists on the left.

And a Little More Reading Material
Two more articles to keep the juices flowing. This one is from IBD and details 20 ways the Obama-Care will take away our freedoms. And some coverage from PolitiFact with their top ten facts to know about health care reform.

Health Care Reform Doesn’t Add Up

Monday, March 22nd, 2010

Dr. ObamaDo you want to know what drives me crazy about our federal government? Well, lots of things drive me crazy. But in light of the passage of Obama-Care last night, simple mathematics just never add up in Washington.

I drive a ’96 pickup truck. Some day it will need to be replaced. We’re hoping that it lasts long enough so that we have our car paid off by the time we have to replace the truck. But what if my truck dies next week? It would be difficult for us to be a one car family. And it will be very difficult for us to add a second car payment to our budget. Decisions will have to be made. What else can we cut from our budget? What are our opportunities to increase our income?

If this particular health care reform bill is so vital to the future of our country, doesn’t that in turn mean that it’s MORE important than other items currently in the budget?

According to the U.S. Treasury, here’s where we spent our federal tax money in 2009.

Department of Agriculture: $114 billion
Department of Commerce: $11 billion
Department of Defense: $637 billion
Department of Education: $53 billion
Department of Energy: $24 billion
Department of Health and Human Services: $796 billion
Department of Homeland Security: $52 billion

This is just a partial overview, but you get the picture. (Data provided by the U.S. Treasury.) We really couldn’t come up with a few cuts elsewhere to help pay for health care reform?

Fuzzy Math 101

Now back to my original point. I guess it’s important to understand that supporters of this legislation don’t care what it costs. Explaining to them that the math doesn’t add up falls on deaf ears. They point to the recent report released by the CBO and say “See, this will reduce the deficit.” Well, the CBO report doesn’t tell the whole picture. And this bill will not reduce the deficit.

1. The CBO was told that we’ll cut $500 billion from Medicare. The CBO doesn’t take into account how, or if, it will actually happen. All they take into account is that they’re told that we will cut $500 billion from Medicare to help pay for health care reform.

So how will we do it? I don’t know. And obviously the government doesn’t know either. They plan to put a panel in place to make these decisions later.

So what happens if they don’t find $500 billion in cuts? Well, nothing happens. The bill has already become law. Who is going to track this and hold Obama / Pelosi / Reid accountable in 2020 if we don’t really cut $500 billion from Medicare?

With millions of baby boomers soon to flood Medicare, there’s not a chance that we’ll actually be able to cut $500 billion from Medicare.

2. The CBO was told that we’d raise another $500 billion through tax increases. The CBO doesn’t take into account how, or if, it will actually happen. All they take into account is that they’re told that we will provide an additional $500 billion through taxes.

So how will we do it? I don’t know. And obviously the government doesn’t know either, as many of the tax increases that will be needed to reach $500 billion do not exist yet. This puts the burden on future congresspeople to pass new tax increases to cover health care reform.

So what happens if they don’t raise $500 billion in new taxes? Well, nothing happens. The bill has already become law. Who is going to track this and hold Obama / Pelosi / Reid accountable in 2020 if we don’t really raise $500 billion in new taxes?

3. What about the expansion of Medicaid that will be required to fulfill the requirements of this bill? Well the CBO doesn’t care about that either. Much of this expense will be picked up by the states who implement Medicaid. Where will this money come from? Out of the state’s budget. That doesn’t factor into the CBO’s findings, or their cost analysis of health care reform.

Kansas is already going through a significant financial crisis, as are most states. Obama has pledged to help the states. With what money? Oh don’t worry, we’ll figure that out later. That doesn’t need to be included when determining the costs of the bill.

4. Last night the House of Representatives made some “reconciliations” to the Senate bill that was passed by the House. My understanding is that one of the components in the reconciliation bill deals with increasing payments to doctors through Medicare compared to the Senate’s bill, thus increasing the expense of the bill. When asked about the increased cost, Congressman Barney Frank replied “We’ll pay for that later.” So once again, more expenses that are not covered in the CBO’s analysis.

5. One component of this bill is that it mandates that Americans purchase health insurance. Who will enforce this? Well the IRS will enforce it. And it has been estimated that the IRS will need to add more than 16,000 employees in order to manage their new responsibilities. Who will pay for this? We will. Did the CBO factor this into their cost analysis? Nope.

This legislation is not budget neutral as we’ve been told repeatedly by supporters. It will cost us a lot of money.

Lawrence Hit By Snow, Jayhawks Hit By Panthers

Sunday, March 21st, 2010

Kansas JayhawksNot a great way to start the spring. Lawrence gets hit by six inches of snow. And the Jayhawks get hit by the Panthers of Northern Iowa. Making the Final Four is tough. It never surprises me for a team to lose in the Sweet 16 or Elite 8. But losing in the second round yesterday was a bit of a shock. I’m still proud of the Jayhawks. It’s been a great year.

The Good
The Jayhawks won the Big 12 regular season championship, and the Big 12 tournament championship. They compiled a sterling record of 33-3. They Jayhawks swept K-State and Missouri, and were ranked as the number one team in the country most of the season. None of this was a fluke. This was an awfully good team.

The Bad
These are college kids, so I won’t spend a lot of time beating them up over how the season ended. The frustrating thing to watch this season has been their inconsistency. They start slow, especially against weaker opponents. They never developed that killer instinct that you come to expect from great teams. And on Saturday, it came back to bite them. A pesky team from Northern Iowa with nothing to lose played carefree basketball and never looked back. If they played ten times, the Jayhawks would win eight or nine of them. But that’s what makes the NCAA basketball tournament such a great event.

The Future
Sherron Collins has played his last game as a Jayhawk. It’s been enjoyable watching Collins develop into the undisputed leader of the Jayhawks. I’m not sure I’ve seen a player step up and embrace the mantle of leader like Collins. But Collins fought his own demons this year with inconsistency. And typically if Collins was off, so was the team.

Jayhawk fans will be waiting with baited breath to hear the decisions of Cole Aldrich and Xavier Henry. Let me put this one to rest — unless something unforeseen happens (like an injury during the off-season) Aldrich and Henry will enter the NBA draft. Both are projected to be lottery picks.

So where does that leave Jayhawk basketball next year? KU will lose it’s star power without Collins, Aldrich and Henry. But the team may find some more consistency underneath it all.

The Bigs: Bill Self prefers a three man rotation for his big men, and was able to achieve that most of the year with Aldrich and the twins. Cole has done a great job of staying out of foul trouble most of his career. The Morris twins have not. The Jayhawks will likely have to play a four man rotation next year with Thomas Robinson and Jeff Withey combining to replace Aldrich.

Small Forward: Xavier Henry showed flashes of brilliance this year. He has one of the sweetest strokes I’ve watched at KU. But he would seemingly disappear for large portions of a game. Mario Little may not have the upside of Henry, but don’t be surprised if he isn’t more consistent than Henry, and better slashing to the basket. My prediction is that Little is really going to surprise the Jayhawk faithful next year. Travis Releford is likely inline to backup Little at the three.

The Guards: Nobody was more inconsistent this year than Tyshawn Taylor. It will be interesting to see what Self does with him next year. Down the stretch it was Tyrel Reed who played well and was on the floor at crunch time over Taylor and Brady Morningstar. Reed is one of my favorite Jayhawks. Plays hard. Plays smart. And knocks down the three. Elijah Johnson will be a sophomore, and figures to get a long look at the point. And then there’s C.J. Henry who continued to battle through injuries this year. Will he be back? I hope so, but it wouldn’t surprise me if he left Lawrence and never returned. I’d really like to see him get a shot at some quality minutes. He handles the ball well, he seems to have a really nice outside shot, and he can create his own shot.

The Starting Five: I think the Morris twins and Little are locks at starting spots next year. It’s harder to predict what’s up with the guards. Personally I’d like the see C.J. Henry and Reed get shots at starting. But it won’t surprise me if Self ends up with Taylor and Morningstar.

The Rotation: Self prefers an eight man rotation. Nine if he’s forced into it. Like it or not, he may end up with a ten man rotation next year. But with less star power to worry about, Self can go with the hot hand.

Healthcare Reform Likely to Pass Despite Public Opinion

Friday, March 19th, 2010

Dr. ObamaIt appears that President Obama will get his vote this weekend, and it’s sounding more and more as if healthcare reform is going to pass.

At this point I only hope I’m wrong about how bad this bill will be for our country.

According to Rasmussen, polls have remained steady with 53% of those polled opposing the  bill, and only 43% in favor of the bill. Those findings include 23% who strongly favor the plan and 46% who strongly oppose it.

A few other points of interest:

57% of voters believe the health care reform plan will hurt the economy.

55% of voters believe the cost of health care will go up.

Only 24% of voters think the quality of health care will be better, while 52% say it will get worse.

76% of those with insurance now rate their own coverage as good or excellent.

55% of voters would like to see Congress scrap this plan and start over.

51% fear the federal government more than they fear private insurance companies.

This has been a truly amazing process. I can think of no other issue in recent history where the American people have become this involved and educated on a political and social issue, and have so proactively voiced their opinions. Yet the administration and Congress have decided that they know better, and plan to twist every arm and cut every deal necessary to get the votes they need to pass this bill.

Truly amazing.

Doctors Will Quit if Obama-Care Becomes Law

Wednesday, March 17th, 2010

46.3% of primary care physicians (family medicine and internal medicine) feel that the passing of health reform will either force them out of medicine or make them want to leave medicine.NOTE: I’ve left my original post intact below, but the New England Journal of Medicine is now distancing themselves from this survey and content. As of this morning they had posted two detailed articles about the results of a survey conducted by The Medicus Firm. They have now removed the two articles and instead are linking to The Medicus Firms’ website for information about the survey. The NEJM now says: “The opinions expressed in the article linked to above represent those of The Medicus Firm only. That article does not represent the opinions of the New England Journal of Medicine or the Massachusetts Medical Society.”

I still find the survey interesting, but now it’s harder to know how closely this survey mirrors the opinions of doctors across the country. Maybe Rasmussen will pick up these same questions and do a new survey for us.

Lee

*****

Let me start with a personal story. I good friend of mine was seeing a doctor in Kansas City this last summer. The doctor is a specialist and widely considered among the best in his field in the country. The doctor told my friend that he was working on his MBA, and would be leaving medicine if Obama-Care passed.

One of the complaints among opponents about this massive healthcare reform bill is that it will drive doctors away from medicine. And even though I knew of a personal story about a doctor who was already planning to leave medicine, it’s been difficult for me to tell how much of this was rhetoric, and how much of it was legitimate. Until now.

In a new article from the New England Journal of Medicine, they report that a recent survey shows that “46.3% of primary care physicians (family medicine and internal medicine) feel that the passing of health reform will either force them out of medicine or make them want to leave medicine.”

See the full story here in the NEJM. And here is a quick overview of the key findings. (NOTE: These links used to take you to the two articles on NEMJ’s website, but now take you to information where they explain that it wasn’t their survey.)

Here are a few of the comments that stuck out to me:

Physicians agree that healthcare reform is needed. Only 3.6% of physicians prefer the “status quo” and feel that the U.S. health care system is best “as is”.

Only 28.7% of physicians are in favor of a public option.

62.7% of physicians feel that health reform is needed but should be implemented in a more targeted, gradual way, as opposed to the sweeping overhaul that is in legislation.

The Bureau of Labor Statistics “predicts a more than a 22 percent increase in physician jobs during the ten-year period ending in 2018. This places physician careers in the top 20 fastest-growing occupations from 2008 to 2018. Meanwhile, nearly one-third of physicians responding to the survey indicated that they will want to leave medical practice after health reform is implemented.”

“What many people may not realize is that health reform could impact physician supply in such a way that the quality of health care could suffer,” said Steve Marsh, managing partner at The Medicus Firm in Dallas. “The reality is that there may not be enough doctors to provide quality medical care to the millions of newly insured patients.”

Let me put it this way — doctors understand that we need healthcare reform. But they already know what it’s like for the federal government to get their hooks into health care. And they don’t want any more of it. They deal with Medicare every day. And they watch as Canadians come to the U.S. because they’re unable to receive high-quality of care in a reasonable amount of time in Canada.

NFL Free Agency Begins — Chiefs Needs

Friday, March 5th, 2010

NFL free agency is set to begin, and there’s already been some movement as teams release players no longer in their plans. The Chiefs have many needs, but don’t expect them to fill many of them in free agency. It’s not the Chiefs fault. There just isn’t much out there, and 31 other teams who will be going after this same small group of unrestricted free agents. So who should the Chiefs pursue? Here are a few suggestions:

Antrel RolleSafety Antrel Rolle: Released by the Arizona Cardinals in a financial move, Rolle would appear to be a good fit for the Chiefs. He would be an upgrade over Mike Brown. He’s played both corner and safety. And he’s only 27. He would be my number one target. I can’t imagine he’ll last long in free agency. There are a couple other free agent safeties who might be worth looking at including Ryan Clark from the Steelers and Dawan Landry from the Ravens.

Nose Tackle Jamal Williams: At 33 it’s hard to know how much Williams has left in the tank, but he’s a true nose tackle with tons of experience in the 3-4. Last year the Chiefs had Ron Edwards and not much else. Williams would provide depth, and might even push for a starting spot.

Antonio BryantWide Receiver: Fill in the blank here. The Chiefs are attempting to resign Chris Chambers, which I think would be an excellent move. But the Chiefs will need to consider yet another receiver. I’ve always like Laveranues Coles, and he was recently released by Cincinnati. Though at 32 his best seasons are well behind him. And I really like Antonio Bryant. He’s a playmaker, and only 28 years old. Plus there still might be an opportunity to trade for Anquan Boldin.

Running Back: The Chiefs will need to find a complementary back for Jamaal Charles. Preferably somebody with some size for short yardage situations. Chester Taylor from the Vikings is probably the biggest name out there, but he’s not necessarily the best fit for the Chiefs. Not sure where the Chiefs go here, but you’d think they’d bring in somebody to provide competition. Or they might just wait till the draft.

Offensive Line: I would expect the Chiefs to sign a couple of guys to create some competition, but there’s not much out there. Chad Clifton, the offensive tackle from the Packers, is probably the biggest name available, but he’s certainly not an elite tackle. I’d rather see the Chiefs draft an offensive tackle than sign Clifton.

The two biggest names on the market are linebacker Karlos Dansby and defensive end Julius Peppers. I don’t anticipate the Chiefs making a push for either of them. Dansby would certainly be an upgrade for the Chiefs at inside linebacker, but the Chiefs have such bigger needs elsewhere that it’s hard to see them going after Dansby. And Peppers would have to convert to an outside linebacker in the 3-4. He’s capable of making that transition, but with the Chiefs resigning Mike Vrabel this week it’s hard to see them making a play for Peppers.

The Health Care Debate Continues

Wednesday, March 3rd, 2010

The health care debate is an interesting one. People are passionate on both sides of this issue. And for every comment I receive on this blog, I also receive a handful of emails from people who don’t want to express their opinions publicly. Liberals are mad at republicans because they view the republicans as obstructionists for standing in their way in passing health care reform. Republicans are the “party of no” say the liberals. And the conservatives and independents are mad at democrats for failing to listen to the people and attempting to pass a massive federal program despite waning public support.

As usual, I have a few opinions to share on both sides of this. But first let me tell you a story about a bus system.

Lawrence Transit BusThe “T”
For those of you who don’t know much about Lawrence, let me give you a quick overview of our community. We’re a college town with a population of less than 100,000. Lawrence is a liberal community embedded in a conservative state. The views of our community are much different than they are for most of the Midwest. We have more in common philosophically with San Francisco than we do Wichita.

Several years ago we were deciding on whether or not Lawrence should have a public transportation system. Liberals explained how important the bus system would be to the community, and how it would be financially self-sustaining within a few years. Conservatives countered that Lawrence was just too small, and didn’t need a bus system. My point at the time was that there was no way that public transit would be self-sustaining financially, and that the debate needed to be on whether or not we, as a community, were willing to pay for a bus system.

The voters supported the bill, and Lawrence Transit, typically referred to as the “T”, was born.

To make a long story short, ridership has been abysmal. Lawrence has been losing approximately $2.5 million per year on the “T”. And at the last major election we were asked to vote for a significant sales tax increase in order to keep public transit afloat. And like good liberals, we voted for the tax increase to save the bus system.

So my question is this: Did our city’s liberals really believe that the bus system would be self-sustaining? Did they talk themselves into believing their wildly optimistic revenue projections? Or were the projections just distractions to begin with? Financial slight of hand so to speak. The truth is probably a little of both. Some of the liberals believed the financial projections because that’s what they wanted to believe. And others probably didn’t care. They were so determined that our city “needed” a bus system that they didn’t care about the future costs or flawed revenue projections.

Liberals wanted what they always want, and that’s for the government to step in and right social wrongs. Lawrence liberals felt like it was wrong for us not to offer public transportation to our community. But instead of debating the merits of public transportation in a city of less than 100,000 people, many of whom were already being served by KU’s bus system, they focused on their wildly optimistic projections of revenues to explain how there was no reason NOT to create a public transit system. At the time I viewed their reasoning as flawed and intellectually dishonest.

Nancy PelosiGive the Democrats their Props
The republicans were in control of Congress from 1994 to 2006 and failed to solve our country’s health care problems. I give a lot of credit to the democrats for moving forward and attempting to solve this problem. I think it’s interesting that often we condemn politicians for doing what’s in their own self-interest, and not doing what’s best for the country. But in this case we’re witnessing the democrats commit political suicide as they attempt to pass what they perceive as a solution to our country’s health care problems. And now many on the right are condemning the democrats for sticking to their principles.

But a word to democrats, your cry of republican obstructionism is lame. The democrats decided to throw a big party and didn’t invite the republicans. Don’t blame the republicans for whining about it. With significant majorities in the Senate and the House, and a democrat in the White House, democrats viewed this as their opportunity to pass a massive federal program to “fix” health care. They knew that fiscal conservatives would never get onboard with their plans, so they didn’t invite them to the party. They thought that they could force this legislation through Congress without the republicans. And now democrats are whining because they haven’t been able to pass this legislation despite majorities in the Senate and the House.

Liberals want what they always want, and that’s for the government to step in and right social wrongs. Liberals want nationalized health care, and this legislation is a significant step towards a single-payer, government run solution. I don’t begrudge liberals for this. But I do begrudge the intellectual dishonesty of many of their arguments for this legislation. I’ve already covered several in past posts, but here are a couple more.

CongressFinancial Slight of Hand #1: The president has repeatedly talked about the 10 year and 20 year projections for costs associated with their plan. But the numbers are flawed and misleading. In the first ten years, the program is paid for because we have almost ten years of tax increases and Medicare cuts, but most the benefits only kick in during the second half of this ten year projection. So we’re paying for the plan for ten years, but only receiving five years of benefits. Why? Because that was the only way to make the numbers work over the first ten years.

But the financial projections over the first 20 years are just as flawed and misleading. The 20 year projection is based on significant future budget cuts that are not included in the current legislation. Even the CBO recognizes that these budget cuts are never likely to happen, making the 20 year projection irrelevant.

Financial Slight of Hand #2: The administration continues to claim that by adding more people (the currently uninsured) to the health insurance pool, insurance rates will go down, even though most projections still show premiums on the rise with the passage of their bill. The plan is to force all Americans to buy health insurance. The reasoning is that since many of our “uninsured” are actually young, healthy Americans, adding them to the pool will reduce premiums. This is again flawed logic. Many of these young Americans will continue to go without coverage and risk the potential penalties. And it’s possible that forcing Americans to buy health insurance will be found to be un-Constitutional anyway.

But the people who are more expensive to cover will certainly enter the health insurance pool. People who cannot afford premiums because of health issues, and those who are currently denied coverage for pre-existing conditions, will drive up health insurance premiums.

Like the Lawrence liberals who focused on wildly optimistic revenue numbers for a public transportation system, democrats would rather make the case for expanding the government’s role in health care based off of flawed financial projections than the merits of the program. I’d call this intellectually dishonest.

Note: Here’s a post I wrote about Congress being empowered by their beliefs in healthcare reform.