Consumer Power Report #230

Published July 16, 2010

Welcome to the Consumer Power Report – Greg Scandlen is off this week.

As the conversation in Washington shifts to debate about deficits in the wake of the crisis in Europe, I want to take the opportunity to share a recent speech by Michael Barone that I found particularly insightful – not just into the debate about health policy, but about the direction we’re headed as a country. You can find the full text at the American Enterprise Institute:

“Up through the end of the 19th century there did not seem to be a significant tension between universal democracy and property rights. The Founders’ vision prevailed. But that was no longer the case in 1910. By then, another vision was being advanced, the vision of the Progressives – the vision of Presidents Theodore Roosevelt and Woodrow Wilson, of political philosophers Herbert Croly and John Dewey. The Progressives explicitly repudiated the Founders’ vision of limited government. They argued that government needed to redistribute property, to take money from one group of citizens to help others, and to regulate economic activity in ways previously considered unconstitutional. The Constitution, they said, was a ‘horse and buggy’ document, suited perhaps to the simpler society of the 18th century, but dangerously out of date in a complex industrial society which could not expect ordinary citizens to make their way without government guidance and assistance. They were acting, they said, in the interests of the people. Their critics said they were acting out of hunger for power. I want to advance another thesis: That they actually acted more out of fear than of benevolence. They feared revolution.”

As you will see in our first item, the redistributionist agenda of the Progressives, having achieved some triumph by a narrow margin in the halls of Congress, is now about to be applied in a meaningful way through our newly recess-appointed administrator of Medicare and Medicaid, Donald Berwick. It is always amazing how each new generation of Americans seems to think it is having a debate for the first time – when in reality, these clashes of ideas about the role of government in society have stretched back for centuries.

– Benjamin Domenech



Daniel Henninger does us all a service by collecting in The Wall Street Journal a full gamut of the audacious quotes of Donald Berwick, all of which lead one to ask: Why was this man allowed to take over the Centers for Medicare & Medicaid Services, with a budget larger than all but 15 nations in the world, without publicly answering one question from Senators, or even completing the standard financial vetting process?

“Barack Obama’s incredible recess appointment of Dr. Donald Berwick to head the Centers for Medicare & Medicaid Services (CMS) is probably the most significant domestic-policy personnel decision in a generation. It is more important to the direction of the country than Elena Kagan’s nomination to the Supreme Court. The court’s decisions are subject to the tempering influence of nine competing minds. Dr. Berwick would direct an agency that has a budget bigger than the Pentagon. Decisions by the CMS shape American medicine. Dr. Berwick’s ideas on the design and purpose of the U.S. system of medicine aren’t merely about ‘change.’ They would be revolutionary. One may agree with these views or not, but for the president to tell the American people they have to simply accept this through anything so flaccid as a recess appointment is beyond outrageous. It isn’t acceptable.”

You can read my own take on Berwick’s appointment at FreedomPub and listen to my Health Care News podcast with Avik Roy on this topic at The Apothecary.

SOURCE: Wall Street Journal


Michael Tanner, a senior fellow at the Cato Institute, offers this new report on the costs and consequences of Obama’s new health care law: “For better or worse, President Obama’s health care reform bill is now law. The Patient Protection and Affordable Care Act represents the most significant transformation of the American health care system since Medicare and Medicaid. It will fundamentally change nearly every aspect of health care, from insurance to the final delivery of care. The length and complexity of the legislation, combined with a debate that often generated more heat than light, has led to massive confusion about the law’s likely impact. But, it is now possible to analyze what is and is not in it, what it likely will and will not do.”

Read and be informed.

SOURCE: The Heartland Institute


The latest polling data from the Pew Research Center illustrates that the more Americans learn about this new health care regime, the less they like it. “If President Obama and Democrats were hoping the public would come around on the healthcare overhaul passed in March, they might want to step up their outreach efforts. … Overall, 47 percent disapproved of the law, while 35 percent approved. Seventeen percent couldn’t answer the question. Along party lines, the perception is stark: 82 percent of Republicans disapprove, while only 17 percent of Democrats disapprove. Independents track closer to the overall sample: 52 percent disapproved of the law, while 30 percent approve.”

SOURCE: National Journal


John Goodman makes a critical point in a blogpost at Health Affairs, one that rebuts an all-too-common myth about emergency room traffic – namely, he makes the point that Medicaid patients, not the uninsured, are the primary overusers of ERs: “As we pointed out in a recent National Center for Policy Analysis (NCPA) Brief Analysis, the use of the emergency room by uninsured patients is not that much different than usage by the insured. The heaviest users of the ER (in proportion to their numbers) are Medicaid patients, probably because Medicaid rates are so low that physicians are not anxious to see them. And the reason why that is important is that more than half of the people who gain insurance under the new health reform bill will enroll in Medicaid. … In general, people with insurance consume twice as much health care as the uninsured, all other things equal. The trouble is that the new health insurance law has no provision for increasing the number of health care providers. As a result, when people try to increase their use of physician services, many will be disappointed and a large number are likely to turn to the emergency room when they cannot get their needs met at doctors’ offices.”

NCPA’s Devon Herrick wrote on this story for Health Care News this month.

SOURCE: Health Affairs Blog


John R. Graham of the Pacific Research Institute offers this new report on medical malpractice laws across the 50 states: “For three years, 2007 through 2009, PRI published the U.S. Index of Health Ownership. The Index continues to be the only effort to measure the degree to which individuals, whether patients, health professionals, entrepreneurs, or taxpayers, ‘own’ the health care in their states. It quantifies how state laws and regulations affect the liberty of citizens involved in state government health plans (primarily Medicaid), the private health insurance market, and the provision of medical services, as well as the effect of medical tort on people’s freedom to engage health services.” Read additional material about the study here.

SOURCE: The Heartland Institute


The Senate Republican Conference, which raised serious questions about the facts behind a brochure distributed to all Medicare recipients by HHS Secretary Kathleen Sebelius in May, offers this comprehensive fact-check of the brochure, which they say “included inaccurate information and blatantly contradicted, in some instances, conclusions made by Medicare’s chief actuary. … For each claim, the document cites conclusions made by Medicare’s chief actuary and the Congressional Budget Office to provide a more accurate explanation of how the new health law will affect seniors and the Medicare program.” Health Care News originally reported this story here.

SOURCE: The Heartland Institute