I present you Robert Laszewski’s magnificent take on ObamaCare and Wisconsin, Democrats and Republicans.
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Health Care
What on Earth Is Ezra Klein Talking about?
The Washington Post’s Ezra Klein writes:
It’s put-up-or-shut-up time for Republicans. They managed to make it through the health-care debate without offering serious solutions of their own, and — perhaps more impressive — through the election by promising to tell us their solutions after they’d won. But the jig is up. They need a health-care plan — and quickly.
The GOP knew this day would come.
Say what? Exactly what political factors are forcing the GOP to put up or shut up? Their base is happy; it wants an all-out assault on ObamaCare, and congressional Republicans are giving it to them. Republicans are even winning the ObamaCare debate among the broader public:
![Media Name: HealthCarer.png](/sites/cato.org/files/styles/pubs_2x/public/download-remote-images/pollster.com/138572616196/HealthCarer.png?itok=Py-DS27r)
So why should Republicans all of a sudden stop attacking ObamaCare and start talking about their own refor–ohhhh…I see. Klein is trying to talk the dog off the meat wagon. Good luck with that.
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So This Is Freedom? They Must Be Joking.
That’s the title of my latest Kaiser Health News column, which addresses President Obama’s offer to accelerate the waiver process that would allow states to replace many of ObamaCare’s most offensive provisions:
If you think that means the president was himself exhibiting flexibility, you would be wrong. Despite the rhetoric about compromise, what the president actually did was offer states the option of replacing his law with a single-payer health care system three years earlier than his law allows…
HHS Secretary Kathleen Sebelius has written that ObamaCare gives states “incredible freedom” to implement the law. We now know what she meant: states are free to coerce their residents even more than ObamaCare requires. What’s incredible is that she calls that freedom.
Apologies to to the Housemartins.
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How Dare Conservatives Stand athwart ObamaCare Yelling, Stop!
In a column for Kaiser Health News, Michael L. Millenson, President of Health Quality Advisors LLC, laments that conservatives in the U.S. House are approaching ObamaCare like, well, conservatives. He cites comments by unnamed House GOP staffers at a recent conference:
The Innovation Center at the Centers for Medicare & Medicaid Services? “An innovation center at CMS is an oxymoron,” responded a Republican aide…“Though it’s great for PhDs who come to Washington on the government tab.”
There was also no reason the government should pay for “so-called comparative effectiveness research,” another said.
“Everything’s on the chopping block,” said yet another.
No government-funded comparative-effectiveness research? The horror! For my money, those staffers (and whoever hired them) should get a medal.
Millenson thinks conservative Republicans have just become a bunch of cynics and longs for the days when Republicans would go along with the left-wing impulse to have the federal government micromanage health care:
After all, the McCain-Palin health policy platform in the 2008 presidential election called for coordinated care, greater use of health information technology and a focus on Medicare payment for value, not volume. Once-and-future Republican presidential candidates such as former governors Mike Huckabee (Ark.), Mitt Romney (Mass.) and Tim Pawlenty (Minn.), as well as ex-Speaker of the House Newt Gingrich, have long promoted disease prevention, a more innovative federal government and increased use of information technology. Indeed, federal health IT “meaningful use” requirements can even be seen as a direct consequence of Gingrich’s popularization of the phrase, “Paper kills.”
He even invokes the father of modern conservatism, William F. Buckley, as if Buckley would disapprove of conservatives standing athwart ObamaCare yelling, Stop!
Millenson’s tell comes toward the end of the column, when he writes:
traditional GOP conservatives… [have] eschewed ideas in favor of ideological declarations.
Eschewed ideas in favor of…ideas? My guess is that what’s really troubling Millenson is that congressional Republicans are eschewing left-wing health care ideas in favor of freedom.
Better late than never. Now if only GOP governors would do the same.
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Spending Growth: Mandatory Programs
While Congress haggles over Republican ambitions to trim $61 billion in funding for domestic discretionary programs, it’s important to remember that mandatory (or “entitlement”) spending is the main driver of recent and future budget growth.
The following chart compares fiscal 2007 spending to the president’s proposal for fiscal 2012 for the largest areas of overall federal spending:
![Media Name: SpendingAreas2007vs2012.jpg](/sites/cato.org/files/styles/pubs_2x/public/download-remote-images/www.downsizinggovernment.org/155835193655/SpendingAreas2007vs2012.jpg?itok=P96PDquV)
Note that the area of spending that has increased the most dramatically is “other mandatory.” Major programs in this category range from food stamps to retirement and disability benefits for federal workers. The following chart shows the increase in spending for the largest of these programs:
![Media Name: OtherMandatory2007vs2012.jpg](/sites/cato.org/files/styles/pubs_2x/public/download-remote-images/www.downsizinggovernment.org/155835193655/OtherMandatory2007vs2012.jpg?itok=oHBq_laL)
This area of spending, and the programs that it consists of, are often forgotten in the debate over how to rein in our extraordinary deficits and mounting debt. That needs to change.
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I’m Not So Sure I Like Your Mental Activity
The latest federal judge to declare ObamaCare constitutional claimed that Congress can regulate “mental activity,” like the mental activity of choosing not to purchase health insurance. Or shoes and ships and sealing wax. Or my book.
National Review editor Rich Lowry has an excellent column explaining why this latest, ahem, legal victory for ObamaCare “delivered a more telling blow against the law in the course of ruling it constitutional than critics have in assailing it as a travesty…It’s the most self-undermining defense of the constitutionality of a dubious statute since then–solicitor general Elena Kagan told the Supreme Court that under campaign-finance reform, the government could ban certain pamphlets.”
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Mitch Daniels’s ObamaCare Problem
That’s the title of my latest column at National Review Online. An excerpt:
Mitt Romney isn’t the only Republican presidential hopeful with an Obamacare problem: Indiana governor Mitch Daniels, were he to become the GOP’s nominee, could also undermine the repeal campaign that has united the party’s base and independent voters.
Among his liabilities:
Daniels’s decision to accept Obamacare funds and move forward with implementation is further undermining the repeal effort. Yesterday, federal judge Roger Vinson reversed his initial order forbidding the Obama administration to implement the law. He did so in part because plaintiff states such as Indiana are implementing it, which he said “undercut” their own argument that he should block it.
But all is not lost for Daniels.
Daniels can spare himself and the repeal movement such setbacks by following the lead of Florida governor Rick Scott (R.) and Alaska governor Sean Parnell (R.) and flatly refusing to implement any aspect of Obamacare. Daniels could even organize another letter in which his fellow governors all make the same announcement.
A move like that could separate him from the pack.