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Wednesday, March 31, 2010

Health Care Bill Signed Plus Odds & Ends

Democrat health care reform legislation, aka Obamacare, has been like a cat hanging on to its ninth life by one whisker, yet last week, on March 23, 2010, President Obama signed the landmark bill into law. As Joe Biden so eloquently put it, "this is a big * deal." That date, indeed, may go down in history along with August 14, 1935 (Social Security Act) and July 30, 1965 (Medicare Bill) as a pivotal moment in the evolution of America's political/social/economic culture.

However, evolution and "change" do not always move us in a positive direction as a nation. The historic nature of this milestone is unquestioned, but whether it will help cure the many ills of our health care system and mitigate our dire financial straits or simply push down the accelerator on an already unsustainable and perilous path will be the subject of rampant debate for the foreseeable future. A key distinction between this historic legislation and the two before is that those enjoyed significant bipartisan support, this bill had none.

First to the policy objections. I have written extensively over the past year addressing many of the pivotal issues and hidden burdens embodied in the 2,000 plus page legislation, so let's take a big picture view. In fairness, there are good and bad features of the legislation. Now that the bill is law, I can only hope it works to slow or reverse our current trajectory of higher cost and higher deficits, but I'm afraid such a hope finds little grounding in reality and rational expectation. For example, it is "politically inconceivable" that future Congresses will show more courage than this one mustered and actually implement the spending cuts and tax increases critical to the cost projections of the bill. I do fear that this bill, focused on more government to fix the problem and more spending to reduce the deficits, will only exacerbate the problem in the midst of already record deficits and out of control spending. When the "doc fix" is included (adding $371 billion) and deceptive double counting eliminated, the deficit actually increases by an additional $260 billion over ten years.

Even with half a trillion dollars in new taxes and another half trillion in Medicare cuts, this legislation does not bend the cost curve down, a cost curve that, if not reversed, will break a lot more than our health care system. Instead it drives up cost and over time could actually reduce access to health care as rationing will likely become our last best hope of staying off the financial precipice. The "disagreeable absence of a free lunch" strikes again. Despite the many budget gimmicks and dodges cleverly built into the package, which paint a deceptively rosy picture of overall cost, it will push our health care costs and deficits only higher. We cannot fail to drastically and boldly reduce health care costs that are crippling an already weak economy. This law fails. It it a "fiscal time bomb" waiting to explode as the revenue will never come and costs soar ever higher.

In light of this already grim outlook, we all, Democrats and Republicans, agree that our health care system is in desperate need of reform, but Republicans tend to believe, rightly in my view, that this brand of reform will only make our current problems exponentially worse and pile new ones on top. The Republican solution is, broadly, to increase consumer choice and competition as a means of immediately reducing costs while correcting a system of perverse incentives and opaque costs by emphasizing tax incentives and state innovations. Viewed through the prism of the philosophical dichotomy between the parties, Democrats favor a solution predicated on increased government involvement and control while Republicans favor greater individual liberties and a free-market approach to the problem.

Now, because nothing that happens in Washington is without wide-ranging and often complex political implications, to the political fallout of Democrat health care reform. Yes, Democrats achieved a goal of paramount importance to the party in pushing through Obama's top legislative priority, but could it do more harm than good for majority and haunt them in November and beyond?

From raucous town halls during the summer months to demonstrations on the Capitol steps in the final hours of the sausage making, Americans of all political stripes have passionately and repeatedly expressed their displeasure with the Democrats' proposals. The will of the American people, expressed in polls from sea to shining sea, notwithstanding, Democrats tirelessly pushed their liberal agenda for health care through the halls of Congress. This seemingly blind and ideological pursuit could cost them dearly at the ballot box and prove to be a "colossal miscalculation." The year-long, tumultuous debate has inflicted significant damage on Obama and the Democratic Party.

As I recently outlined, 2010 is shaping up as the year of the Republican elephant. It's hard to see how the passage of Obamacare, which voters did not want, ameliorates what is looking like an electoral disaster for Democrats in November. Many analysts believe they have now dug the hole deeper, pointing to the voter backlash in 1994 following the failure of Hillarycare. The twenty Democrats hailing from John McCain won districts who voted in favor of the bill have earned bright red targets on their backs, with Sarah Palin and other national Republicans pouncing.

While we're all tired of legislative process stories, it's worth acknowledging voters' distaste for the kind of arm twisting, backroom dealing, logrolling, rules changing and raw politicking they witnessed from Democrats in a no-holds-barred effort to see their will done on a straight party-line vote, not to mention the broken promises. The use of reconciliation to push the legislation through the Senate on a simple majority vote after Democrats lost their 60th seat to Scott Brown in Massachusetts was only the tip of the iceberg.

Following passage, the public is very divided but hardly undecided about Obamacare, less than 10% without an opinion. In the immediate aftermath, Republicans are predictably unhappy, Democrats are happy and Independents are divided but favor Republicans on the ballot. The economy will almost certainly remain voters preeminent concern in November, but both sides will attempt to use health care to fit their own narrative. An improved perception of health care among the electorate is only one leg of the stool Democrats must build between now and November to avoid an unmitigated walloping that could cost them control of one or both houses of Congress. For starters, they need Obama's popularity and the sluggish economy to make marked improvements.

The President has certainly gotten a lot of positive press following the signing, but how long will the afterglow last and will any real bounce show up in the polls? Some polls indicate a slight post-signing bounce while others indicate no real change since the battle lines were drawn last summer. If anything, the Democratic base has ticked up a notch in enthusiasm, something they have been sorely lacking since electing Obama in 2008. Whether any positive bounce is lasting on transient will depend on "salesmanship and implementation" by Obama, his fellow Democrats and the administration. We'll have to wait until November to see how this saga ultimately plays in the minds of the only ones who matter, voters.

PG Poll: Do you support the passage of Democrat health care reform? Vote on the left side of the page.

Texting and driving has been in the news a lot over the last several months, and as someone who has been guilty from time to time, I find it interesting. Unless you're the rare "supertasker," the practice does impair your driving. From distracted driving forums to Senate legislation to an executive order from Obama, lawmakers are cracking down. The practice has even been dubbed a "menace to society." Society agrees. Ninety-one percent favor a ban. In my home state of North Carolina, DWT (I want a patent on that acronym) is now illegal and punishable by a $100 fine. Over a dozen states have passed such laws. Lest we paint texting with too broad a negative brush, remember that soft-hearted texters sent over $20 million to Haiti in one week. Political candidates are now wondering if they can leverage the technology to their benefit. Regardless of why you're punching away at the phone keyboard, make sure you steer clear, ha, of the banned words of 2010. Oh, and watch out for cell phone induced brain cancer.

While we're on technology, see the next generation of must have electronics. To make these gadgets run faster, the FCC is launching a "visionary" plan to expand broadband access across the country, something Google and everyday users have anxiously awaited. Speaking of Google, the behemoth of all things internet played a major role in Scott Brown's stunning victory in Massachusetts. Meanwhile, the White House has been all aTwitter of late, even Obama tweeted, and the GOP has launched a hot new BlackBerry app for congressmen. Check out these two fascinating videos on the power of social media. Finally, after years of rumor, it looks like the iPhone really is branching out from AT&T.

Here's an assortment of particularly interesting pieces:
Turns our jerks are bad decision makers. Tall people are happier than short people. The 50 best YouTube videos of all time or the best and worst in four minutes. Nobody trusts congressmen or car salesmen but give nurses and doctors hight marks, would hope you trust your doctor. Scientific evidence points to life after death as 59% of Americans are "absolutely certain" there is a God. Basic arithmetic illustrates why the enemy of my enemy is my friend. The Toyota crisis has demonstrated the "price of modernity." Your race may determine your nighttime and sleep habits. The President has a Facebook feed, sorta. In honor of a midterm election year, brush up on your political lexicon.

I'll end with what we all know is the most important thing gripping our nation this month, March Madness! Even as his health care reform was in its final hours and he was sharpening his 22 pens for the signing, the President was "examining the rubble of his bracket." He filled out a tourney bracket for the second year, but isn't seeing the success he enjoyed last year. With Duke in the Final Four, I (on the right in this ESPN pic) and my fellow Cameron Crazies are boiling over with excitement and anticipation, excitement that brain researchers at Duke and UNC have recently studied. Lest you hate, these Dukies "should be cheered" and are "worth rooting for." Heck, even UNC coach Roy Williams, sweating through an NIT Final Four game as I type, is picking Duke! Senate candidates in Kentucky are actually attacking each other on their Duke ties, love it! Turns out sports viewers generally and college basketball fans in particular are largely Republican, and most of the Final Four teams have GOP fan bases. If you don't quite get what the big * deal is (thanks Biden), see this guide on bluffing your way through the Dance... or follow the hilarious name bracket instead. If you do get it, Let's Go Duke!!

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