Health Care Bill At 60

Kevin Drum is reporting, as I predicted, that the Democrats have bought off the remaining votes they needed (with our tax money) and that there will be a successful cloture vote this evening on the health care bill.  Bad news, though I have been prepared for it for a while.  I honestly believe that 90% of this country is going to end up worse off to help out the remaining 10%.  The analogy I often use is that this is just like the crappy public housing we built in the 1960's, except everyone, not just the poor, are going to have to move into it.    The only remaining questions that remain are 1) how long after passage of this bill do Democrats admit they grossly fibbed on the price and start jacking up taxes; and 2) how hard a hit (and how fast) will drug and medical innovation take.  Enjoy.  The only silver lining is that many of the folks who passed this mess are not going to have their jobs a year from now.

Update: Overlawyered has more bad news about the bill's provisions.   A lot more of this will come out as the people are actually allowed to read it.


  1. mysterian1729:

    one possible upside: the government will fail because of a currency collapse before real disaster strikes.

  2. Evil Red Scandi:

    I think what will happen in health care will be the same thing that happens when the government starts horribly restricting other things: underground economy, baby. I'm ready for some good, old-fashioned civil disobedience...

  3. Dr, T:

    "1) how long after passage of this bill do Democrats admit they grossly fibbed on the price and start jacking up taxes"

    They won't have to raise taxes on John & Jane Normalcitizen. They'll change the private health insurance coverage rules, which will require the health insurers to charge more. (This will be labeled as private insurer greed rather than government nastiness.) The premium increases will drive more people to the lower cost (due to taxpayer subsidies) "public option" health insurance. Once enough people switch, the government will mandate a complete single-payer scheme. Soon thereafter we'll see a combination of massive taxes on the rich (including wealth taxes on top of income taxes) and premium increases for everyone. But, the government propagandists will convince Joe & Jane Normalcitizen that they didn't have any tax increases.

  4. DKH:

    The people over at Kevin Drum's blog are already working on the next step: "if [the exchange] fails, we add a public option because the market failed." Err yea...

  5. Chris:

    is passage of the revised health bill assured after conference?

  6. whee:

    as far as i can tell, self-insured companies are in the same position as congress-- that is, their employees don't have to deal with most of the garbage in this bill, and the companies don't have to deal with most of the employer provisions either.

    interesting outcome, that.

  7. commieBob:

    I'm Canadian. I haven't followed the American health care debate because it mostly baffles me.

    We do have government health care up here and the vast majority of us want to keep it. We spend less of our GDP on health care than the Americans and our health outcomes are at least as good. Our life span, for instance, is a couple of years better than Americans'.

    Personally, I've heard the stories about the American HMOs. Those are your death panels. Granny dies because some fat cat CEO needs a few more gallons of bunker C for his yacht. OK so maybe I'm just a dumb Canuck from Canuckistan but I choose the government over an HMO any day of the week.

  8. morganovich:

    this trend of aggressively buying senators is getting way out of hand. the new health bill apportions a lot of its new costs to the states. allowing individual senators (like the guy from florida) to legislate an exemption from paying those costs for their state (and freeriding) is dishonest and unethical.

    it's like supporting a law against theft, but only if you are still allowed to steal.


    your outcomes are as good? you have to be joking. cancer survival is much lower. access to specialists takes years. your life expectancy is only better because you count it differently and because americans drive more and are murdered more frequently than canadians.

    take out murder and auto deaths and US lifespan exceeds canada even though you guys don;t consider a baby live until far after we do. in the US, it's any child that takes a breath, no matter how premature - the rest of the world does not count preemie deaths at all , which makes as big difference, and also do'nt count even full term babies for 24hrs to 30 days after birth.

    if your care has better outcomes, why do so many canadians come to the US when they get sick or need surgery?

    it's certainly nor because it'c cheaper.

  9. Fay:

    commieBob: Don't forget all those other socialist hellholes, like Australia, Japan, Israel, etc., that all have government-guaranteed health care. Oh also, they don't innovate anything, ever. Except for how the MRI was invented in Japan. Where they also have shorter wait times to see specialists than the US. Or how mammography came from Germany (again, shorter wait times). Or balloon angioplasty came from Europe. Yes, they've certainly killed medical innovation over there.

    Maybe they are all just too stupid to realize how un-free they are. Or maybe they're too busy not worrying about going bankrupt if they get sick.

  10. DKH:


    Except I can choose not to join an HMO. HMOs are one offering of the American healthcare system. In general, they are cheaper but more restrictive with respect to services. There are other options that offer other price/value relationships (e.g. PPOs, HDHPs).

    There are a lot of other factors that make it difficult to quantify relationship between spending and health outcomes:
    1. Accident rates in different countries
    2. Different definitions of terms, e.g. live birth or infant mortality
    3. Research and development or commercialization
    4. Negotiating power of sovereign governments vs. private companies

  11. MikeinAppalachia:

    commieBob-appears to be well-named. I'm sitting in one of the small hotels surrounding the Cleveland Clinic which provide for out-patient and visitor lodging. At breakfast this am, about 1/3 of the other guests were Canadians. Just why would that be, Bob?

  12. Raven:


    No public system can exist without rationing of the supply of care because cost cannot be used to limit the demand. This means no public system can exist without a parallel private system which gives people the choice of paying for their own care when they disagree with the public system's funding priorities.

    This is NOT an argument against a public system which meets 80-90% of the medical needs of people. A public system can be a net benefit even if it does not provide all possible care to all people all of the time.

    Canada has choosen to outsource its parallel private system to the US. If the US did not have the capacity or was unwilling to take Canadians then Canada would have built its own parallel private system. So the fact that Canadians seek treatment in the US is not evidence that the US system is better.

  13. commieBob:


    Yep, some people who are desperate or who have lots more money than I do travel abroad for medical treatment. We've had major problems with Americans illegally obtaining our medical care cards. The result is that it is now a major PITA for legitimate Canadians to get or renew a card.

    The reason I post here at all is that I agree with 99% of the stuff you guys say. The reason I call myself commieBob is that I do support, and am willing to pay taxes for, universal medical care. As far as I can tell, having talked to my colleagues in the States, I'm better off in Canada. YMMV

    Merry Christmas,

  14. The Dirty Mac:

    commieBob: I went to a water park in Canada as I have done many times in the US. I couldn't help but to notice that there substantially fewer morbidly obese people at the Canadian water park. That might help result in better outcomes in Canada.

  15. Fred Z:

    I'm Canadian too and commiebob is wrong. Our system sucks.

    I guess that commiebob is young and healthy and doesn't need the system much. Me too, mostly, but I'm watching elderly parents and in-laws suffer with an incompetent, expensive and uncaring system.

    The commiebobs never understand that Americans spend a lot on medical care ... because they have it. Commibob, the yanks got money and we don't, because they are not commies.

    My sense is that Canadians are growing more fed up with commiebob's willingness to steal our money to fund his problems. We experimented with socialism first and we'll leave it first.

    Why are you Yanks such copycats? Why do this thing after watching the pain of it everywhere? Kipling had it right I guess:

    As it will be in the future, it was at the birth of Man
    There are only four things certain since Social Progress began.
    That the Dog returns to his Vomit and the Sow returns to her Mire,
    And the burnt Fool's bandaged finger goes wabbling back to the Fire;

    And that after this is accomplished, and the brave new world begins
    When all men are paid for existing and no man must pay for his sins,
    As surely as Water will wet us, as surely as Fire will burn,
    The Gods of the Copybook Headings with terror and slaughter return!

  16. Anonymous Mike:

    Commie Bob,

    What province is it a "major PITA" in to get or renew a card?

    Could you also point to an article or 2 about the major problems with Americans illegally obtaining health care cards? I don't keep up with the Canadian papers as much as I used to so I missed that story and as someone who lived a number of years in Canada I'm concerned about this.

  17. DKH:

    "As far as I can tell, having talked to my colleagues in the States, I’m better off in Canada."

    Yes, well, of course, if it's something you want and it's offered one place and not another, then you're better off in the place that offers it. What about all those in the US (or Canada) who don't want to be forced to buy health insurance that would be under this plan?

  18. Technomad:

    I notice that when Canadians talk about the US government, they generally tend to distrust it---until the subject of government-run health care comes up. Then they all of a sudden act like the US government's as good as good can be, and would never, no NEVER, do anything rotten...and expect us to believe the same thing.

    Personally, I'd rather just off myself rather than take government-run health care. I know too much about the ways the VA system's screwed up, as well as the care available in our prison system---both 100% government-run, you notice.

  19. commieBob:

    Anonymous Mike,

    The thing with Americans illegally getting health cards was back in the 1990s, then they tightened up the security.

    The PITA is from personal experience. I can renew my driver's license and car registration by mail. Not so the health card. In Ontario, you have to go in personally. In my experience, almost no amount of identification seems to be enough. OK they do give you a list of what you need to bring but somehow the clerk manages to make it seem like you did something wrong. You not only have to prove that you are who you say you are but you have to prove that you have been living in the province for the last six months. I had six months of pay stubs. The rules say that works if you are a recent immigrant. Since I had lived here for thirty years the clerk thought that six months of pay stubs weren't adequate!

    There always seems to be a police car parked outside the local issuing office. My theory is that he's there to handle freaked out disgruntled customers. We sure had one of those the day I went in (no it wasn't me).

  20. Rob:

    So the last time America tried to nationalize health care, border Americans mooched care from Canadians. The future doesn't bode well for you.

  21. Anonymous Mike:

    Thanks CommieBob....

    I enjoyed the timing of the article... right about when the push for HillaryCare was starting up in the US, certainly no coincidence in the timing by the NYT.

  22. epobirs:


    You are grossly misinformed on those outcomes. It has been well documented that America leads the world in things like cancer survival rates. It has also been well documented that the ways stats are kept can make things look worse for Americans than they actually are. For example, differences in how infant mortality is tracked can make lifespans appear shorter. This is similar to the fallacy that almost nobody a thousand years ago lived much past the age of forty, when in fact the majority who survived to adulthood made it well past that or were more likely to die of homicide than of a medical condition not induced by another human. High infant and child mortality rates can distort the historical view.

    Today, many countries treat a lot of what the US terms as infant deaths as having never happened. Every such death swept under the rug makes each person surviving to an advanced age count for more than they should. When you adjust for that and self-inflicted medical problems, Americans enjoy the best health care in the world by a considerable margin. Destroying the level of quality by having the government increase its level of interference massively is not going to make things better. Nor is that the political intent. It is purely about seizing power.

  23. Chris K.:

    I'm going to make this simple for you to understand, I would rather see all of you collectivists in Canada and the US frozen to DEATH than give or be forced to give you one cent for YOUR healthcare. You see, I live for me and mine. If you want something from me you have to offer me value in return. Stealing my productivity for your "right" to healthcare is just that, theft.

    Now I know the collectivist rant, I'm an evil self obsessed white guy. And you're right, I am.
    The difference is I'm also armed to the teeth. You move douchebag.

  24. Chris K.:

    A friend of a friend wrote this see if you can understand it Commiebob,

    By Any Means Necessary
    Though I find much in the life, philosophy and words of Malcolm X with which I disagree, there is one phrase of which I am perhaps more fond than he: By Any Means Necessary.

    This great Republic is filled with men who - like me - will not submit to tyranny.

    Though I have maintained medical insurance throughout my adult life - at great expense, especially during periods of unemployment - This I vow: if this disgusting travesty is signed into law I will immediately and permanently drop my coverage.

    Further, I will take any and all possible steps to avoid paying any taxes or penalties associated with this ridiculous abuse of power.

    Let me be plain: I hereby announce my intention to do everything within my power to willfully violate the so-called "coverage mandate" - for no other reason than the fact that I am a free man and will not be subjugated by this or any other regime.

    Let this statement serve as my declaration and confession of guilt - if I am without coverage it is due to a deliberate and willful act on my part.

    Further, let this serve as a warning that I will resist any and all attempts to use physical force to compel my compliance (or punish my non-compliance) by any and all means which are or may come to my disposal.

    By Any Means Necessary.

    Let me be clear: I have always maintained health insurance and will continue to do so - but an out-of-control government's demand that I do is probably the only thing which could PREVENT me from doing so.

    I am a citizen, not a subject.

    I will not submit.

    I will resist.

    By Any Means Necessary.