The Countdown

The Senate's countdown to Christmas Eve is on, with Senate Majority Leader Harry Reid facing an almost impossible schedule that has to go precisely as timed to get his health care vote by 7 p.m. on Christmas Eve. And that means working nights and all weekend long.

But the bigger problem is that Sen. Reid still doesn't have the 60th vote to carry him over the finish line. Sen. Ben Nelson (D-NE) is a brave man who is standing up to incredibly intense pressure, telling Sen. Reid that the compromise language he's been offered guarding against abortion coverage in the bill "is not sufficient." And even if that is fixed, he says that he still has other problems with the bill.

Sen. Nelson told a Nebraska radio station yesterday he doesn't believe the Christmas deadline is realistic. Listen to the man! He wants more time. When asked whether these issues could be resolved by the Christmas deadline, he quipped, "Are you talking about this Christmas or next Christmas?"

Politics not policy: I don't have a crystal ball to predict what is going to happen. This debate has moved out of the realm of policy into politics, as I wrote on Tuesday. But from the political sidelines, the meltdown on the left over losing the public plan, at Sen. Joe Lieberman's insistence, seems very real.

The White House is going nuts about former Democratic National Committee Chairman Howard Dean imploring liberals to "Kill the Bill," something conservative grassroots groups have been saying for months. Sometimes politics becomes circular.

Liberals are apoplectic that the bill would require everyone to purchase private health insurance without a public plan. And just wait until the younger supporters find out how much they will be forced to pay for this government-defined insurance policy.

But the fact that the labor unions did not go into outright revolt says that the political arm-twisting is getting incredibly intense. Union leaders are being promised there will still be time for changes down the road. Changes to make the bill more liberal and put the public plan back in? Not on your life.

I'm also listening for clues from Sen. Jim Webb from my home state of Virginia. He's a former Marine (who served in combat in Vietnam with my brother-in-law), and this man is tough. He's popular now but would face a very tough re-election fight in 2012 if he were to support a bill that is so overwhelmingly unpopular in his state.


No score: Sen. Reid clearly wanted to release a Congressional Budget Office score of his big "manager's amendment" on Monday before the confab with President Obama at the White House on Tuesday. It didn't happen.

Sen. Reid is still trying to figure out how to put the pieces of this incredibly complicated puzzle together in a way that satisfies key senators and purports to stay within the president's magic $900 billion budget (which, as we and others have written time and again, is pure fiction).

Watch this space. We will keep you posted on progress.


Do No Harm Petitions delivered: We produced a petition in April based upon a Consensus Group statement which outlined key elements of the health reform agenda that we felt would be most destructive.

With virtually no advertising budget, the petition went viral, and we collected more than 10,000 signatures at our dedicated website, And while the phones in the Senate were ringing off the hooks yesterday from constituents calling about the bill, our communications gurus, director Jeff Lungren and deputy Andrew Palczewski, hand-delivered petitions to Senate offices with the signatories from their states.

This was a huge effort, and we thank profusely everyone who signed the petition. Your voice was heard when it counts the most! And thanks to Jena Persico, Sterling Meyers, and the rest of our team here for their work in pulling all of this together. You can read Andrew and Jeff's report here about the delivery of the petition.


Stossel! And while they were delivering the petitions, I was in New York as part of an hour-long show hosted by John Stossel on FOX Business. It aired last night at 8 p.m. Eastern and re-airs opposite John’s old “20/20” timeslot tonight at 10 p.m. Eastern and twice more this weekend. See the events listing for times.

It's a fun show, showcasing John Mackey, CEO of Whole Foods, who touted his company's employee-centered health plan this summer in a Wall Street Journal op-ed, unleashing a firestorm of criticism from the left.

But he's all in now. A former liberal who has been enlightened by the reality of what actually works in the world, Mackey has developed a popular health plan that provides his employees excellent health insurance, and he deposits about $1,800 a year into each of their personal spending accounts that they can use to pay the deductible and buy the health services of their choice. The money rolls over year to year and accumulates. Employees love it!

And, perhaps not coincidentally, revenues are up at Whole Foods as free-market advocates have staged a "buy-cott" to shop at the store.

Do tune in. You can also watch a clip of my appearance below; I explain why profit and competition are good things, even in health care.



In addition to the video of her appearance on John Stossel’s show, this week's Clip of the Week highlights Grace-Marie Turner’s appearance on the FOX Business Network's "The Stuart Varney Show" on Wednesday. Grace-Marie sat down with Stuart in FOX Business's New York studios to discuss the trajectory of the Senate reform efforts, including whether ReidCare will pass this year, and how the Senate is attempting to shift cost estimates to make the bill seem less expensive than it really is.

Clip of the Week Bonus — Since Health Policy Matters won't be published for the next two weeks because of Christmas and New Years, as a special "Clip of the Week" holiday bonus, here is the link for the Galen Institute's brand new podcast, hosted on iTunes. Subscribe to the podcast on iTunes and watch for more original audio content from the Galen Institute in 2010!


It's All Politics Now

Grace-Marie Turner, Galen Institute
National Review Online: Critical Condition, 12/15/09

The health overhaul debate is no longer about policy; it's all politics now, Turner writes. And the tone at both ends of Pennsylvania Avenue is becoming increasingly desperate. With vulnerable senators being reminded back home how unpopular this bill really is, it's still not a sure thing. Th
ere is a lot more wrong with this bill than whether it contains a public option or a Medicare expansion. Centralized control is built into the fabric of the legislation. The American people understand that, which is why its unpopularity grows by the day. Read More »

Undone by Overreach

Grace-Marie Turner, Galen Institute
National Review Online: Critical Condition, 12/14/09

Majority Leader Harry Reid is having a difficult time piecing together a health reform bill that will get 60 votes in the Senate because of his overreach in trying to create a health care "system" that would be run out of Washington, Turner writes. We don't have a health care system now, but rather countless independent programs and entities. In trying to assemble them into a system, all of the parts must interlock. Pull one out and several others collapse — threatening to tear apart the entire overhaul. They need to regroup and pass health reform in 2010 with a smaller bill that includes bipartisan ideas. Read More »

Medicare Early Buy-In: Unlucky 13 Oppose Reform

Grace-Marie Turner, Galen Institute
National Journal Expert Blogs: Health Care, 12/14/09

Allowing everyone from an age group to buy in to Medicare is a blunt approach that would cause a cascade of unnecessary distortions in the existing market, Turner writes. It is a clumsy response to a problem that needs a much more sophisticated solution, as 13 senators said in a letter to Sen. Harry Reid. Subsidies should be targeted to those who need help in purchasing coverage. Those with lower incomes, limited options to obtain group coverage, and difficulty purchasing insurance because of health problems, whatever their age, should be the focus of reform. Read More »


We Already Know Why Healthcare Overhaul Will Fail

John E. Calfee, American Enterprise Institute
The American, 12/16/09

The Democrats' health care reform bill is built on a chain of regulations, mandates, penalties, minimum federal standards, and subsidies, Calfee writes. Congress' futile attempt to use predominantly untested measures to curtail the very spending juggernaut it will create shows why health care overhaul is shaping up as the highest-risk legislation in modern times. The error lies in thinking that if something works in one context after years of painstaking trial and error, it can easily be disseminated through central leadership, demonstration projects, and clever financial incentives. Experience clearly shows otherwise. Removing barriers like the ban on cross-border insurance sales would be far more effective in fostering spontaneous new improvements in health care delivery. It is high time to back up and start over. Read More »

Health Bills' Tax Increases Would Harm Health Care and the Economy

Michael Schuyler
Institute for Research on the Economics of Taxation, 12/11/09

Fundamentally, the House and Senate bills take a big-government approach, featuring more federal government control over health care financing and delivery, greater government spending, and higher taxes. These proposed taxes would weaken the U.S. economy, slow its growth over time, and diminish people's future opportunities because they would discourage work, saving, and investment, Schuyler writes. The revenue raisers would add more paperwork and further complications to a tax system that already burdens Americans with huge administrative costs and mind-numbing complexity. It is surely disingenuous to include taxes that would raise health care costs in legislation being advertised as lowering health care costs. It is similarly troubling that while supporters of the House and Senate bills promise their bills would improve the quality of health care, some of the bills' taxes, such as those on medical devices and pharmaceuticals, would hurt health care quality. Read More »

Entitlement Reform Should Precede Health Care Expansion

James C. Capretta, Ethics and Public Policy Center
The Heritage Foundation, 12/15/09

Any credible plan looking at long-run sustainability must address the rapidly rising costs of the nation's largest health entitlement programs — Medicare and Medicaid, Capretta writes. But that job could be made impossible if a health care bill locks-in legislative changes aimed almost entirely at financing insurance expansion. What is needed now, therefore, is a coherent and comprehensive plan that puts the nation's fiscal house in order and specifically accommodates rational reorganization of health care both to control costs and expand coverage. That means that adoption of a comprehensive fiscal plan should precede adoption of health care legislation and, at a minimum, must precede implementation of any health care expansion. Read More »

In a separate paper, Capretta writes that the Senate bill would dramatically increase federal budget deficits in coming years, not reduce them, because key assumptions in CBO's cost estimate — especially the viability of the so-called "firewall," which aims to prevent most workers from accessing new subsidies for insurance — will never hold up over time. Read More »


Medicare Advantage or Medicare Monopoly? Protecting Seniors' Choices and Taxpayers' Wallets in the Federal Government's Largest Entitlement Program

John R. Graham
Pacific Research Institute, 12/17/09

The report examines the costs and benefits of Medicare Advantage, which allows consumers to get their benefits through private insurance plans. In a very narrow sense, Medicare Advantage plans cost more, per beneficiary, than the traditional government-run Medicare monopoly, Graham writes. Medicare Advantage increases the total costs of Medicare by about $12 billion a year, or about 2 percent. However, because traditional Medicare (a government monopoly) does not pay providers enough to cover their costs, they shift costs to the privately insured. This imposes a "hidden tax" on privately insured Americans that accounts for $49 billion a year, four times greater than the narrowly defined extra costs of Medicare Advantage. Most Medicare Advantage plans relieve this hidden tax because they are more likely to pay providers enough to cover their costs. Rather than imposing higher costs, Medicare Advantage actually exposes the hidden tax and transfers the burden from the privately insured to society in general.
Read More »

Why Medicare Part D Is the Answer to Health Reform

Benjamin E. Sasse, University of Texas
U.S. News & World Report, 12/15/09

Medicare Part D is (or should be) a policymaker's dream: a government program that efficiently delivers high-quality services, and does so under budget, Sasse writes. Unfortunately, throughout this year's health care reform debate, Part D's success has been at best ignored and at worst maligned. Some in Congress have missed the fundamental lesson of Part D: When you identify a specific problem, build a competitive market that motivates the private sector to solve it. Provide incentives for consumers to make rational cost decisions, and everyone wins. We don't need more central planning. We don't need more government price-setting and mandated coverage levels. Read More »


Grace-Marie Turner on the Drew Mariani Show
Relevant Radio Network Broadcast
Friday, December 18, 2009
5:15pm EST

Grace-Marie Turner appearing on the Stossel show
FOX Business Television Broadcast
Friday, December 18, 10pm EST
Saturday, December 19, 7pm EST
Sunday, December 20, 11pm EST