It's Not Over

It has been a very difficult week of shock, disbelief, depression, and outrage — all the phases of grief except acceptance — among those of us who so strongly oppose the arrogant approach and method of passing ObamaCare, especially in the face of such overwhelming public opposition.

Let's start with the hubris of thinking that it is even remotely possible to write 2,900 pages of legislation and get it right in overhauling one-sixth of our economy. In just the first few days, we have begun to see the mistakes:


  • Oops, we didn't actually mean it when we said children with health problems could immediately get insurance. Turns out somebody made a mistake in the drafting, but the White House is going to try to get HHS Secretary Sebelius to fix that…
  • Caterpillar and John Deere, two important U.S. manufacturers, are among major companies that announced this week they may be forced to shave as much as $14 billion from corporate profits this year because the law changes provisions impacting retiree drug coverage. The drug coverage of several million retirees of these and other companies also is threatened.


Gov. Mitch Daniels of Indiana is making plans to terminate his incredibly popular Healthy Indiana Program that provides health insurance to 50,000 low-income Hoosiers. "I hope those folks will do all right when they are pitched into Medicaid," he wrote in today's Wall Street Journal.

And Massachusetts State Treasurer Timothy Cahill said in the Journal of his state's health overhaul upon which ObamaCare was modeled: "It has been a fiscal train wreck…The only reason MassCare has survived is that we have been repeatedly bailed out by the federal government. But that raises the question: Who will bail America out?"

I could go on, but it's too painful…


Take two: The second health overhaul bill that Congress passed yesterday increases taxes even more, in a most reckless and economically destructive way, by subjecting investment income to Medicare taxes! The tax burden of ObamaCare alone will squeeze the life out of a recovering economy and will burden small businesses that historically have been the engine of jobs creation.

Is it any wonder that the latest CBS poll says that 62% of the American people want Republicans to continue to challenge the bill? Rep. Paul Ryan, in a commentary article in today's New York Times, wrote that "we will need to repeal the entire faulty architecture of the government behemoth and replace it with real reform," starting with tax reform and empowering the states to strengthen the safety net for those with problems getting coverage.

It seemed yesterday that the country was a tinder box, ready to combust with public outrage, as this Washington Post article about an Iowa citizen protestor reported. Other people have gone over the edge with gunshots into campaign offices, coffins on lawns, and threats to members of Congress.

The president is president of all the people, and he has a responsibility to tone down the rhetoric, not fuel it. But his speech in Iowa yesterday was combative, and its us-against-them tone was most vividly illustrated when he taunted those who want to repeal ObamaCare to "Go for it." Is he really trying to change the tone in Washington with comments like this about his own citizens?

Passage of ObamaCare this week is a huge shock to our economy and health system. Members of Congress are heading home this weekend, and they will see and hear from constituents who can now tell them in person what they think of this health overhaul law.


Looking forward: We hosted another fabulous conference in our series about the value of innovation in health care yesterday in Washington. Our terrific team at the Galen Institute put together a dynamite list of speakers who talked about the remarkable new technologies that bring us the medical miracles we have come to expect from our health sector.

But these will certainly be threatened by the suffocating government bureaucracy of ObamaCare, patent rights being seized by foreign governments, and the reluctance of investors to support the huge and expensive risks of developing new medicines and technologies if government bureaucrats can arbitrarily block their entry to market.

You can access archived presentations of this incredible program featuring talks by Dr. David Brailer on the culture of innovation in health care, Rep. Dan Lungren on the enormous overreach of subjecting one-sixth of our economy to government power, and Dr. Julian Goldman on the importance of thinking past electronic medical records to the interoperability of health information and technology.


Pauly: If you are in Washington this coming week, you won't want to miss the program on Thursday April 1, "Health Reform without Side Effects: Making Markets Work for Individual Health Insurance," at the American Enterprise Institute. Wharton Professor Mark Pauly will discuss his latest monograph Health Reform without Side Effects: Making Markets Work for Individual Health Insurance that provides both a warning about the risks of getting health insurance reform wrong and guidelines on how to do it right. Please join us!



Galen Institute's "Intelligent Health" Conference

This week's Clip of the Week highlights the first panel discussion at the conference on "Intelligent Health: Exploring the Value of Innovation in Health Care" hosted by the Galen Institute on March 25. Look for more audio and video from the conference in the coming days.

Right click here to save the file:


The Morning After: Waking Up with a Coyote Ugly Healthcare Bill

Thomas P. Miller, American Enterprise Institute
The American, 03/23/10

Rather than recycle the well-worn criticisms of fundamentally flawed legislation that threatens to undermine future health care choices and competition while further destabilizing both our economy and politics, let's look ahead to what could and should be done to reverse the damage and make real progress, Miller writes. The strategy going forward would include challenging and slowing down early stages of the final law's implementation at various chokepoints and mobilizing the tens of millions of irate voters who were dissed and dismissed by leaders of the current (but not future) majority on Capitol Hill. Candidates need to construct a more accessible, credible, and understandable short package of "this is what we have to change and do differently" instead of just yelling "repeal" in crowded town hall meetings. Yes, it's hard to
reverse deceptive and destructive promises cynically embedded into the modern welfare state, and the going just got tougher. But we have dug out of deeper holes before, and the hunger across the country for change that we really can believe is indeed shovel-ready. Read More »

Massachusetts Is Our Future

Timothy P. Cahill
The Wall Street Journal, 03/25/10

The Massachusetts health plan, often hailed as a "template" for national health reform legislation, has been a fiscal train wreck, writes the state's treasurer. The universal coverage adopted by Massachusetts in 2006 was projected to cost taxpayers $88 million a year. However, since the program was adopted, health care costs have in total exceeded $4 billion. Just last week, Gov. Deval Patrick's office announced a $294 million shortfall related to health care costs. If not for federal Medicaid reimbursements and commitments from Washington to prop up this plan, Massachusetts would be broke. But that raises the question: Who will bail America out if we implement a similar program? Read More »

Cahill's piece is part of a larger symposium on ObamaCare in today's Wall Street Journal.

We Good Europeans

Gov. Mitch Daniels
The Wall Street Journal, 03/25/10

Now that ObamaCare has become law, there's a whole new to-do list for Daniels' state of Indiana. First, plan for termination of the state's enormously popular Healthy Indiana Plan, which is currently providing health insurance to 50,000 low-income Hoosiers. Next, start preparing voters for a state tax increase and check to see if Indiana should drop its health insurance plans and dump its government workers into the exchanges. The state should also ramp up its job retraining programs to handle those who will be fired by the medical device companies, student loan providers, and small businesses as they wrestle with new taxes and penalties. It's discouraging that all of this could have been avoided, but for the moment, our federal overlords have ruled, Daniels writes. We better start adjusting to our new status as good Europeans.
Read More »

Gov. Daniels' piece is part of a larger symposium on ObamaCare in today's Wall Street Journal.

Costs of This Debacle Will Be High

Rep. Paul Ryan
Milwaukee Journal Sentinel, 03/23/10

The yearlong partisan crusade about health reform — right through its ugly conclusion — revealed that this debate was never about policy but rather a paternalistic ideology at odds with our historic commitment to individual liberty, limited government, and entrepreneurial dynamism, Rep. Paul Ryan writes. The proponents of this legislation reject an opportunity society and instead assume you are stuck in your station in life and the role of government is to help you cope with it. Rather than promote equal opportunities for individuals to make the most of their lives, the cradle-to-grave welfare state seeks to equalize the results of people's lives. Read More »

Iowa Man Joins Protest Against Obama and Health-Care Reform

Eli Saslow
The Washington Post, 03/26/10

The Washington Post tells the story of Randy Millam, who drove 50 miles across the cornfields of eastern Iowa on Thursday to join protesters for President Obama's visit to Iowa City. Millam's resolve was reinforced by the sense that he was taking part in a movement — a rising tide of anger, fear and vitriol in the wake of the health care overhaul signed into law by Obama this week. Even though he has health insurance through his wife's job, the politics of the past few weeks confirmed his fears about the direction of his country. He had spent the past week calling congressional offices and the White House to tell them about his feelings on health care reform, waiting through hold times only to reach answering machines and busy signals. "Fellow patriots," he bellowed from his megaphone, "We are standing outside the arena right now because the president controls the crowd, controls the message, controls the people of this country. That is not freedom! That is not democracy!" While the president flew back to Washington, Millam drove home on the rural highways of Iowa. He wondered: What would it take to be heard, and what would he try next? Read More »

The Wrong Prescription: Democrats' Health Overhaul Dangerously Expands IRS Authority

Committee on Ways and Means, Republican Staff, 03/18/10

This report examines the Individual Mandate Tax (IMT) proposed in the Democrats' health care legislation, which would make the IRS the chief enforcer for a new government-run health insurance system. Key findings:

  • IRS agents will verify if you have "acceptable" health care coverage
  • IRS has the authority to fine you up to $2,250 or 2% of your income (whichever is greater) for failure to prove that you have purchased "minimum essential coverage"
  • IRS can confiscate your tax refund
  • IRS may need to hire as many as 16,500 additional auditors, agents and other employees to investigate and collect billions in new taxes from Americans
  • Nearly half of all these new individual mandate taxes will be paid by Americans earning less than 300% of poverty

Read More »

ObamaCare and American Power

Max Boot, Council on Foreign Relations
The Wall Street Journal, 03/25/10

If we are looking at major threats to our global standing, we should not look at China, Iran, or Russia. We have met the enemy and he is us — specifically, our insatiable demand for entitlement spending, which ObamaCare will only exacerbate, Boot writes. The U.S. currently spends roughly as much on defense ($661 billion in fiscal year 2009) as the rest of the world combined. But that's a pittance compared to what we spend on Social Security, Medicare and Medicaid. Combined, they cost $1.38 trillion or almost 35% of the budget, compared with 17% for defense. And entitlements will only grow dramatically. What happens if the U.S. switches spending from defense to social welfare? Who will protect what used to be known as the "Free World"? Who will police the sea lanes, stop the proliferation of weapons of mass destruction, combat terrorism, respond to genocide and other unconscionable human rights violations, and deter rogue states from aggression? Those are all responsibilities currently performed by America. But it will be increasingly hard to be globocop and nanny state at the same time. Read More »


2010 Disparities Forum with Dr. Atul Gawande
Massachusetts General Hospital Event
Monday, March 29, 2010
8:00am – 9:00am
Boston, MA

The Future of Innovation in America
PhRMA Event
Wednesday, March 31, 2010
2:30pm – 4:30pm
Washington, DC
For more information, please contact Michelle Nyman at

Health Reform without Side Effects: Making Mar
kets Work for Individual Health Insurance

American Enterprise Institute Book Forum
Thursday, April 1, 2010
9:30am – 11:30am
Washington, DC

The Learning Healthcare System in 2010 and Beyond
Institute of Medicine of the National Academies Event
April 1-2, 2010
Washington, DC

Health Policy Lunchtime Seminar: Understanding Systems That Affect Families
George Washington University Event
Wednesday, April 7, 2010
12:00pm – 1:00pm
Washington, DC