Palin: I told you so!

posted at 8:48 am on December 23, 2009 by Ed Morrissey

It didn’t take long for Jim DeMint’s outrage over highly unusual language protecting a care-rationing board to generate a response from Sarah Palin.  This came just days after Politifact called her statement about “death panels” the “lie of the year,” but the attempt to rule any Congressional motion that changes the rulings of the Independent Medical Advisory Board out of order in perpetuity has highlighted once again this rationing board and its potential impact in a government-run system.  And that, Palin writes at her Facebook page, was her point all along:

No one is certain of what’s in the bill, but Senator Jim DeMint spotted one shocking revelation regarding the section in the bill describing the Independent Medicare Advisory Board (now called the Independent Payment Advisory Board), which is a panel of bureaucrats charged with cutting health care costs on the backs of patients – also known as rationing. Apparently Reid and friends have changed the rules of the Senate so that the section of the bill dealing with this board can’t be repealed or amended without a 2/3 supermajority vote. Senator DeMint said:

“This is a rule change. It’s a pretty big deal. We will be passing a new law and at the same time creating a senate rule that makes it out of order to amend or even repeal the law. I’m not even sure that it’s constitutional, but if it is, it most certainly is a senate rule. I don’t see why the majority party wouldn’t put this in every bill. If you like your law, you most certainly would want it to have force for future senates. I mean, we want to bind future congresses. This goes to the fundamental purpose of senate rules: to prevent a tyrannical majority from trampling the rights of the minority or of future congresses.”

In other words, Democrats are protecting this rationing “death panel” from future change with a procedural hurdle. You have to ask why they’re so concerned about protecting this particular provision. Could it be because bureaucratic rationing is one important way Democrats want to “bend the cost curve” and keep health care spending down?

The Congressional Budget Office seems to think that such rationing has something to do with cost. In a letter to Harry Reid last week, CBO Director Douglas Elmendorf noted (with a number of caveats) that the bill’s calculations call for a reduction in Medicare’s spending rate by about 2 percent in the next two decades, but then he writes the kicker:

“It is unclear whether such a reduction in the growth rate could be achieved, and if so, whether it would be accomplished through greater efficiencies in the delivery of health care or would reduce access to care or diminish the quality of care.”

Though Nancy Pelosi and friends have tried to call “death panels” the “lie of the year,” this type of rationing – what the CBO calls “reduc[ed] access to care” and “diminish[ed] quality of care” – is precisely what I meant when I used that metaphor.

All health care gets rationed in one manner or another, as does every commodity (except air, although with cap-and-trade, that would change).  Insurers ration, and so do consumers in a fully free-market system such as the Lasik or cosmetic-surgery industries.  The difference is that those systems involve free choice, especially the latter.  With insurers as third-party payers, there is less free choice, but the solution to that is more competition and better ability to be completely portable — or better yet, the removal of third-party payers for normal health care services.

When government rations commodities, it does so with the force of law.  Considering the power it would have had in a completely government-run system to make the kind of decisions now left to insurers in a competitive market, people are correct to be worried about how exactly IMAB would bend the cost curve.  Their mission in the ObamaCare bill is to “reduce the per capita rate of growth in Medicare spending.”  The way ObamaCare is structured, the only way to hold down costs would be to start denying more treatments, or to cut compensation to the point where long wait times take care of the rationing by discouraging access to a dwindling number of providers. Will that prevent more deaths and make Americans healthier?

With insurers, consumers have the option to find another insurer or self insure.  Those options won’t exist in a government-run system, and are seriously limited in ObamaCare, even in the latest incarnation.  Without those options, the IMAB’s decisions will be inescapable — and thanks to Harry Reid’s language, citizens won’t even have the opportunity to challenge IMAB actions in Congress.  It’s an abomination.

Update: I just talked to a source on Capitol Hill who wants to make sure everyone understands the mechanics of the issue.  The bill sets up a supermajority threshold of 67 votes to bring accountability to IMAB decisions, and the rule on being in or out of order can get waived at 60 votes.  However, as this battle shows, even getting to 60 is almost an impossibility, let alone 67.  Clearly Reid wants to put accountability out of reach with these radical propositions.


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Comments

Insurers do not ration anything, they insure against financial risk. The consumer determines the extent of rationing by decing which level of protection he prefers. Please stop falling into the Dem trap of moral equivalence–”we can ration with our bill because you get that now from you current insurance coverage.” Apples and oranges.

FalseProfit on December 23, 2009 at 8:56 PM

They do. Via formularies, caps, gatekeeping, and a plethora of pooled policy prerogatives.

If we are supposedly going to a new health care system, with a gigantic pool, why are we repeating the problems which are present in the older systems, which their inventors claim are due to their smaller pools?

unclesmrgol on December 23, 2009 at 9:08 PM

Palin is an prop
lovingmyUSA on December 23, 2009 at 8:32 PM
Amen.

voxpopuli on December 23, 2009 at 8:35 PM

Evade much? Must be because the batteries are running down in your “toys”…

Punchlines–throw out “Quitter” meme to start, then “primate” talk, then “homosexual innuendo”, even though she has no proof of such statements made by whomever is in her sights that night, and of course, “basement dwellers” comes up at some time. These are all “catch” phrases.

In between, she thinks she is impressing us with her “wit”…35yrs of stunted growth–that’s what happens when you live with your mother, and work at the local Goodwill store.

lovingmyUSA on December 23, 2009 at 9:08 PM

Hey Simple, I noticed you would not die for any beliefs and that does not surprize me. Many Americans died during the Revolutionary war, The War Between the States and WW2. They died trying to preserve our way of life here in the United States. I am not sure if any of the leftists would die for their cause but thank God our fore fathers had the courage to fight to keep this land free. As for Palin, she must be right because there won’t be enough money or doctors to take care of the elderly and they will be sent home in casket or pain pill.

garydt on December 23, 2009 at 9:11 PM

voxpopuli on December 23, 2009 at 8:01 PM

Vox are you pro-corruption?If it can benefit you? Or if it goes against you? Or both?

theTarCzar on December 23, 2009 at 9:21 PM

Explain how a government paid system makes private insurance policies so exspensive.

That’s easy. I’ll concede that most insurance group plans do not pay the full amount for any visit. But government, pays even less than private insurers do. (I’ve heard some doctors complain that medicare/medicaid will only cover $18 of a 75$ visit. But that’s just one example.)

So, doctors offices are merely small businesses and operate as such. If your government patients are only paying 25% of the full cost, then the only way to try to increase revenue is to increase your prices, cut overhead or get rid of your government patients. Most places keep the patients, cutting overhead is darn near impossible when dealing with billing, so prices go up. So that $75 dollar visit becomes $100. And for the private patient that means their insurance company pays $50 instead of $37.5, while the government patient only pays $25 vs $18. If we were to compare the increase in prices: $7 vs $12.5, the private patient is paying 44% more. Multiply these increases out over millions of people, then you’re talking about serious money which causes premiums to increase.

This is not the only factor in increases, but it does have an effect.

xax on December 23, 2009 at 4:34 PM

Very good explanation. If the government plan paid as well as the other insurance plans, the impact would be minimal. Because it pays so much less, hospitals and clinics raise their prices and collect more from other insurances.

I worked for a hospital a few years back that was dealing with the approach of an HMO where none had ever been before. Once they figured out that the HMO would demand to pay only a very small percentage of their charges, they … immediately raised their charges across the board.

Price gouging? No. Survival.

BTW, this was a non-profit hospital. But they still had to watch their costs or go out of business.

There Goes The Neighborhood on December 23, 2009 at 9:35 PM

Check out today’s NYT article on the Dartmouth study which was endorsed by OMB director Orszag. The study criticized the UCLA Med Center for the extraordinary lengths they go to to save patients’ lives. The findings, however, were based only on a study of those patients who died, not those who recovered.

Yet Orszag supported the Dartmough findings and is quoted in the article.

Is this a sign of creeping death panels?

gary fouse on December 23, 2009 at 9:39 PM

I am not sure if any of the leftists would die for their cause…

Leftist don’t believe in ANYTHING enough to die for it, not even their own selfish cause, just ask one. And that is what makes them un-American. It’s the question that needs to be asked of every one of these bastards; Are you prepared to DIE for this? If you don’t believe in something, THEN YOU’LL BELIEVE ANYTHING.

Pole-Cat on December 23, 2009 at 9:45 PM

I guess Vox is on a crack run…it should be here around noon.Or do welfare checks arrive tomorrow?Might be an early rise for the vox!

theTarCzar on December 23, 2009 at 10:02 PM

Hey Dark-Star, the majority of the military will be on the side of the revolutionaries. In fact, it is VERY unlikely they will fire on their own citzens. So keep enjoying your fantasy that they’ll be crushed. Oh, and spare us your home-erotic day-dreams about Marines.

For you leftists trolls, it makes me smile to know your hatred eats you alive and makes you miserable. You are going to lose BIG in 2010!

Hard Right on December 23, 2009 at 10:17 PM

Hey Dark-Star, the majority of the military will be on the side of the revolutionaries. In fact, it is VERY unlikely they will fire on their own citzens. So keep enjoying your fantasy that they’ll be crushed.

(sources needed)

Dark-Star on December 23, 2009 at 10:32 PM

So keep enjoying your fantasy that they’ll be crushed. Oh, and spare us your home-erotic day-dreams about Marines.

Hard Right on December 23, 2009 at 10:17 PM

Yes, it’s fantasy to think that the most powerful armed forces in the world will hand a bunch of poorly organized, badly-equipped, largely combat-inexperienced rabble their arses on a silver platter. Keep dreaming.

Dark-Star on December 23, 2009 at 10:36 PM

Palin was right about death panels. The truth of the matter is that baby boomers are retiring and going on to medicare at record numbers and there isn’t enough money in the system to cover them. Medicare paid very little to doctors to begin with. I think a regular visit gets the doctor around $37. My hairdresser gets more and she doesn’t have a post secondary education. The same government that knows that doctors are turning down medicare patients because of the low reimbursements wants to put more people on the medicare rolls? Isn’t that a death wish? Good luck finding a qualified doctor. Would you pay big bucks for medical school and make $37 bucks a visit? If the NYT repoted it, you can guarantee it is much worse. http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html
However, Obama wants to give you a choice- an unqualified SEIU doctor. http://www.doctorscouncil.com/ If he can’t fix it medically, maybe the doc will punch you in the face and you’ll forget about your other problem or maybe he’ll prescribe the koolaid, they think it will cure all your ailments.

http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html

njpat on December 23, 2009 at 10:52 PM

http://www.doctorscouncil.com/
Wrong link above…Obama thinks he’s got the cure.

njpat on December 23, 2009 at 10:54 PM

Dark Side every powerful empire in the past has been defeated,, usually after that power has become so corrupt that even its military will turn on it. Keep dreaming Darkside.

garydt on December 23, 2009 at 10:59 PM

Yes, it’s fantasy to think that the most powerful armed forces in the world will hand a bunch of poorly organized, badly-equipped, largely combat-inexperienced rabble their arses on a silver platter. Keep dreaming.

Dark-Star on December 23, 2009 at 10:36 PM

Of course your right Gen Cornwallis. General Giap lost his arse, sir.

Fighton03 on December 23, 2009 at 11:04 PM

I trust Sarah Palin.

redwhiteblue on December 24, 2009 at 12:27 AM

There are very, very, very few politicians I trust. I trust Sarah Palin.

redwhiteblue on December 24, 2009 at 12:29 AM

For those that think Palin isn’t winning over hard core democrats in droves:

http://hillbuzz.org/2009/12/23/an-open-letter-to-sarah-palin-by-patricia-melton-and-the-mineral-city-coffee-club/

gary4205 on December 24, 2009 at 12:34 AM

“Thomas Jefferson would’a’ quit. Gen. George Patton would’a’ quit. And little known fact, before my spirital father Ronald Regan was known as ‘The Gipper,’ everyone called him ‘The Quitter.’ So ya see, it’s a proud legacy.” — Sarah Palin

voxpopuli on December 10, 2009 at 4:48 PM
Agitvoxprop.

unclesmrgol on December 23, 2009 at 8:54 PM

Thank you, thank you. *bows*

voxpopuli on December 24, 2009 at 1:58 AM

hey Vox,

Having trouble dealing with a strong woman are you?
Maybe you should see someone about that…

jerrytbg on December 23, 2009 at 9:07 PM

LOL Project much?

voxpopuli on December 24, 2009 at 1:59 AM

voxpopuli on December 23, 2009 at 8:01 PM
Vox are you pro-corruption?If it can benefit you? Or if it goes against you? Or both?

theTarCzar on December 23, 2009 at 9:21 PM

Hey TarCzar, did you quit beating your wife yet?

voxpopuli on December 24, 2009 at 2:00 AM

A provision was slipped mandating that small construction companies provide health insurance if they have more than five employees. Other small businesses are exempt from providing health coverage if they employ 50 or less.

So not only will businesses with 49 employees be discouraged from hiring, so will construction companies with five.

So much for equal protection under the law.

Akzed on December 23, 2009 at 9:10 AM

OBVIOUSLY intended for the industry that hires more illegal aliens than any other.

fred5678 on December 24, 2009 at 2:10 AM

LOL Project much?

voxpopuli on December 24, 2009 at 1:59 AM

You seem to have prob with the strong women….

Fighton03 on December 24, 2009 at 2:33 AM

Congratulations Ed. Glad to see you got a Sarah post for a change. And glad to add to it.

The voice troll is soprano, er castrato? Seems no appropriate character but perhaps Lady Macbeth in the canon. Pity her lyrics are Disney, Michael Moore or drums.

It’s late. Will take on loudmouth on another thread.

Again, well done. Thanks

Caststeel on December 24, 2009 at 2:43 AM

LOL Project much?

voxpopuli on December 24, 2009 at 1:59 AM
You seem to have prob with the strong women….

Fighton03 on December 24, 2009 at 2:33 AM

If by “seem” you mean “a conclusion drawn directly from your posterior in the face of all available evidence,” then yes, you would appear to have a point.

BTW what strong women are we talking about? Not the Gutless Quitter, I hope?

voxpopuli on December 24, 2009 at 3:22 AM

OBVIOUSLY intended for the industry that hires more illegal aliens than any other.

fred5678 on December 24, 2009 at 2:10 AM

AND WHAT EVER BECAME OF THIS ISSUE ANYWAY? Is there ANYONE in the useless party leadership who is going to apprise us of this issue?

voxpopuli on December 24, 2009 at 3:24 AM

Palin’s latest Tweet:

c tomrrw’s Healthcare Takeover vote=the sleeping giant will awaken&action will b takn by”average”Americans as lite shines on big govt growth

Not many people have their finger on America’s pulse like Sarah. Another spot on diagnosis.

Mr Purple on December 24, 2009 at 7:12 AM

For those that think Palin isn’t winning over hard core democrats in droves:

http://hillbuzz.org/2009/12/23/an-open-letter-to-sarah-palin-by-patricia-melton-and-the-mineral-city-coffee-club/

gary4205 on December 24, 2009 at 12:34 AM

Awesome letter. Best Xmas gift I could have asked for.

WordsMatter on December 24, 2009 at 7:57 AM

hey Vox,

Having trouble dealing with a strong woman are you?
Maybe you should see someone about that…

jerrytbg on December 23, 2009 at 9:07 PM
LOL Project much?

voxpopuli on December 24, 2009 at 1:59 AM

Sorry I didn’t stay up to read your Masterful response…
HAHAHAHAHAHAHA !!!

jerrytbg on December 24, 2009 at 8:22 AM

Yes, it’s fantasy to think that the most powerful armed forces in the world will hand a bunch of poorly organized, badly-equipped, largely combat-inexperienced rabble their arses on a silver platter. Keep dreaming.

Dark-Star on December 23, 2009 at 10:36 PM

You moron. We won’t defeat the “most powerful armed forces in the world” – they’re on our side. The American soldier is conservative (maybe not 100%, but still overwhelmingly). And the few who aren’t wouldn’t dare to fire on citizens. Your side doesn’t believe there’s anything worth dying for – our side does.

Squiggy on December 24, 2009 at 8:24 AM

No one in here can explain how we will have enough doctors to go around to insure the extra 43 million uninsured, and congress themselves don’t want to personally use this system. So, who is going to get the less help once this bill is enforced? Whether Sara quit or not no oone can explain this gap. Vox,,, can you explain how we will have enough doctors?

garydt on December 24, 2009 at 8:28 AM

garydt on December 24, 2009 at 8:28 AM

She doesn’t do that. She’s only here to bash Palin, not discuss the topic.

fossten on December 24, 2009 at 8:40 AM

yes fossten, I have a terrible time getting a leftist to answer. All they do is trash the messenger whether she is a quitter or not they can’t answer who will fill up this gap for the 43 million and expected invasion of illegals wanting the same service too. Why is this such a hard question for them?

garydt on December 24, 2009 at 8:59 AM

Are there mods on this site? Why is this insane drivel allowed to fill up 8 pages? How much longer will HA be taken seriously?

stvnscott on December 24, 2009 at 10:52 AM

Are there mods on this site? Why is this insane drivel allowed to fill up 8 pages? How much longer will HA be taken seriously?

stvnscott on December 24, 2009 at 10:52 AM

I’ve got a great site for you. It’s called Little Green Footballs. Why don’t you go there and stay there?

Disturb the Universe on December 24, 2009 at 11:23 AM

I’ve got a great site for you. It’s called Little Green Footballs. Why don’t you go there and stay there?

Disturb the Universe on December 24, 2009 at 11:23 AM

Oh come on. You can’t seriously think the trolls are adding anything constructive to the conversation. HA should (IMHO) be held to higher intelligent discourse. LFG is a whole different ballgame.

stvnscott on December 24, 2009 at 11:27 AM

stvnscott on December 24, 2009 at 11:27 AM

I have a lot more respect for a site that allows a free exchange of opinion than one that employs the ban hammer everytime someone disagrees with the host.

And, it doesn’t seem you were so much bothered by the “trolls” as you were the lack of “mods”.

Disturb the Universe on December 24, 2009 at 11:35 AM

Oh, unclesmrgol. Did you take a pause from beating your wife?

voxpopuli on December 23, 2009 at 6:57 PM

Hey TarCzar, did you quit beating your wife yet?

voxpopuli on December 24, 2009 at 2:00 AM

One Hit Wonder — but it takes 7 hours to recycle.

unclesmrgol on December 24, 2009 at 11:39 AM

Even better:

Oh, unclesmrgol. Did you take a pause from beating your wife?

voxpopuli on December 23, 2009 at 6:57 PM

Hey TarCzar, did you quit beating your wife yet?

voxpopuli on December 24, 2009 at 2:00 AM

LOL Project much?

voxpopuli on December 24, 2009 at 1:59 AM

unclesmrgol on December 24, 2009 at 11:41 AM

I have a lot more respect for a site that allows a free exchange of opinion than one that employs the ban hammer everytime someone disagrees with the host.

Yeah, but there is no “free exchange of opinion” from these trolls. All they do is insult and generally behave like 11 year olds. You sure have low standards if you consider what these jackasses write as “free exchange of opinion”.

And, it doesn’t seem you were so much bothered by the “trolls” as you were the lack of “mods”.

Disturb the Universe on December 24, 2009 at 11:35 AM

BS. Quit licking AP’s arse.

atheling on December 24, 2009 at 1:50 PM

unclesmrgol on December 24, 2009 at 11:41 AM

Lol, and Disturb the Universe considers that drivel a “free exchange of opinions”.

atheling on December 24, 2009 at 1:51 PM

However, as this battle shows, even getting to 60 is almost an impossibility, let alone 67.

Fastforward to January 2010.
She looked at me with big brown eyes and said…
 
You ain’t seen nothin’ yet.

67? I laugh at your pessimism. How about a real challenge?
 
FREEDOM!

Blacksmith8 on December 24, 2009 at 1:52 PM

unclesmrgol on December 24, 2009 at 11:41 AM
Lol, and Disturb the Universe considers that drivel a “free exchange of opinions”.

atheling on December 24, 2009 at 1:51 PM

Yes…but the beat goes on…lol !

jerrytbg on December 24, 2009 at 4:53 PM

c tomrrw’s Healthcare Takeover vote=the sleeping giant will awaken&action will b takn by”average”Americans as lite shines on big govt growth
Not many people have their finger on America’s pulse like Sarah. Another spot on diagnosis.

Mr Purple on December 24, 2009 at 7:12 AM

LOL Yes you are right, only Sarah Palin could tell us that Obamacare is unpopular with Americans.

Are there mods on this site? Why is this insane drivel allowed to fill up 8 pages?
stvnscott on December 24, 2009 at 10:52 AM

“Drivel” indeed.

voxpopuli on December 24, 2009 at 5:33 PM

No one in here can explain how we will have enough doctors to go around to insure the extra 43 million uninsured, and congress themselves don’t want to personally use this system. So, who is going to get the less help once this bill is enforced? Whether Sara quit or not no oone can explain this gap. Vox,,, can you explain how we will have enough doctors?

garydt on December 24, 2009 at 8:28 AM

As you should know, since you know me well enough to ask me, of course I cannot explain it. This is why I have opposed Obamacare to the bitter end.

voxpopuli on December 24, 2009 at 5:35 PM

Oh, unclesmrgol. Did you take a pause from beating your wife?

voxpopuli on December 23, 2009 at 6:57 PM
Hey TarCzar, did you quit beating your wife yet?

voxpopuli on December 24, 2009 at 2:00 AM
One Hit Wonder — but it takes 7 hours to recycle.

unclesmrgol on December 24, 2009 at 11:39 AM

LOL Maybe you Palinbots should quit reading from the same stupid script then.

voxpopuli on December 24, 2009 at 5:39 PM

HAHAHAHAHAHAHAHAHA !!!

jerrytbg on December 24, 2009 at 5:54 PM

voxpopuli on December 24, 2009 at 5:33 PM

voxpopuli on December 24, 2009 at 5:35 PM

voxpopuli on December 24, 2009 at 5:39 PM

Are you feeling lonely…/R

jerrytbg on December 24, 2009 at 5:59 PM

Just got home vox and glad to get your answer. Have a great year and a Merry Christmas.

garydt on December 24, 2009 at 6:56 PM

The health care bill just passed by the Senate is so unconstitutional, I don’t see how they could use up all their political capital by doubling down and passing it… Oh well, bring on SCOTUS!

Khun Joe on December 24, 2009 at 7:53 PM

However, as this battle shows, even getting to 60 is almost an impossibility, let alone 67. Clearly Reid wants to put accountability out of reach with these radical propositions.

Not so clearly, Ed. Since they’ve just proven that they can buy 60 votes, what it will really depend on is how much more they want to add to the deficit in bribe money which, apparently, is of no concern to these criminals, crooks, public servants, Treasury looters, (sadly) elected officials.

PoodleSkirt on December 24, 2009 at 8:43 PM

LOL Maybe you Palinbots should quit reading from the same stupid script then.

voxpopuli on December 24, 2009 at 5:39 PM

Merry Christmas!

unclesmrgol on December 25, 2009 at 1:18 AM

The truth of the matter is that baby boomers are retiring and going on to medicare at record numbers and there isn’t enough money in the system to cover them. Medicare paid very little to doctors to begin with.

magicky on December 25, 2009 at 3:18 AM

Would you pay big bucks for medical school and make $37 bucks a visit?

njpat on December 23, 2009 at 10:52 PM

It would depend on the length of the visit. 5 minutes a visit turns into $444/hr. I know how one of my doctors handles the problem — which is to separate individual reimbursables. So the office visit is done one day, and the tests which would normally have been done during the office visit are done the next day. The doctor would not have been reimbursed for the office visit if the tests were taken on the same day, so he goes around this by separating the two. A pain for me, but the doctor gets to stay in business.

unclesmrgol on December 25, 2009 at 12:11 PM

Anonymous on August 28, 2010 at 7:54 PM