In 2003, Newt Gingrich wrote Saving Lives & Saving Money: Transforming Health and Healthcare. It does offer some “free market” solutions. But doctors are apparently free only as long as they do what Newt thinks they should.

The backup plan is: “When all else fails, mandate.” Specifically, physicians who “insist on doing it the old way…should simply not be allowed to practice medicine.” As far as I know, even Obama doesn’t go this far.

In developing his plans and strategies, the CHT boasts a lot of allies: along with top leaders in federal and state governments, it includes “key corporations, top hospitals, disease advocacy groups, professional and industry associations, and leading research institutions.” Many if not all of them probably endorsed the Patient Protection and Affordable Care Act (“ObamaCare”).

Newt has embraced the key fallacy that “the number of uninsured in America is a threat to our civilization.” He thinks that medical errors are “morally unacceptable,” and that they could somehow be prevented by forcing everybody to use the health information technology that his supporters, just coincidentally, happen to sell. He speaks favorably of outgoing CMS director Donald Berwick, an avowed admirer of the British National Health Service’s rationing system. He is convinced that “disease management programs” can” dramatically improve outcomes.”

Apparently, what Newt thinks we need to do is to get all medical care paid for (or denied) by approved third parties and all health information into a form that permits monitoring and surveillance. Cost escalation because of third-party payment; difficulty defining what a “medical error” is in the absence of an infallible judge; potentially deadly outcomes related to software flaws; absence of evidence that existing disease management and other schemes either save money or improve health—none of these are problems for a big-idea man like Newt.

Newt avoids obvious gaffes like accusing doctors of taking out tonsils or cutting off legs just to make more money. He sticks to generalities such as the need to “drag the medical system into the 21^st century.” That system provides miraculous imaging technology and marvelous advances in noninvasive surgical techniques, but falls down on having information on your every sniffle accessible to the System.

Although he has no apparent qualifications in medicine or science, he seems to think all doctors could benefit from government supervision, and he freely offers his own health advice. For example, you should vote for zoning changes that encourage walking, and wash dishes with your nondominant hand.

The Gingrich “transformation” doesn’t look all that different from Obama’s to me—either in concept or in the cheerleaders it appeals to. Based on the tone of the book, the two men also don’t seem to be that different in level of self esteem, condescending attitude, or tendency to sermonize.

In my review of the book for the Journal of the American Medical Association on Jan 14, 2004,  I wrote that “this book is primarily useful as a guide to the mind of Newt Gingrich.” It also showed his political ambitions, featuring 14 pages of photographs of himself with dignitaries, babies, and constituents.

Perhaps Newt has been converted from his dedication to top-down central planning for American medicine, and really would repeal ObamaCare without “replacing” it with something very similar. He should know that before absolution comes confession and repentance. So far, I haven’t heard a disavowal of this book.

I’m biased, of course, so I’ll understand if you discount what I say. But I hope you’ll agree that my colleagues have put together an excellent video response to the President’s state-of-the-union speech.

As part of my contribution to the video, beginning around 6:35, I debunk the President’s class-warfare tax agenda by citing IRS data from the 1980s to explain that higher tax rates don’t necessarily mean higher tax revenue.

After a night’s sleep, here are a few additional observations on the President’s remarks.

• I was disappointed, but not surprised, that he repeated the economically foolish assertion that Warren Buffett pays a lower tax rate than his secretary.
• I also was not surprised that he didn’t say much about jobs and the economy. These four charts show he doesn’t have much to brag about.
• It was also noteworthy that he didn’t spend much time talking about Obamacare, which suggests that White House pollsters understand that government-run healthcare isn’t very popular.
• It was equally revealing that he didn’t spend much time on the so-called income inequality issue. Redistribution was implicit in what he said, to be sure, but the Occupy-Wall-Street crowd is probably disappointed that he didn’t explicitly embrace their agenda. More evidence that the pollsters played a big role in this speech.
• I’m definitely not surprised that he talked about eliminating Osama bin Laden. Kudos to the Commander-in-Chief.
• I was amazed that he had the gall to say “no bailouts,” particularly given his support for TARP, the Dodd-Frank bailout bill, and the giveaway to GM and the auto unions. And if the GM bailout is supposed to be a success, I’d hate to see his definition of failure.
• And I was stunned that he could talk about the housing meltdown and mortgage crisis without mentioning the Federal Reserve, Fannie Mae, or Freddie Mac. Sort of like analyzing World War II and pretending Germany and Japan didn’t exist.

Since most of the previous observation are critical, I want to stress that I’m not being partisan. I also was disappointed in the Republican response. Was the GOP smart to showcase a governor who was part of the big-spending Bush Administration? Especially one who has said nice things about the value-added tax?

I even was a bit disappointed in Governor Daniels’ remarks. He focused a lot on means-testing for entitlements, but that’s the wrong way of reforming the programs. Such policies impose higher implicit marginal tax rates on people who save and invest during their working years.

If we’re going to reform entitlements, do it the right way.

Health and Human Services Secretary Kathleen Sebelius said, “These historic guidelines are based on science and existing (medical) literature and will help ensure women get the preventive health benefits they need”.

However a recent Fox News article states “generic versions of the pill are available for as little as $9 a month. Still, about half of all pregnancies are unplanned. Many are among women using some form of contraception, and forgetting to take the pill is a major reason.” This shows that even if we offer them free birth control, we have no guarantee they will not get pregnant.

Who will pay to offset the cost of these new “free” services? We all know that nothing is truly free. The rest of us will be forced to pay for these services and premiums all over will be increased. In a Bloomberg editorial they admitted, “The average yearly cost to an insurer of providing full coverage for the entire range of contraceptive methods and counseling services (with no copays or deductibles) is about $40”.

As a young woman I believe these services should not become subsidized especially when the generic brand is easily accessible. We are 14 trillion in debt; there is no more money in order to cover all of these services. It is not a lack of access or information; they already have birth control and choose not to use it. We have an accountability issue not accessibility issues. If you choose to be sexually active then you are responsible for preventing a pregnancy, not the rest of us. These are goods and services, not a civil right. Do we really want the government micromanaging something as personal and private as pregnancies?

One of the key observations of the video is that Medicaid block grants would replicate the success of welfare reform. Getting rid of the federal welfare entitlement in the 1990s and shifting the program to the states was a very successful policy, saving billions of dollars for taxpayers and significantly reducing poverty. There is every reason to think ending the Medicaid entitlement will have similar positive results.

Medicaid block grants were included in Congressman Ryan’s budget, so this reform is definitely part of the current fiscal debate. Unfortunately, the Senate apparently is not going to produce any budget, and the White House also has expressed opposition. On the left, reducing dependency is sometimes seen as a bad thing, even though poor people are the biggest victims of big government.

It’s wroth noting that Medicaid reform and Medicare reform often are lumped together, but they are separate policies. Instead of block grants, Medicare reform is based on something akin to vouchers, sort of like the health system available for Members of Congress. This video from last month explains the details.

In closing, I suppose it would be worth mentioning that there are two alternatives to Medicaid and Medicare reform. The first alternative is to do nothing and allow America to become another Greece. The second alternative is to impose bureaucratic restrictions on access to health care – what is colloquially known as the death panel approach. Neither option seems terribly attractive compared to the pro-market reforms discussed above.

Donald Berwick, the person appointed by Obama to be in charge of Medicare, has a column in the Wall Street Journal that makes a very good observation about how relative prices are falling for products bought and sold in the free market. But he then draws exactly the wrong conclusion by asserting that further crippling market forces for healthcare will yield similar cost savings for programs such as Medicare.

Here’s the relevant passage from his Wall Street Journal column.

The right way is to help bring costs down by making care better and improving our health-care system. Improving quality while reducing costs is a strategy that’s had major success in other fields. Computers, cars, TVs and telephones today do more than they ever have, and the cost of these products has consistently dropped. The companies that make computers and microwaves didn’t get there by cutting what they offer: They achieved success by making their products better and more efficient. …Under President Obama’s framework, we will hold down Medicare cost growth, improve the quality of care for seniors, and save an additional $340 billion for taxpayers in the next decade.

I have no idea whether Berwick realizes that he has inverted reality, so I can’t decide whether he is cynically dishonest or hopelessly clueless. All I can say with certainty is that what he wrote is sort of like asserting “gravity causes things to fall, so therefore this rock will rise when I let go of it.”

To explain, let’s start by looking at why relative prices are falling for computers, cars, TVs and telephones. This isn’t because the companies that make these products are motivated by selflessness. Like all producers, they would love to charge high prices and get enormous profits. But because they must compete for consumers who are very careful about getting the most value for their money, the only way companies can earn profits is to be more and more efficient so they can charge low prices.

So why isn’t this happening in health care?

The answer, at least in part, is that consumers aren’t spending their own money so they don’t really care how much things cost. As this chart illustrates (click to enlarge), only 12 percent of every healthcare dollar is paid directly by consumers. The rest comes from third-party payers, mostly government but also insurance companies.

In other words, Berwick’s column accidentally teaches us an important lesson. When consumers are in charge and responsible for paying their own bills, markets are very efficient and costs come down. But when government policies cause third-party payer, consumers have little if any incentive to spend money wisely – leading to high costs and inefficiency.

Defenders of the status quo argue that the market for healthcare somehow is different than the market for things such as computers. But here’s a chart (click to enlarge) showing that relative prices are falling in one of the few areas of the healthcare system where consumers spend their own money. And I’ve previously noted that the same thing applies with abortion, where prices have been remarkably stable for decades. Regardless of one’s views on the procedure, it does show that costs don’t rise when people spend their own money.

That’s common sense and basic economics. But it’s not a good description of Obama’s healthcare plan, which is explicitly designed to increase the share of medical care financed by third-party payer.

The White House presumably would argue that price controls will help control costs. And the President’s Independent Payment Advisory Board (a.k.a., the death panel) will have enormous power to directly or indirectly restrict care, but that’s probably not too comforting for the elderly and others with high healthcare expenses.

The right approach, needless to say, would be to restore market forces to healthcare, which is the core message of this video narrated by Eline van den Broek of the Netherlands.

Obama, who can be thin-skinned when people disagree with him, was downright irritated when the early polls showed that a majority of Americans opposed his health care “reform” bill.  On April 1, he criticized the polls as premature, saying “So before we find out if people like health care reform, we should wait to see what happens when we actually put it into place.  Just a thought.”

The problem with his argument is that the more Americans find out what is actually in this monstrosity of a bill, the less they like it.  Polls conducted by Rasmussen Reports show that 55 percent of the public supported the repeal of ObamaCare on March 25, just two days after its passage.  Today, a half-year later, the number of those favoring repeal has grown to 61 percent.

I am not one to call the President a liar.  I have too much respect for the office held by giants like George Washington and Ronald Reagan for that.  But I do believe that much of what Obama has said about his own health care bill is simply not true.  He claimed in Maine that people could keep their own health insurance, in Maryland that people could keep their own doctors.  In Washington, DC, he promised that his plan would cut costs but would not lead to the rationing of care.  He has consistently claimed that it would not fund abortions, and that its “end-of-life visits” would not lead to euthanasia.

Six months later, all of these claims are being questioned by taxpayers who see people losing their health care plans and paying more for health insurance.  More and more Americans are realizing that they and their children will be stuck with the bill as healthcare costs rise, and that they will be paying for “family planning services” that include not just sterilizations and contraception, but abortions as well.
Obama has repeatedly reassured nervous Americans that “if you like your insurance plan, you will keep it.  No one will be able to take that away from you.  It hasn’t happened yet.  It won’t happen in the future.” (April 1, 2010)  In reality, millions of Americans will lose their health insurance in the coming years as a direct result of ObamaCare.

On September 21, 2010, the Centers for Medicare and Medicaid Services (CMS) announced 1.2 million seniors will be forced out of the Medicare Advantage or Medicare prescription drug plan that they currently enjoy next year.  Add to this the news that nHealth has dropped all its customers because of ObamaCare and is going out of business, and that the American National Insurance Company will not sell health insurance to early retirees, self-employed workers, and small businesses because of ObamaCare.  In fact, the worst blow of all may fall upon small businesses.  Regulations issued by the Obama administration may cause up to 80 percent of small businesses to lose their current plans.

You will also be paying more for your health insurance in years to come because of ObamaCare.  Obama continues to maintain that “This law will cut costs and make coverage more affordable for families and small businesses.” (June 22, 2010)  But the reality behind the rhetoric is that ObamaCare is causing health insurance prices to skyrocket.  The Wall Street Journal reported that ObamaCare is causing rates to increase up to 20 percent for some buyers.  In Connecticut, rates are increasing 18 percent for small businesses and 14.2 percent for the self-employed, early retirees, and others who buy their own coverage on October 1, 2010.

These increases are taking place not because of greed on the part of insurance companies, as Obama’s media minions like to claim, but because of the new mandates and regulations contained in ObamaCare, all of which cost real money to comply with.

The elderly will bear the brunt of Obama’s deceptions, such as his claim that “If you like your doctor, you can keep your doctor.” (June 8, 2010)  The reality is that doctors are already fleeing Medicare in droves. In Texas alone, more than 300 primary care physicians have stopped seeing seniors in the last two years. When ObamaCare cuts Medicare payments to doctors next year, even more doctors will bail out of a system that overworks and underpays them, leaving millions of seniors without a personal physician.

Costs are rising as well, flying in the face of Obama’s claim that “over time, costs will come down for families, businesses, and the federal government, reducing our deficit by more than $1 trillion over the next two decades.  That’s what this reform will do.” (April 1, 2010)  We now know that, according to President Obama’s own Center for Medicare and Medicaid Services (CMS), ObamaCare will increase health care spending by 6.3 percent annually and will cause health care to consume almost 20 percent of the our nation’s GDP.  In other words, ObamaCare will only pile more debt on the mountain of debt that Obama’s other forays into socialism have caused.

The easiest Obama claim to refute is his contention that ObamaCare would not fund abortions.  This is because he refuted it himself by issuing an executive order that purportedly forbade the funding of abortions through ObamaCare.

When I first learned of this particular ruse, I didn’t know whether to laugh or cry.  Because it is a ruse; albeit very clever one that many people, apparently including “pro-life” Democrats like Bart Stupak, failed to see through.

You see, if ObamaCare had not funded abortion in the first place, then his executive order would be unnecessary.  So the executive order (at http://www.whitehouse.gov/the-press-office/executive-order-patient-protection-and-affordable-care-acts-consistency-with-longst) constitutes evidence that, contra Obama, ObamaCare had funded abortion all along.

At the same time, however, since federal law always and everywhere trumps executive orders, Obama’s order is not worth the paper it is written on.  As a Harvard-trained lawyer, the President surely realizes that his executive order will not stand up to the most cursory of judicial reviews.  Obamacare will then be used as Obama, Reid and Pelosi intended, as a vehicle to promote and perform abortions.

It seems to me that our choice as Americans is simple:  Either we euthanize ObamaCare before it is too late, or it winds up euthanizing us.

It is time to pay an “end-of-life” visit to ObamaCare.

The measure—based on the American Legislative Exchange Council’s model Freedom of Choice in Health Care Act now proposed in 42 states—challenges the individual mandate, a key provision of the new federal healthcare law that requires people to have health insurance or pay fines by 2014.

Predictably, special interest groups and their big-government allies have launched a full-scale assault on Proposition C and the concept of health care freedom.

But as the late Senator Daniel Patrick Moynihan once said, “Everyone is entitled to his own opinion, but not his own facts.”

Let’s look at the most common accusation launched by Proposition C opponents and why the Show Me State would benefit from a little truthtelling.

The Missouri Hospital Association charges that, without a requirement to purchase health insurance, people will become “freeloaders” who impose their costs on taxpayers and clog emergency rooms.

Although the cost of treating the uninsured is borne by those of us with health insurance, researchers estimate these costs to be just 2-3% of overall health spending.

And the most recent study from the National Center for Health Statistics shows that people on Medicaid—a program that, thanks to Obamacare, will add 300,000 Missourians to its rolls—are more than twice as likely to visit the emergency room than the uninsured.

What Proposition C opponents don’t tell you is that so-called “freeloaders” will continue to show up in the emergency room with or without a mandate.  Massachusetts, a state that imposed an individual mandate in 2006, has seen its ER use climb by 17% since the law was enacted.

One Massachusetts survey reported that although the newly-insured had insurance coverage on paper, 90% of them did not have access to care from a non-ER provider.  The Massachusetts Medical Society reports that the average wait to see a primary care doctor is 36 days.

But let’s pretend that Proposition C opponents are right, and that an individual mandate would eliminate “freeloaders” from our healthcare system.  The problem is that Missourians will still be paying for the freeloaders with massive government subsidies to purchase the required insurance.

Thanks to Obamacare, a low-income family of four can qualify for more than $20,000 in government subsidies to purchase coverage in the new health insurance exchanges—which means increased federal taxes for Missourians.

This doesn’t include the $524 million that Missouri must pay to expand its Medicaid program or the countless taxes and costly regulations contained in the new law.

Missourians know that mandates just don’t work, and that hospitals who get favorable tax treatment to care for the poor shouldn’t shift those costs to taxpayers and businesses.

Looks like the only “freeloaders” are Proposition C opponents who know that forcing you to purchase health insurance will increase government power—and their bottom line.