Obamacare and its Successors

For those keeping score, once again, I was right and the so called experts were wrong.  The Supreme Court upheld Obamacare, 5-4.  The solid liberal block only had to peel off one of the Justices who actually read the constitution.  So the bad news?  Obamacare upheld.  The good news?  I was right once again!

Based on just a brief commentary I’ve heard so far on the decision, there is actually some other good news.  The court upheld the individual mandate based on the taxing power of the constitution, not the commerce clause.  So when it came to deciding if the commerce clause meant the government could do anything, they punted.  So rather than ignoring the constitution, they merely ignored the text of the law.  That’s a far better situation than if the court had decided to not recognize any limits to the commerce clause.  This is no Kelo.  This is a political decision that was only about this particular law.  It didn’t set a legal precedent.

But this doesn’t really change the playing field, at least not yet.  Even if the Court had repealed Obamacare in its entirety, we still would have been left with the situation of having to replace it with something.  This only pushes back the date to when we can do that; until we have a Republican President.  That makes a Romney win all the more important.  Politically, this might even be beneficial to Romney.  It would fire up a base who was otherwise rather “meh” on him.

So, assuming a Romney victory, what can we replace the shambling corpse of Obamacare with?  It’s not enough to get rid of Obamacare, declare victory, and go home.  The reason Obamacare had any traction in the first place was because there was a universal recognition that our healthcare system was broken.  It cost too much and didn’t cover enough people.  Even with Obamacare out of the way, the real issues that it was advertised to address remain.

Luckily there have been many alternatives proposed, and the pool of various reform plans is large enough to provide a good mix of alternatives to the slap dash political Frankenstein’s monster that was the Patient Protection and Affordable Care Act. The most obvious place to check with first is with the proposed healthcare plan of Mitt Romney.  Some of the major proposals of Romney’s plan include:

End tax discrimination against the individual purchase of insurance

Block grants to Medicaid.

Cap non-economic damages in medical malpractice lawsuits

Empower individuals and small businesses to form purchasing pools

Allow consumers to purchase insurance across state lines

Unshackle HSAs by allowing funds to be used for insurance premiums

Promote alternatives to “fee for service”

Encourage “Consumer Reports”-type ratings of alternative insurance plans

Most of these ideas are common features of other alternative health care reform proposals.  It shares similar features with the National Center for Policy Analysis proposal, the Heritage Foundation, the Competitive Enterprise Institute, the GOP, and the Options Act, a bill currently in committee in the House (as HR 4224).  All of these proposals are similar enough in their general outlines that one bill could probably be crafted out of them rather quickly.

One of the more interesting plans came not out of a think tank or campaign headquarters, but from a businessman, John Mackey, the CEO of Whole Foods.  His plan came out of his experience of trying to provide health care benefits to his employees.  Like the other proposals, Mackey supported equalizing the tax laws so that individual and employee health insurance plans had the same tax treatment, competition across state lines, and tort reform.  He also wanted to allow a check box on tax forms to allow a contribution to a fund to provide healthcare for people not otherwise covered, and expand the use of Health Savings Accounts, which are utilized extensively in the Whole Foods health care plan provided to their employees.

Naturally liberals were apoplectic that the CEO of the place where they purchased their overpriced arugula was proposing a counter proposal to the one Dear Leader was proposing.  The publication of Mackey’s article in the Wall Street Journal lead to a short lived lefty boycott of Whole Foods, at least until liberals decided they couldn’t find a more expensive place to purchase their organic veggies.

All of these proposals are all well and good in and of themselves, and would probably do a good job at “bending the cost curve” as the President inaccurately claimed Obamacare would do.  However they don’t do as much to reduce the number of people uninsured or dealing with people with pre-existing conditions.  Those are issues as important as bending the cost curve is.  That solution was John McCain’s healthcare proposal for the 2008 election.  McCain’s plan would have provided a tax credit for low & middle income people to be applied to their health insurance premium.  A good idea, except that he applied it to both individual and employee plans, boosting the cost of his program (although well below even friendly Obamacare estimates).

Recognizing the extra cost associated with Pre-existing conditions, McCain’s advisors were considering a proposal to have risk rated the tax credit so that people with pre-existing conditions would get a higher tax credit based on the rated expense of their particular condition.  He also supported State based risk pools, similar to the ones in Obamacare.

So looking at all of these plans together, shaking them up in a big healthcare reform bag and baking at 350°, this is what I’ve come up with as key features of a good alternative to Obamacare:

1)       Equalizing the tax treatment between individuals and businesses for health insurance premiums.  This would mean giving a first dollar deduction to individuals and families on their taxes plus for low and middle income people, a tax credit that would be applied to the health insurance premium.  McCain’s plan had a $5000.00 tax credit for family insurance premiums.  That would probably need to be updated and perhaps indexed to the growth in the cost of health care insurance premiums.

2)      I like the proposal to have a formula to increase the health insurance premium tax credit based on the severity of the pre-existing condition, but some pre-existing conditions are so severe that they are not insurable at any price.  For those, I go along with the state risk pools; not as a separate insurance plan, but as a secondary payer to the member’s regular primary insurance.  By applying and being accepted into a state pool, the member will be able to purchase regular insurance at regular prices and the diagnosis’s and procedures related to the members’ severe pre-existing condition the risk pool would pay as a secondary payer, similar to the way worker’s comp and auto accident insurance are handled.

These two main points handle the bulk of our current uninsured and pre-existing conditions crisis.  Of course I concur with the bulk of the other alternative reforms as well, such as Romney’s idea to allow purchasing pools for small businesses and other organizations.  I’m not clear as to why we would prohibit organizations like churches from organizing their own insurance purchasing pools.

There are many other options to Obamacare.  Options that are cheaper, more efficient, and would actually facilitate expanding healthcare, that are not top down statist solutions that guarantee to be more expensive and reduce consumer choice and little else.

Tags:  Politics, News, Obamacare, John Mackey, Whole Foods, Mitt Romney, Healthcare Reform, health insurance tax credit, pre-existing condtion,

Hispandering Executive Orders

Although I didn’t coin the term, ’Hispandering,’ I love it!  It’s a word that you understand the meaning of as soon as you hear it.  Quite an accomplishment when the prefix of the word comes from a made up government term of hazy definition itself.  Ahh, the flexibility of the English language…

So when I tell you that Obama’s executive order to allow young illegal immigrants to stay in the country and get work permits is hispandering, you know exactly what I’m talking about.  Of course, the more you look into it, the more hispandering it looks like and the less policy change it appears.

First of all, it turns there is no executive order.

I checked the White House website for executive orders and found that the latest one, on June 14th, has to do with Accelerating Broadband Infrastructure Deployment.  It turns out the much ballyhooed “executive order” is really just a memo from Big Sis, Janet Napolitano.  Nothing about this memo is any sort of overreach or violation of the law.  It just covers those currently in removal proceedings and provides discretion for ICE agents to not waste their time on illegals who meet the memo criteria:

•              came to the United States under the age of sixteen;

•              has continuously resided in the United States for a least five years preceding the date of 

this memorandum and is present in the United States on the date of this memorandum;

•              is currently in school, has graduated from high school, has obtained a general education

development certificate, or is an honorably discharged veteran of  the Coast Guard or 

Armed Forces of the United States;

•              has not been convicted of a felony offense, a significant misdemeanor offense, multiple

misdemeanor offenses, or  otherwise poses a threat to national security or public safety;

and

•              is not above the age of thirty.

Even the much touted work permits are for those who’ve been granted deferred action by the agencies of the DHS.   And that’s not automatic; they have to apply for it which current law already provides for.  So this whole immigration action is really about nothing.  In fact, considering the lack of real reporting on this, it almost seems like a hoax.  There is no real change to the law, only smoke and mirrors to trick Hispanic organizations that this really means something.  It isn’t really a coincidence that Obama timed this right before He and Romney were to speak before the National Association of Latino Elected and Appointed Officials at Disney World.

If you need proof that Reporters and the media are nothing more than stenographers when a Democratic President is in office, you really don’t have to go much further than this story.  Virtually everything about this story that the Administration has touted has been false.

So as policy, it’s a fail, but as politics, it did work like a charm.  Romney was flummoxed for several days.  I can’t understand how he was caught so flat footed.  Obama’s entire campaign strategy has been to shore up his base, which he has proceeded to do one step at a time, going back to George Stephanopoulos’s contraception question in the January Republican primary debate.  So how hard should it be to know that Obama was going to make some sort of immigration move to hispander to the Hispanic vote?

Mostly the Romney campaign has been pretty good at waving off all of the everything-but-the-economy distractions the Obama campaign has been throwing out, but sometimes you have to be prepared to respond, and then get back to talking about jobs and the economy.  Hopefully Romney can already have an answer prepared by the time the Obama administration goes after the youth vote and tries to declare a jubilee on student loans.

My Netfix Review: Lilyhammer

What happens when you take an average gabba goul eating Goodfella; transport him to Norway, and let him try to blend in with the locals?  Well antics ensue of course, and that’s the premise of the Netflix original series Lilyhammer.  Yes I know it sounds preposterous, but the premise of this limited series seems pretty clearly to have come from some late night drinking.

“We take this mafia guy who joins witness protection, but instead of being relocating to Southern California or someplace, he wants to relocate to… I dunno, Norway?”     

Publicidad de Netflix

Publicidad de Netflix (Photo credit: Daniel_Afanador)

“Put the bottle down, you’ve had enough.”

It’s interesting that Netflix, for its first original project, chose this idea over what I’m sure were a multitude of others.  I can only assume that someone among Netflix’s higher ups really missed the Sopranos, since this show has all of the markers of a Sopranos’s sequel, Silvio on Ice.

Steven Van Zandt, who played Silvio in The Sopranos, plays much the same character again, only with a different name.  When he suspects (via an attempted hit) that he’s on the outs with the new boss, he decides to turn State’s witness against him in exchange for relocation… to Lillehammer, Norway.  Why Lillehammer?  Eh, he liked the way it looked during the 1994 Olympics.

Really.

It’s a bit of a bizarre fish out of water tale, but this fish actually adapts fairly well into the community, quickly becoming a successful club owner in a country where proper permitting and licenses can take years, Van Zandt’s character manages it in days thanks to his ability to bring his mob business tactics to the rigid Norwegian bureaucracy.  Naturally, he manages to also attract some unwelcome police attention.

Although that’s part of the cross cultural stranger in a strange land story, the way the show handles the language barrier is also unique.  The Norwegians speak Norwegian and Van Zant’s character, Frank Tagliano, speaks English.  The conceit of the show is that Tagliano, shown listening to language tapes on his way to Norway, can understand the language, but can’t speak it.  So he speaks English, the Norwegians speak to him in their language, and he understands.  It’s a weird way to have a conversation, but it mostly seems to work, if you can accept the premise that a guy can understand the language perfectly, but can’t speak a word; so half the show is subtitles.  Now some people just will not accept subtitles (yes I’m referring to my fellow Americans) under any circumstances, so if that applies, this show isn’t for you.

More interesting than the show is the business model that got this show on the…air.  Netflix intends to use original programming to attract subscribers.  Their logic is that the old advertising model that has funded on the air and cable television is on the way out.  The multiplication of TV channels and the alternative options to regular television mean that the audience is getting smaller and smaller for each channel.  The days of getting 106 million viewers for a single show, like the series finale of MASH, are, with the exception of major sports events, gone forever. As the television audience becomes more bifurcated, the revenues these channels can get for advertising shrinks.

Netflix ignores advertisers.  It’s only interested in attracting new subscribers.  Will Lilyhammer help with that?

I’m guessing no.

Although it did garner enough viewers to justify a second season, I doubt the show actually did much to pull in new subscribers to the service.  However for its next show it’s decided to go after an already established fan base.  It’s producing 10 new episodes of the show Arrested Development.  Like Community, which I wrote about here, Arrested Development has an established, loyal fan base that could be tempted to sign up for a Netflix account to view the shows.  Other properties that Netflix was considering, like Terra Nova, did not.  There is even talk about reviving Firefly on Netflix (please oh please!)

When the second season of Lilyhammer comes out next year, I’ll probably watch it.  Hey I’m invested in the story now and want to see where it goes, but I don’t think the potential audience for a show like this is particularly big.

That’s why it’s on Netflix.

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My TV Season Sitcom Wrap Up

Last fall, I wrote about my expectations for the new TV season here and here.  Now that the season finales are all wrapped up I thought I would go over the shows I initially reviewed to see how the shows, and my comments on them, panned out.  I’ll go over the freshman shows at a later date.

The Office:  With the departure of Steve Carrell I still had high hopes that the show would continue putting out the same high quality comedy even though the departure of its main star forced the show to switch gears.  As I said last fall…

Although I have been a loyal Office fan, I admit that my interest has waned a bit the past few seasons.  I mean, how long are they going to film this documentary?  But the addition of James Spader’s Robert California has breathed new life into the show.  Spader showed up in last year’s season finale as an interviewee to replace Michael Scott as Manager.  The couple of minutes of screen time was so compelling, that I would consider it Emmy worthy.  Truly, great acting as Spader’s character shows himself so supremely confident that he intimidates the search committee into selecting him.  As the new season opens Jim’s to-the-camera interview reveals that Robert California immediately drove to Florida and talked the CEO out of her job, a concept that seems totally plausible given how Spader is portraying the character.  I think James Spader is a great addition to the show, and actually may have been the only direction the show could go into that would continue to make The Office worth seeing.

So what happened?  I lost interest.  Spader was not on the show frequently enough to retain my interest, and I stopped making the show a “must see” program.  From what I’ve heard from other Office fans, my opinion is fairly widely shared.  Andy (Ed Helms) taking over as manager struck me as kind of a clunker.  Although the character is entertaining in small bites, I never was enamored with the character and couldn’t care less about his relationship with Erin.  Maybe that’s just me though since the show will be back next fall.  Perhaps my mood will change by then.

The Big Bang Theory:  My theory that Leonard and Penny would get back together panned out, although in extreme slow motion.  I’m not sure a couple who had been together, broke up for over two years, and then got back together would actually get back in such careful, baby steps, and in such a totally unromantic way that these two did, however the romance/non-romance of Leonard and Penny is one of the key building blocks of the show, so if you really want to stretch it out over several episodes, this is the way to do it.

Otherwise the general quality of the show remains strong and entertaining and I’m enjoying the budding romance, if that’s what it is, between Sheldon and Amy Farrah Fowler (Mayim Bialik).  Although they have been technically dating for two seasons, the relationship has only been one of convenience, to keep both of their parents off their backs.  However now Amy Farrah Fowler (for some reason it feels more natural to use her full name) wants to bring that relationship to the next level via B.F. Skinner-like operant conditioning.  I can see that some fans might have some hesitation that a real romantic relationship for Sheldon could change the character, but my gut feeling is that even aspies need love too and a Sheldon romantic relationship could work.  We’ll see how this plays out next season.

Two And a Half Men:      Since I wasn’t a regular viewer of the show, I probably wouldn’t have even commented on it other than the very public mental breakdown (what else would you call it?) by Charlie Sheen, that lead to him being fired from the show.  It was still a popular moneymaker so CBS wanted to continue it, adding Ashton Kutcher to the cast, in what I felt was as TV-plausible way to integrate him into the cast as possible without hiring some prize winning novelists to carefully craft a high concept season opener.  But high concept isn’t what this network show is about.  Still, it’s not the same show, and the ratings for this show have been steadily declining all season.  Not declining so much that this show won’t be back next fall. But I doubt if it can eek out any more seasons after that, and that’s probably for the best.

Community:  Community is of course my absolute favorite sitcom.  It follows in the tradition of Arrested Development in that the show has a sometimes sophisticated and complicated storyline, requiring the viewer to actually pay attention, and has lots of Easter eggs that will pay off several episodes later.  Also, like Arrested Development it suffers from perennially low ratings.  That’s to be expected of course.  A majority of people are not interested in paying close attention to a sitcom.  They’re popping popcorn in the microwave, and fielding homework questions from the kids at the same time.

The low ratings lead to Community being taken off the air in November of last year until finally returning to the schedule in March after a fan protest.  When the show returned in March, it was evident to me that the producers had already decided that they were probably going to be cancelled.  I mean nobody; NO BODY does a parody of Ken Burn’s Civil War unless they know this is their last hurrah.  That episode, awesome as it was, would have been totally impenetrable to an outsider.  And that’s the problem with Community, and similar shows like it.  At a certain point, the inside jokes, self references, and knowledge of the characters become so obtuse that only a hardcore fan would get the jokes.  Any casual user would be flummoxed.  I’m not the only one who’s made this observation.  It’s a real problem for a struggling show trying to attract an audience.  What new audience could sit down to watch an episode like Virtual Systems Analysis, and have any idea of what was going on?  The average guy sitting down on his couch to channel surf would have not understand this episode in the least.  If they were familiar with Star Trek: The Next Generation’s holodeck, they might understand what the Dreamatorium is supposed to be, but the finally detailed psychological profile that the show has built up on Abed for three seasons would be incomprehensible.  And the fantastic acting by Danny Pudi would probably go unnoticed.  Pudi played not only several versions of his own character Abed, but a version of Jeff Winger, not as he was, but as Abed imagines him to be.  That’s not only heavy writing, but heavy acting.  If you know what he was trying to do.

In spite of Community trying to sabotage itself for the last part of the season by doing some of the most brilliant avant garde  comedy on television, it got picked up for another season for a 13 episode order.  How the show can push the envelope any more than it already has I don’t know, but I’m perfectly willing to watch and see.

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