Eating more while getting thinner

Russ - One more thought on this...I was listening to a great podcast from one of my favorite ecnomists this morning. He discussed trade. He explained how trade is a positive sum game rather than a zero sum game.

It seems that if we apply that positive sum game to medical care, we may just be able to lower costs and make it available to everyone (who wants it). Or am I missing something?

A lot of comments are saying that it is presumptive of Russ to assume that lowering costs and expanding coverage are in contradiction. I think the point is that President Obama is the one being presumptive assuming these things are not in contradiction. For one thing, Russ's assumption falls harmlessly to the ground whereas President Obama's aassumption will be forced upon people.

Secondly, Russ's assumption follows logic that is simple enough for a five year old to understand: more things cost more money. Even if you agree with Obama's belief that more coverage will cost less money, the underpinning logic should at least raise a furrowed brow. Of course, if you believe that Obama's assertion is true, you neccesarily have to believe that Obama has access to a limited source of superior knowledge. In which case, you should be able to understand why all us simpletons who disagree with you don't believe it when a politician says we can have more for less.

I really just wanted to listen (read) to an explanation of the assumption, hopefully so I can understand his position a bit better. Thanks txslr for explaining this position.

Wow, what an encouraging post. Thanks for encourage open questioning.\sarcasm

Professor Roberts very clearly implies the mutual exclusivity of "lowering health-care costs for businesses and individuals and expanding coverage to the uninsured."

By the way, more things do not equal more cost when you are talking about the total cost coverage. The number of participants is not relevant when one examines the total cost of a self-funded insurance plan. By "plan" in insurance terminology, one is not referring to an individual policy; rather, one is referring to the overall group of policies bundled and offered to a particular group of employees and funded by those employees. Two self-funded plans can have the same overall cost but have differing numbers of individual policies offered, which is why one might say that an individual's choice to do reduce personal costs can also reduce the total cost of the plan and therefore reduce the cost to the business, which might share in a percentage of the overall plan cost.

Matt,

It is obvious that increasing demand aught to lead to an increase in price. The problem is that the entire debate has been framed under an average premium cost rhetoric. My point wasn't so much that Prof. Roberts is making incorrect assumptions, but that he isn't even speaking the same language that healthcare reform proponents are speaking. I once went to a city meeting were my representative, Peter DeFazio, was espousing the virtues of increasing coverage. I asked him to explain how ostensibly increasing demand could possibly lead to price decreases, and he pretty much gave my account of risk pooling lowering average premium costs.

I think we are splitting non-existent hairs here (something I would know about, being that I'm as bald as a cue ball). Increasing coverage and and lowering costs are in direct conflict, but they aren't mutually exclusive. If something else occurs (individuals directly bear the marginal cost of the services they receive), it might happen. Whether or not health care spending goes up or down in such a system might also be irrelevent. If it reflects the choices people are making with their own money, how can we reasonably conclude that the total amount spent is "too large"?

On the other hand, how it is that the administration figures that they are going to lower the cost of health care for businesses confuses me. The amount of total compensation that one receives for the provision of labor is determined in the labor market. Your employer pays a portion of it in healthcare because they are incented by the tax code to do so. If they are no longer incented to do so, I would expect them to stop providing health insurance but to increase your cash compensation by a very similar amount. The total cost of labor should come out about the same.

Prof. Roberts I'm not sure the compatibility you cite necessarily exists in the way some people envision the insurance issue. One way to expand coverage and reduce costs (I assume some confusion as to what costs we are talking about arises here) is to add healthier people to risk pools. Being that a large portion of the unisured are young, by adding them to the system (probably through some payroll tax) we would reduce premium costs. So, ostensibly we can cover more people and lower premium costs. Twisted logic perhaps, but I suspect that is what is in mind. Unfortunately, I think premium costs are the only thing Obama is considering here.

Dear Professor Roberts,

While I appreciate your perspective and insight, I have to wonder if this post is based on an assumption. Ultimately, isn't cost reduction (in the long term) also a cost reduction for the business? I'm not really certain as to why those two things seem like they can't go together. For instance, I would want to reduce my medical costs by maintaining a health weight, blood pressure, and blood sugar in addition to normal mobility. Wouldn't this route also be monetarily beneficial for my employer in that I would use less medical services even under extended coverage (thus reducing the total cost of a self-funded, employer-provided health insurance plan), take fewer sick days and be more productive?

Unfortunately, Obama continues focusing on health insurance instead of health care, but if we were actually focusing on *health care*, then it would seem as though both individual and business goals, in addition benefits are compatible and we wouldn't really have to discuss this as a kind of zero sum game.

Russ - After overcoming my weight problem about 10 years ago, I found that eating more is an unintuitive secret to weight loss. The tricks of eating more is of what and how often. So, I'm not sure that's best analogy. But, I understand your point.

However, I also agree the other commenters. This is a great example where Republicans and Democrats want the same result, but have vastly differently approaches to getting there.

Freer health care markets can achieve the goals much better than coerced fiction.

These "core goals" are compatible provided he decreases the average cost of insurance per insured person. The consequences of that may be unfortunate. But unfortunate is not impossible. On the contrary, unfortunate happens all the time!

While I think it's worth acknowledging that the mandate is going to raise costs, I think you're wrong to make a blanket statement that these goals are in direct conflcit with one another. We know the uninsured use more expensive services (ie, emergency room) precisely because they are uninsured. We know that failing to take preventative measures (also common for the uninsured) makes care more expensive. There are complications to work out in the plan itself - as there are in any plan. And some facets, like the mandate, are completely counterproductive. But that doesn't mean that expanding coverage and lowering costs are contradictory.

You're acting as if the market for insurance (the coverage question) and the market for health care (the cost question) are the same market, so that expanding quantity has to raise prices. They're not the same market - insurance and care are two different things. And there's good reason to think that a broad, well functioning insurance market can lower costs in the market for care.

We know the uninsured use more expensive services (ie, emergency room) precisely because they are uninsured. We know that failing to take preventative measures (also common for the uninsured) makes care more expensive.

I don't know who this "we" is but you know very little.

In places where HMO's are common, emergency rooms are stuffed to the gills with people who are insured. Why? Because it takes forever to get into a doctors office as a result of the overuse problem.

It is common for both the insured and uninsured to not take "preventative measures". If you are morbidly obese and don't lose weight, you're not "taking preventative measures". By the time medical intervention is necessary, it's managing your condition with meds instead of the much more effective lifestyle changes you refuse to make and that costs more, not less. Further, compliance with medical intervention is abysmal even for people with insurance. Non-compliance usually leads to more expensive treatments further down the road. Non-compliance is the bain of physicians' professional existence.

I realize you're as resistant to learning new things as your buddy Muirdiot, but this is at least the 3rd time you've trotted out these falsehoods.

It's also pretty obvious you have no idea how insurance functions. Good work on the obvious attempts to protect yourself with platitudes like "well functioning insurance market" so that you can take whatever side of the argument most convenient for you. However, there is nothing in the current bills which actually makes the insurance market more efficient. Nothing in the bill allows for portability of insurance or increases choice for the consumer. In fact, the government has already destroyed the insurance market for consumers and the bill destroys it further.

RE: "In places where HMO's are common, emergency rooms are stuffed to the gills with people who are insured. Why? Because it takes forever to get into a doctors office as a result of the overuse problem. "

Right - I didn't say insured people don't use the emergency room. I just said that uninsured people do. Besides, I think of "expanding coverage" not just in terms of making uninsured people insured - but providing better/more appropriate coverage for people who are already insured.

Re: "It is common for both the insured and uninsured to not take "preventative measures"."

Again, I hope you're not misinterpreting me. Of course both insured and uninsured fail to take preventative measures. One important factor in taking preventative measures, though, is having insurance.

RE: "However, there is nothing in the current bills which actually makes the insurance market more efficient."

I tentatively agree. The discipline of a public option MAY help make the insurance market more efficient, but any gain is going to be swamped by the inefficiencies introduced by the mandate.

Again, I hope you're not misinterpreting me.

Oh, God forbid.

There is very little evidence that preventative care reduces costs; and most of the people in ERs are people with medicare/medicaid. The fact of the matter is that the uninsured make up a very tiny amount of health care costs in the U.S. (the reasons for this are obvious with anyone with 1/4 of a brain - a large number of the uninsured are healthy, young people after all).

It may not reduce costs but does it raise outcomes relative to the cost, and are the costs reasonable? A seatbelt certainly raises the cost of a car, and it reduces your odds of dying behind the wheel. Do you really complain that you'd rather buy a car without a seatbelt because its keeping the cost of the car too high?

I don't know about "very little evidence", but yes. I've suggested myself on here that preventative could conceivably raise costs (dying from a heart attack seems to cheaper to me than having an extended old age). I got attacked for suggesting that, probably by the same people who will attack me now for suggesting that prevention can also lower costs :) I would guess ultimately it depends on what kind of prevention we're talking about.

The point is there's nothing dictating that having more insured people will mean more expensive care, as Russ suggests. A well functioning insurance market should help lower the costs of care. This is what markets do - they efficiently allocate resources so that over time you do see more quantity for a lower price. I'm not sure why Russ is suggesting these things contradict.

Look at a supply and demand graph. If you force the demand curve over you will by definition push prices up. If everyone has to buy insurance, than insurance companies will charge more. If you fix insurance companies pricing then true costs will never be known, the market will lose tons of information, people will become ignorant and behave irrationaly. How will this translate to the market? Nobody knows. If free markets are guided by the invisible hand, then government intervention causes an invisible back-hand. We'll never see it coming.

Supply and demand is most useful when you're talking about a single market - not two markets, like Russ is discussing here. But yes, that logic is obvious. The point is also in a consideration of long-term prices and consumption (I assume we're not just concerned with what premiums we'll be paying next month or how healthy we'll be next month... I personally am thinking about how these questions are going to play out in my life over the next several decades). Markets produce goods efficiently and select efficient producers. There's no long term negative trade-off between output and price in the way you describe.

I like "an invisible back-hand" :) I may borrow that one

There is very little evidence ... the whole preventative medicine deal is an undemonstrated meme.

"The point is there's nothing dictating that having more insured people will mean more expensive care, as Russ suggests. A well functioning insurance market should help lower the costs of care."

If you think that a well functioning insurance market will be the result of this, I have some ocean front property to sell you in Arizona. Russ' argument is IMHO based on a number of premises which are easy to surmise; that's why your argument is so silly.

So forcing insurance companies to accept people who are uninsured after they get sick won't raise cost for the rest of us?

Of course it raises costs for the rest of us. Who said it doesn't?

You on Obama's position as "getting more people insured." The only way he accomplishes much of this is to force uninsurable people to be insured upon demand.

As several others have already pointed out, the President's two "core goals" are NOT in direct conflict with each other. If the government were to unleash the free market in the health care sector, costs would go down AND more people would buy health insurance (because it would be cheaper and offer better conditions than at present). Similarly, if the government took over the entire health care sector and rationed medical care Soviet-style, it would theoretically be possible to "cover" everyone AND to lower costs, but this kind of a system would have to sacrifice quality (and freedom) in order to achieve the coverage and cost goals. It is only this socialist-corporatist Obamacare proposal that wouldn't be able to accomplish his two "core goals".

We already have socialized medical care -- we really should put that issue to rest. We currently socialize care through cost-shifting -- and while it's a lot less than transparent, it does work. Like all cost-shifting, the burden is put on those that can pay, won't notice, or won't complain. Those who pay don't complain because they have immediate access to health care. All Obama really intends to do is take away the line pass currently granted to those who pay the bills.

The people who pay the bill did notice and they did complain. The rest of it is BS.

Great point. Like all statist plans, this “core goal” is a house divided against itself. How can anyone imagine, for example, that jobs are generated by extracting funds from one segment of society and donating them to another? Or that prosperity can be purchased on the installment plan and through ever-increasing deficits, when the government cannot even come up with the down payment?

You can eat a heck of a lot more and get thinner if you chose celery over french fries... likewise choosing doctors, nurses, and care providers over paying CEO's, administrators, shareholders, claims and care deniers for health care expenditures.

I was gonna say, see nuance separates the concrete libertarian thinker from the real world pragmatist but heck this isn't even a matter of nuance. It's pretty straight forward common sense. But even that has a hard time with micro-filtrating ideological principles.

"... likewise choosing doctors, nurses, and care providers over paying CEO's, administrators, shareholders, claims and care deniers for health care expenditures."

The 'health care bill' doesn't do anything but require more payments to CEOs et al. by requiring everybody to by insurance, but it adds government bureaucrats to your list of parasites.

Explain how requiring everybody to buy insurance has anything to do with choosing doctors, nurses and care providers. I think the missing nuance is with progressives who can only see solutions through the guns of government. It doesn't take a lot of common sense to see that pointing guns at people has little to do with liberty and everything to do with tyranny, no matter what the goals.

Do you genuinely believe there are any progressives left that support the currently proposed reforms ?

I seem to recall an example from _The Choice_ in which the cost of televisions fell while quality rose. Incompatible goals? Hardly.

Clearly it is possible to provide more for less, the market accomplishes this all the time.

So, while it might be useful to point out the contradiction between Obama's goals I think it would be even more useful to explain how and why the market is able to get around the apparent paradox.

It can work if quality is allowed to fall enough.

Or he could pick goals that are within his purview as outlined by the U.S. Constitution?

Russ,

You might win the hearts and minds of more leftists if you took a minute to explain why only the free market allows those two goals to occur simultaneously (after all, we don't have expensive food because everyone has "access" to it), whereas it is the government provision of these things that causes them to be rivalrous (government is non-productive and non-competitive).

I'm not a leftist, this is just something that stood out to me when I read this post. I agreed with it but I understood that which was implied... many who are less familiar with free markets might not, and as a result this will seem callous and "conservative" to them and thus easily derided and ignored.

Isn't food highly subsidized?

This reminds me somewhat of the way the two core goals of labor unions come into conflict with the law of demand:

1) higher wages for union workers and 2) greater job security for union workers.

Unions predictably pursue policies that reduce the elasticity of demand for union workers (like reducing the viability of subsitutes for union labor).

Where you and I differ with Mr. Obama is that we consider taxes "costs", whereas he considers them "revenue".

Using this definition, his goals can certainly be aligned.

I don't think those are incompatible. Unfortunately for us peons, the political class has no stomach to actually accomplish the task, as it would rid us of the fallacy of a safety net. Basically, it would require removing DC from the equation.

He can do this if quality drops.

you can actually eat a lot more and get thinner. You just can't eat a lot of the things you like.

I'm taking you too literally. But, you can increase the amount of health care provided (which is what Obama says he wants) and also lower the cost of health care provisioning (which is also what he says he wants). But, it would mean standing aside and allowing the market to meet demand unmolested by government. That's precisely the opposite of what Obama wants and that's what makes those "core goals" (or is that "corpse goals, commander in chief"?) so incompatible.

The health care bill has absolutely nothing to do with health care. The "core goal" is a tax increase and a government power grab, pure and simple.

Objectivist professor John Lewis actually read the entire healthcare “reform” bill that was passed by the House. You can read his analysis of what it says here: http://www.capmag.com/article.asp?ID=5668

At the end of his analysis, Professor Lewis gives us a helpful list. If you have any doubt about what Methinks has written -- namely, that this “reform” bill is a naked power grab, i.e. a vast expansion of government’s control over our lives -- just peruse the list that Professor Lewis has compiled showing the new boards, committees, programs, centers, councils, administrations, exchanges, funds, etc created by the House bill:

1. Retiree Reserve Trust Fund (Section 111(d), p. 61)
2. Grant program for wellness programs to small employers (Section 112, p. 62)
3. Grant program for State health access programs (Section 114, p. 72)
4. Program of administrative simplification (Section 115, p. 76)
5. Health Benefits Advisory Committee (Section 223, p. 111)
6. Health Choices Administration (Section 241, p. 131)
7. Qualified Health Benefits Plan Ombudsman (Section 244, p. 138)
8. Health Insurance Exchange (Section 201, p. 155)
9. Technical assistance to employees of small businesses buying Exchange coverage (Section 305(h), p. 191)
10. Insurance risk pooling to be established by Health Choices Commissioner (Section 306(b), p. 194)
11. Health Insurance Exchange Trust Fund (Section 307, p. 195)
12. State-based Health Insurance Exchanges (Section 308, p. 197)
13. Grant program for health insurance cooperatives (Section 310, p. 206)
14. Public Health Insurance Option (Section 321, p. 211)
15. Ombudsman for Public Health Insurance Option (Section 321(d), p. 213)
16. Account for receipts and disbursements for Public Health Insurance Option (Section 322(b), p. 215)
17. Tele health Advisory Committee (Section 1191 (b), p. 589)
18. Demonstration program providing for culturally and linguistically appropriate services (Sec 1222, p. 617)
19. Demonstration program for shared decision making using patient decision aids (Section 1236, p. 648)
20. Accountable Care Organization pilot program under Medicare (Section 1301, p. 653)
21. Independent patient-centered medical home pilot program under Medicare (Section 1302, p. 672)
22. Community-based medical home pilot program under Medicare (Section 1302(d), p. 681)
23. Independence at home demonstration program (Section 1312, p. 718)
24. Center for Comparative Effectiveness Research (Section 1401(a), p. 734)
25. Comparative Effectiveness Research Commission (Section 1401(a), p. 738)
26. Patient ombudsman for comparative effectiveness research (Section 1401(a), p. 753)
27. Q/A and performance improvement program for skilled nursing facilities (Section 1412 (b)(1), p. 784)
28. Q/A and performance improvement program for nursing facilities (Section 1412 (b)(2), p. 786)
29. Special focus facility program for skilled nursing facilities (Section 1413(a)(3), p. 796)
30. Special focus facility program for nursing facilities (Section 1413(b)(3), p. 804)
31. Independent monitor pilot program for skilled nursing facilities and nursing facilities (Section 1422, p. 859)
32. Demonstration program for approved teaching health centers for Medicare GME (Section 1502(d), p. 933)
33. Pilot program to develop anti-fraud compliance systems for Medicare providers (Section 1635, p. 978)
34. Special Inspector General for the Health Insurance Exchange (Section 1647, p. 1000)
35. Medical home pilot program under Medicaid (Section 1722, p. 1058)
36. Accountable Care Organization pilot program under Medicaid (Section 1730A, p. 1073)
37. Nursing facility supplemental payment program (Section 1745, p. 1106)
38. Demonstration program for Medicaid medical conditions for mental diseases (Sec 1787, p. 1149)
39. Comparative Effectiveness Research Trust Fund (Section 1802, p. 1162)
40. Identifiable office or program for coordination between Medicare and Medicaid (Section 1905, p. 1191)
41. Center for Medicare and Medicaid Innovation (Section 1907, p. 1198)
42. Public Health Investment Fund (Section 2002, p. 1214)
43. Scholarships for service in health professional needs areas (Section 2211, p. 1224)
44. Program for training medical residents in community-based settings (Section 2214, p. 1236)
45. Grant program for training in dentistry programs (Section 2215, p. 1240)
46. Public Health Workforce Corps (Section 2231, p. 1253)
47. Public health workforce scholarship program (Section 2231, p. 1254)
48. Public health workforce loan forgiveness program (Section 2231, p. 1258)
49. Grant program for innovations in interdisciplinary care (Section 2252, p. 1272)
50. Advisory Committee on Health Workforce Evaluation and Assessment (Section 2261, p. 1275)
51. Prevention and Wellness Trust (Section 2301, p. 1286)
52. Clinical Prevention Stakeholders Board (Section 2301, p. 1295)
53. Community Prevention Stakeholders Board (Section 2301, p. 1301)
54. Grant program for community prevention and wellness research (Section 2301, p. 1305)
55. Grant program for research and demonstration projects for wellness incentives (Section 2301, p. 1305)
56. Grant program for community prevention and wellness services (Section 2301, p. 1308)
57. Grant program for public health infrastructure (Section 2301, p. 1313)
58. Center for Quality Improvement (Section 2401, p. 1322)
59. Assistant Secretary for Health Information (Section 2402, p. 1330)
60. Grant program to support the operation of school-based health clinics (Section 2511, p. 1352)
61. Grant program for nurse-managed health centers (Section 2512, p. 1361)
62. Grants for labor-management programs for nursing training (Section 2521, p. 1372)
63. Grant program for interdisciplinary mental and behavioral health training (Section 2522, p. 1382)
64. No Child Left Unimmunized Against Influenza demonstration grant program (Section 2524, p. 1391)
65. Healthy Teen Initiative grant program regarding teen pregnancy (Section 2526, p. 1398)
66. Grant program for interdisciplinary training, education, and services for autism (Section 2527(a), p. 1402)
67. University centers for excellence in developmental disabilities education (Section 2527(b), p. 1410)
68. Grant program to implement medication therapy management services (Section 2528, p. 1412)
69. Grant program to promote positive health behaviors in underserved communities (Section 2530, p. 1422)
70. Grant program for State alternative medical liability laws (Section 2531, p. 1431)
71. Grant program to develop infant mortality programs (Section 2532, p. 1433)
72. Grant program to prepare secondary school students for health care training (Section 2533, p. 1437)
73. Grant program for community-based collaborative care (Section 2534, p. 1440)
74. Grant program for community-based overweight and obesity prevention (Section 2535, p. 1457)
75. Grant program for reducing the student-to-school nurse ratio (Section 2536, p. 1462)
76. Demonstration project of grants to medical-legal partnerships (Section 2537, p. 1464)
77. Center for Emergency Care (Section 2552, p. 1478)
78. Council for Emergency Care (Section 2552, p 1479)
79. Grant program to support demonstration programs for regionalized emergency care (Section 2553, p. 1480)
80. Grant program to assist veterans who wish to become EMTs (Section 2554, p. 1487)
81. Interagency Pain Research Coordinating Committee (Section 2562, p. 1494)
82. National Medical Device Registry (Section 2571, p. 1501)
83. CLASS Independence Fund (Section 2581, p. 1597)
84. CLASS Independence Fund Board of Trustees (Section 2581, p. 1598)
85. CLASS Independence Advisory Council (Section 2581, p. 1602)
86. Health and Human Services Coordinating Committee on Womens Health (Section 2588, p. 1610)
87. National Womens Health Information Center (Section 2588, p. 1611)
88. Centers for Disease Control Office of Womens Health (Section 2588, p. 1614)
89. Agency for Healthcare Research and Quality Office of Womens Health Research (Section 2588, p. 1617)
90. Health Resources and Services Administration Office of Womens Health (Section 2588, p. 1618)
91. Food and Drug Administration Office of Womens Health (Section 2588, p. 1621)
92. Personal Care Attendant Workforce Advisory Panel (Section 2589(a)(2), p. 1624)
93. Grant program for national health workforce online training (Section 2591, p. 1629)
94. Grant program to disseminate best practices on implementing health workforce (Section 2591, p. 1632)
95. Demonstration program for chronic shortages of health professionals (Section 3101, p. 1717)
96. Demonstration program for substance abuse counselor educational curricula (Section 3101, p. 1719)
97. Program of Indian community education on mental illness (Section 3101, p. 1722)
98. Intergovernmental Task Force on Indian environmental and nuclear hazards (Section 3101, p. 1754)
99. Office of Indian Mens Health (Section 3101, p. 1765)
100. Indian Health facilities appropriation advisory board (Section 3101, p. 1774)
101. Indian Health facilities needs assessment workgroup (Section 3101, p. 1775)
102. Indian Health Service tribal facilities joint venture demonstration projects (Section 3101, p. 1809)
103. Urban youth treatment center demonstration project (Section 3101, p. 1873)
104. Grants to Urban Indian Organizations for diabetes prevention (Section 3101, p. 1874)
105. Grants to Urban Indian Organizations for health IT adoption (Section 3101, p. 1877)
106. Mental health technician training program (Section 3101, p. 1898)
107. Indian youth telemental health demonstration project (Section 3101, p. 1909)
108. Program for treatment of child sexual abuse victims and perpetrators (Section 3101, p. 1925)
109. Program for treatment of domestic violence and sexual abuse (Section 3101, p. 1927)
110. Native American Health and Wellness Foundation (Section 3103, p. 1966)
111. Committee for the Native American Health and Wellness Foundation (Section 3103, p. 1968)

I believe that virtually everything on the “laundry list” authorizes government to do something it is not presently doing or is not presently authorized to do.
That makes everything on the list an increase in government’s power.

Some of these increases in power may be trivially small. Some may be temporary. But others are sweeping.

In my opinion, the actual "power grab" is far, far greater than what this list implies.

To get a sense of this, go to the bill itself, which is here:

http://docs.house.gov/rules/health/111_ahcaa.pdf

Open the "Full Reader Search Function" from the pull down menu adjacent the "Find" box at the top of the page. Do a search on the two word phrase, “shall establish”. The search will give you a list of 138 instances of that phrase in the bill. Click on each instance of the phrase and you will see what the bill says.

It seems that in virtually all 138 cases, the bill is granting significant new powers to either the Secretary of Health and Human Services or the Health Choices Commissioner -- it is granting them the power to write many thousands of pages of new regulations, every one of which will have the force of law.

Now do a search on the phrase “carry out“. You will get a 168 hits. Click on some of them to see what the government is being authorized to “carry out”.

For fun, do a search on the word “established”. Peruse the 249 instances in which the bill refers to what is to be “established” by government in this bill.

Yes, there is doubtless some overlap wherein “shall establish”, “carry out” and “established” are all used to refer to one new grant of power. But even allowing for such overlap, this bill is indeed a massive expansion of government power and a corresponding reduction in our freedom. It is a giant step down the road to serfdom.

First, a lot of these seem to just be revisions to existing boards and committees, as I understand it. Are all of these new?

Also, a lot just seem to be grants. That's not really a "power grab" - it's just how they're getting the money out. So?

I don't understand why everyone is always so fascinated with these laundry lists. What does this MEAN michaelsmith? How many of these are just titles of funds to spend money? Would you be happier if the exact same amount of money was spent, but it was all distributed out of one fund (that alone would probably cut your list in half)? How many of these boards just meet semi-annually? How many have real power over our lives - vs. committees that a few volunteers meet for every once and a while to submit bullet-point suggestions to Congress? I don't know - I have a hard time getting worked up over laundry lists.

Also, what is an "objectivist professor"? Is that like a professor in an Ayn Rand Studies department?

Is it possible or even worthwhile for the average person to investigate this nonsense? What use are laws that a full 99% of the population does not remotely understand, other than to enrich those who write them.

"I don't know - I have a hard time getting worked up over laundry lists."

Say only 1/4 of these entities are new and would have real power ... that would be something to get worked up over. But as you state, you haven't clue one about what is involved in this, and that should at the least pique your curiosity.

I count 14 "Demonstration" programs and 7 "Pilot" programs which clearly indicates that these are meant to be ramped up in future years.

Of course just because a program does not have the words "demonstration" or "pilot" in the name doesn't mean anything. We can count on all the petty bureaucrats running these organizations to all make great plans to expand their organization's power and spending in future years. How else would they advance their careers?

This bill is just a sour taste of what is to come.

That made me sick to my stomach. Maybe I can be cured by these bureaucratic committees who are making decisions entirely in my interest.

Sometimes sometimes it
makes no sense that a man can
be so very clueless

Well he's certainly no Sarah Palin.

More's the pity.

No. Even Sarah Palin knows the difference between a "corpseman" and a corpsman.

TOTUS (Teleprompter of the United States) 2.0 will be upgraded with phonetic spelling. Kormin.

I don't think TOTUS knows he's about to be replaced!

http://baracksteleprompter.blogspot.com/

Love it.

Thank you for your kind words.

I wrote them on my hand so I could remember them. Yes kindness.. the kind that says The President can redeem himself if he plays the war card and bombs Iran...

Don't mistake me for a Palin fan, I'm not, but at least she wrote her own notes instead of reading something off a teleprompter written by someone else.

I'm not really sure you can verify the source of Palin's speeches one way or another.