On the proverbial eve of the critical vote on health reform, here are some assorted thoughts and observations, Thomas Sowell-style. In no particular order:

1. When lawmakers list the intended effects of a proposal instead of describing the actual controls and regulations, you can bet that the bill will have serious unintended consequences. Don't tell me that a bill will reduce costs; tell me what changes it makes to current law, and I'll judge for myself what the effect will be.
2. According to preliminary numbers from the Congressional Budget Office, health reform will cost an estimated $940 billion. I'm sure we will see people proffer calculations of what that comes to for every man, woman, and child in the nation. But remember to multiply that figure by about two in order to get your share, because over 40 percent of Americans pay no income tax.
3. Advocates of big government believe they have scored a point when they say, "Some people just don't believe government is capable of doing anything complicated" and then list examples such as the U.S. Marines and the Apollo moon landing.¹ Do they really believe the facts would be in their favor if a full survey of government activity were undertaken?
4. The alleged moral argument for universal healthcare comes and goes based on political expediency. At first it was the main message. Then it faded with the rise of the Tea Party movement, which appealed to Americans' sense of independence and self-reliance. Then it reappeared in September when the Democrats had nothing else to offer. Eventually they set it partially aside and tried to argue that if we don't do something, then insurance premiums will continue to rise. Perhaps we can interpret their current approach as meaning they recognize the need to appeal to the rational self-interest of voters. That would be change.
5. I know practically nothing about Representative Jason Altmire (D-PA), but based on a handful of television interviews over the past three weeks, he appears to be a fairly reasonable and decent Congressman. At present, he is undecided, but he has made it clear that he will vote against the bill if it resembles what the Senate passed. If Altmire ends up supporting the bill, it will be a surprise—unlike the Dennis Kucinich turnabout, which should have surprised no one.
6. How would President Obama answer if someone asked him, "What would Americans have to do in order to convince you that they do not want your health reform bill?" The Tea Parties weren't enough. Town Halls weren't enough. The election of a Republican to finish serving Ted Kennedy's Senate term wasn't enough. What if we stood on our rooftops and held signs—how many signholders would be sufficient?
7. No matter what the parliamentary rulebook says, if you need your opposition to tell you that using the Slaughter Rule violates Americans' common-sense standard of what is right, then your stint in public office probably ought to come to a close.
8. The same people who advocate taxpayer-funded incentives for "healthy lifestyle decisions" also support disassociating risk from insurance pricing through community rating. Wouldn't risk-based pricing be the best incentive of all, and spare us all the IRS middleman?
9. Protectionist groups such as the AMA and AHA may be large and powerful, but independent-minded doctors who take the time to write articles, blog, and send letters can neutralize a great deal of the lunacy and turn the tide to boot. We need more. (E.g., Wolf, Hsieh, Madianos, Haynes, Hennenfent). Many more. [UPDATE: One way to get more doctors on our side is to support The Lucidicus Project! We give away self-defense kits to med students.]
10. Whatever his personal appeal to some people, Mitt Romney is going to have a difficult time convincing voters of the wisdom of Romneycare in Massachusetts. He will have a big problem if the national bill is defeated, and a bigger one if it passes.
11. I fear that under socialized medicine, it will be primarily the older doctors who will decide to quit. The younger ones coming out of the universities have been trained to be self-sacrificial, but that doesn't make a good doctor. In five years, your primary care physician could be essentially a social worker.
12. President Obama said at the March 2009 summit that "The status quo is the one option that is not on the table."² How does putting government officials in charge of medical decisions, forcing people to buy government-approved insurance, and auto-enrolling people into government programs do anything but entrench the status quo?
13. A good test of a person's values these days is to bring up the Tea Party movement. Certainly not everyone has to agree with the Tea Parties, but if your acquaintance seriously calls them "astroturf" or uses the "teabag" epithet, then run the other way. You can gain nothing from dealing with a person operating on that level of evasion.
14. If an organization conducts a survey and asks people "Do you want health reform?", how can they possibly not follow up with a question about what kind of reform that person wants? There are two directions, you know.
15. Empirical studies show that penalties (e.g., instituting a tax on soda) are more effective at changing consumer behavior than incentives (e.g., subsidizing the purchase of fruits and vegetables). So what. Rights are a moral concept. Your studies don't trump everyone else's rights.
16. Politicians on both sides repeatedly mistake seniors' protectiveness over Medicare for philosophical approval of the program. If I were 75 and had been forced to pay into the program for 45 years, I would oppose cuts, too. If the government breaks my leg and then hands me a pair of crutches, I'd be a martyr to refuse. But that doesn't mean we can't start phasing it out over the next few decades.
17. Seven voter characteristics off the top of my head that probably correlate quite highly with disapproval of Obamacare: a) being a taxpayer, b) having a job, c) having a family, d) having emigrated from eastern Europe sometime in the last 30 years, e) owning a pick-up truck, f) working in a scientific or technological industry, g) being an entrepreneur.
18. Dick Morris may have unparalleled access to insider information, but as far as guest television analysts go, few are as well-informed as Charles Krauthammer and Dana Perino. Krauthammer occasionally bends to the moral crusade of universal coverage, but he is clearly a very smart man (and coincidentally a medical doctor). Perino knows Washington dynamics inside and out and seems uncommonly genuine. (Plus, she supports PETS2VETS.)
19. Hundreds of thousands of people have spent millions of hours over the past year resisting the further expansion of government. It is tempting to view this as wasted time, since these people surely would have spent this time on other productive activities. But values are neither gained nor kept automatically. One must act. Eternal vigilance, remember, is the price of liberty.
20. Requiring people to buy health insurance as part of an "individual mandate" does not make people more responsible. It makes them more helpless, by substituting government instructions for what should be a self-generated, self-motivated personal decision.
21. Most people today—including members of both parties—have no ability whatsoever to see how problems resolve themselves under free markets. Two reasons for this: 1) because real economics is not taught in school, and 2) because nobody alive today has ever experienced laissez-faire. Not even in Hong Kong.

As this is being published, the administration is working diligently to garner enough votes to pass health reform the reconciliation process. An "up" vote could commit the nation to travel further down the road to serfdom, while a rejection of the bill could not only thwart this proposed takeover but also provide momentum for real reform. Let's continue to work to make the latter come true.

____

¹ For example, Holmes, R. "The party of 'No We Can't'" GateHouse News Service, March 8, 2010

² Obama, B. "Remarks Made by the President at the White House Health Summit" March 5, 2009

©2005-2010 The Lucidicus Project, all content unless otherwise noted.