The Lines Have Crossed

For the first time in his presidency, and even more precipitously than Bill Clinton, President Obama's RCP average (a running average of major polls) has dropped into negative territory. The approve vs. disapprove lines have crossed, and he is down to -0.2.

President Obama Job Approval

Polling Data

Poll	Date	Sample	Approve	Disapprove	Spread
RCP Average	3/3 - 3/18	--	47.5	47.7	-0.2
Gallup	3/16 - 3/18	1547 A	47	47	Tie
Rasmussen Reports	3/16 - 3/18	1500 LV	45	55	-10
FOX News	3/16 - 3/17	900 RV	46	48	-2
NBC News/Wall St. Jrnl	3/11 - 3/14	1000 A	48	47	+1
Pew Research	3/10 - 3/14	1500 A	46	43	+3
Associated Press/GfK	3/3 - 3/8	1002 A	53	46	+7

See All President Obama Job Approval Polling Data

As the Los Angeles Times sarcastically noted, this dip could be due to many things, but is most likely connected to the president's obsession with passing a HC bill, any bill, by any means. Interestingly, the RCP Average will probably drop further tomorrow, after today's Gallup Poll results are included. The Gallup Poll reflected in today's RCP Average has an approval tie, but today's Gallup has the president down by -2.

Today's RCP Average also has the general Republican brand up to +1.6 over the Democrats. It looks more and more likely that November will bring a bloodbath.

Tomorrow: a closer look at the recent CBO scoring.

See Nancy .... Pole Vault?

Apparently, Nancy Pelosi thinks that health care reform is an Olympic sport, rather than a very serious reorganization of 1/6th of the economy.

'“It means, we will move on many fronts, any front we can,” Ms. Pelosi said. “We’ll go through the gate. If the gate’s closed, we’ll go over the fence. If the fence is too high, we’ll pole-vault in. If that doesn’t work, we’ll parachute in. But we’re going to get health care reform passed for the American people, for their own personal health and economic security, and for the important role that it will play in reducing the deficit.”'

The two fences she has to surmount are general public opposition, and more specific concerns by various Democratic factions. Even rah-rah cheerleader, Mary Landrieu, took at shot at the president today. Perhaps if the president were to get serious about bipartisanship, they'd have a way forward, but short of that, it seems unlikely that either the Senate or the House bill can pass as written. The latest proposals center around breaking the bills up into manageable pieces, but as Pelosi's first-up piece has nothing to do with decreasing costs or increasing competitiveness, it's difficult to take her seriously.

'Aides said that a first candidate for a stand-alone measure could be the proposal to eliminate the exemption from federal antitrust law that health insurance companies have long enjoyed. Such a proposal was incorporated in the larger House health care bill.'

I wonder which event Pelosi is competing in?

Debt, Deficit and the Health Care Debate

(I apologize for the extended posting delay - multiple ill family members (including myself) kept me away from the laptop along with frantic dissertation work. On to the topic at hand):

I'm refraining from posting anything about Sen. Kennedy. There is more than enough material out there, and it seems more fitting to leave his memory to those who knew him. Instead, we return to a familiar topic at The ModCon, deficit and the national debt, and in particular, their impacts on the health insurance/health care (depending on the week) debate. This post begins a series of discussions between BMG and a more liberal friend who will be posting counter-point (or at least, alternative ideas).

A recent article by David Gergen at the CNN AC360-blog site, was entitled "Deficits: Why they might threaten health reform - and what Obama might do." The implied question - "Can the President win the health reform debate given the dramatically increasing deficit and debt burden?' - is an excellent one. Putting aside the merits of particular aspects to the five bills circulating through the two houses of Congress, the very fact that the deficit and total national debt have grown so dramatically in the last eight months, is a large factor in much of the opposition to the proposals. The heart of Gergen's musings are laid out in four paragraphs:

'Yet even the Bernanke story cannot fully deflect attention from the other economic story engulfing the administration today: its official announcement of new economic projections – in particular, its acknowledgment that deficits over the coming decade will be even higher than it said only three months ago. Now, the administration is predicting that instead of $7 trillion in new deficits, the country will rack up a staggering $9 trillion in new deficits for the 2010-2019 period. (The Congressional Budget Office has published its own numbers today that are largely parallel.). Deficits of that magnitude would be extraordinarily dangerous and irresponsible for the country. They would double the national debt, risk much higher inflation, saddle future taxpayers with annual interest payments of over $900 billion, make us even more reliant upon China as a creditor, and over time would weaken us as a great nation. Talk about trend lines that are unsustainable! ... In view of all this, President Obama has a choice. He can push forward with health reform efforts, giving short shrift to these deficit concerns. If so – if he continues to insist that Washington is just too “wee-weed up” — he will find that some of his strongest allies will become more reluctant on a big health reform bill this year. Or he can come to grips with these grim forecasts and present to the nation a credible, comprehensive plan for reining in long-term deficits before Congress acts on health reform. The second path demands more courage – and is also the one of real leadership.'

The CBO's economic projections for the next decade were grim to begin with, and have been revised further downward over the last month. Spending $1 trillion on overhauling 1/6 of the economy, when the debt has been revised upward to $9 trillion (and the deficit to $1.6 trillion) and within months of TARP 2, the stimulus package and the largest budget in US history, is going to be a tough sell even to supporters.

Many of the Congressional leadership, and in the Administration, seems completely unwilling or incapable of accepting that much of the anger expressed in the Town Hall meetings is not about racism, gasping conservatism, or even plain contrariness, but rather a deep, abiding dislike of governmental creep and stratospheric debt. Dan Gerstein, a former adviser to Sen. Lieberman, recently published a telling article in Forbes.

'In the best-case scenario, the cumulative toll of all this spending and intervening would test most voters' tolerance for another major government expansion on health care. But for many already anxious Americans, it has rapidly resuscitated their skepticism about government and its competence in managing one-sixth of the economy. The fact that so much of what has come out of Congress is every bit as partisan and one-sided as the last eight years is only compounding those doubts--particularly for swing voters.'

The concept that the President and Congress are trying to sell, that one will lower the long-term deficit and debt by increasing government involvement and spending, is ludicrous to most voters. They're well-aware that increasing spending, and increased involvement leads to increasing debt, and therefore the increased need to pay for that debt. There are only two ways to pay the bill: increase taxes, decrease spending. The latter is the principle reason there is so much concern over rationing and a loss of Medicare benefits. The former is already being floated by multiple Administration officials. The more sordid aspects (cronyism and favoritism in particular) of pushing a bill this large are not helping sweeten voter temperaments. Neither is the 'tone-deaf' aspect of the sales pitch coming from the President. Until 'listening' to these real concerns becomes important to the Administration and Congress, the people are going to continue to push back. They desperately need a new tact and fresh ideas; in fact, they should scrap all the current bills under discussion and begin anew. I doubt they have the sense, guts or humility enough to try.

What's Good for the Goose Should be Good for the Gander

Congressman John Fleming (R, LA) is a physician who is a co-sponsor of the 'Empowering Patients First Act,' and of House Resolution 615, a measure to ensure that Congress is required to participate in any health reform plan passed in Congress. You can click on a link (included below) to send a request to your own members of Congress, asking that they agree to House Resolution 615. The website also allows one to view a summary of his health care reform proposal. I encourage you to read the summary of the act, and to send the request to each member of Congress for your state.

From the congressman's website:

THE LATEST UPDATES:

Empowering Patients First Act

We need to bring about changes that make health care affordable, accessible and available to the millions of Americans that want health care insurance, but either can’t afford it or are denied for reasons such as a pre-existing condition.

To address these and other fundamental reforms that are necessary to improve our health care system, Congressman Fleming is proud to be an original co-sponsor of the Empowering Patients First Act.

This bill preserves the important decisions made between an individual physician and the patient and improves the quality of care offered across the country.

This bill contains all the essential elements of good health care reform including expanding private insurance to all Americans who want it, removing pre-existing illnesses, portability, subsidies to the working poor, access to excellent primary and specialty care and lawsuit reform. All of this is accomplished without a government takeover, gutting Medicare, long lines, bureaucrats interfering in the sacred doctor-patient relationship, and it is budget neutral.

Keeping the Truth From the Public

Opponents of a government run take over of health care have put together an organizational chart of what this plan would look like. House Democrats DO NOT want the American people to see this and even constructed roadblocks in approving communication between Republican congressman and their constituents. To view what House Democrats don't want you to see, click here.

There are "Seven Dirty Words" the House Democrats don't want you see when it comes to their health care plan. To view the list, click here.

House Resolution 615

Over the past few weeks, members of Congress and the American people have come to know the details of the Administration's proposed health care plan. Call it whatever you like, I believe this proposal is nothing more than government-run health care. As a physician, I am amazed at the number of bureaucrats in this House who are quick to claim a government-run health care plan is the reform this country needs. In response to this, I have offered a resolution that will offer members of Congress an opportunity to put their money where their mouth is, and urge their colleagues who vote for legislation creating a government-run health care plan to lead by example and enroll themselves in the same public plan.

Under the current draft of the Democrat healthcare legislation, members of Congress are curiously exempt from the government-run health care option, keeping their existing health plans and services on Capitol Hill. If Members of Congress believe so strongly that government-run health care is the best solution for hard working American families, I think it only fitting that Americans see them lead the way. Public servants should always be accountable and responsible for what they are advocating.

Together we will work to ensure that any plan that is good enough for American families is good enough for every member of Congress.

View Resolution

If you would like to download a letter and ask your representative to consider supporting House Resolution 615, click here.

To see a list of Representatives who currently support H. Res 615, please click here.

UPDATED: President's Press Conference on Health Care

Update 1: Text of the President's prepared remarks (prior to questioning) may be found here.

Live blogging President's press conference:

Claims and comments that jump out:

1. The 'Recovery Act' has already saved new jobs and created new ones: where?
2. Investment in green energy is what will make the economy ready to compete in the 21st century.
3. Failure to act 'now' on health care will prevent elimination of the deficit.
4. "The reform we're proposing will ... keep government out of health care. ... prevent out of pocket costs ... "
5. The failure of Congress [over 50 years] is a major reason he 'inherited' a 1.3 trillion deficit (umm - try looking at what the deficit was on the day you took office Mr. President and then look at the contributions of TARP 1 and TARP 2 and the stimulus and your budget and the health care proposals and .....)
6. If Congress would only take on the President's cost-saving proposals, all would be well.
7. Any opposition is just about people wanting to 'play politics as usual,' and to 'get' the President.
8. Medicare should be cut- that will help the elderly.
9. People are skeptical about the proposals because they're cynical [yes, we are, but that's not entirely the point].
10. "The plan that I put forward ... the estimates are that it will cover 97 - 98%." According to the Dems, part of the problem is that the President hasn't actually put forward a plan, and that various parties and interests in and out of Congress are the ones making the plans.
11. The August deadline isn't really a deadline, it's just a goal to make sure Congress is debating and working.
12. "You haven't seen me out there blaming the Republicans." Huh???!!!
13. "If they've [the Repubs] got a good idea, we'll take it." Guess you haven't read any of the alternate plans.
14. Taxation is OK, as long as it's not on the middle class.
15. Jake Tapper: "Experts say ... Americans giving up tests, referrals, choice, end-of-life-care. When you talk about [it] you, understandably don't talk about sacrifices ..." Asks the President to state what sacrifices are really there. Reply: "They're going to have to give up paying for things ..." That answers the question (not)! Goes on to rhetorically ask why we would want to pay for what doesn't work. Still not answering the actual question. Wait, maybe: "It will require doctors as well as patients to be more discriminating consumers." Dancing up to the edge of discussing rationing. Moves on to deficit and debt, and concerns people have, then say those concerns are no more than, "...that argument has been used by those who don't want to reform health care." No - it's been used by those of us who are completely fed up with government take overs and expenditures and taxes.
16. "If we had done nothing, you'd have a 9.3 trillion-dollar deficit over the next nine years. Because of the changes we've made, we'll have a 7.1-trillion-dollar deficit ... but it's 2.2-trillion less than what we would have had we kep the policies in place when we came in." Complete and utter B.S. that. The deficit expansion is utterly due to the stimulus and budget and TARP. "Health care reform is designed to lower it [the deficit]." Not according to CBO.
17. Sacrifice question on current and future beneficiaries of Medicare. "It's not going to reduce Medicare benefits, it's going to change how those benefits are delivered so it's more efficient." Not if one reads the bill - the plain language of the bill (and the language of Pelosi and others in leadership) make it clear that both total benefit dollars and benefit allottment will be reduced. Savings from private monies from Pharm. doesn't mean that benefits aren't being reduced.
18. Slam! Called on transparency promises vs. what's really happening. Interesting that his own IG on TARP says transparency isn't happening.
19. Anything bad (deficit, TARP, etc.) is all inherited.
20. Moving far afield (it is a press conference and they can ask what they want): financial regulatory reform is next up. Government will be able to step in to ensure share-holders are aware of compensation packages. May impose fees for 'risky' investments. Who defines what's 'too risky?' I don't mind the first idea, but the second is a non-starter.
21. "To follow up on Jake's question, sir ... Can you guarantee that this legislation will lock in, that the goverment will not deny any coverage ... and that you and the Congress will abide by the same plan." President says that the reform plan will be the same thing as the fed. employee plan. Moved on to talking about decision-making about what's best for patient-care, by not doing unecessary procedures. Great, but who decides what's necessary. You, Congress, some faceless bureaucrat? Decision-making means someone has to make those decisions. Cited the Mayo and Cleaveland Clinic as examples. Mayo Clinic has rejected the House plan as it stands, and the proposed reform of Medicare.

Here are some articles to be considering while you consider to the sales pitch.

Blue Dogs. Taxation. Cost. Partisanship. More costs.

I strongly suggest (and hope you sign) the: Responsible Health Care Reform Pledge.
Text:

'All 535 Members of the U.S. House and Senate have received multiple copies of the Pledge by fax, email, regular mail or personal visitation. Any Representative or Senator not shown on the list of signers below may therefore reasonably be classified as having declined to sign. A few Senators have insisted that although they are supportive of our Pledge, they have adopted a blanket policy against signing pledges that prevents their signing ours. Although Let Freedom Ring believes that that they should make an exception for our pledge, because it is narrowly drawn and quite specific, we have agreed to post letters from those Senators in a separate section following the list of signers. You may read the letters by clicking on the Senators’ names.'

Click here to download the pledge.

Pay Us to Outcompete You (No, You Can't Recoup the Cost)

I don't claim to know the best way to reform the health care system, although I'm pretty sure tort reform should be a big part of it, but I do know this is the wrong way.

'WASHINGTON, July 15 (Reuters) - A group of Democrats on the tax-writing Senate Finance Committee on Wednesday called for health insurers to pay fees worth up to $100 billion over a decade to help pay for the overhaul of the U.S. healthcare system. The proposed fees are among the options being discussed by the committee, Senator Charles Schumer told reporters at a briefing with fellow committee Democrats Debbie Stabenow, Robert Menendez and Jay Rockefeller. ... Schumer said an effort would be made to prevent insurers from passing the costs along to consumers.'