Morning Must Reads

“Now, people when I say that look at me and say, ‘What are you talking about, Joe? You’re telling me we have to go spend money to keep from going bankrupt?’” Biden said. “The answer is yes, that’s what I’m telling you.”

That may have worked with AARP of Alexandria, but the same logic got nowhere with the head of the Congressional Budget Office, which delivered a smackdown to the idea that a national health service would be a long-term cost savings.

Examiner colleague Susan Ferrechio ably describes the icy blast CBO Director Douglas Elmendorf gave the idea that a $1.6 trillion health care plan would be a money saver. Highly regarded Elemndorf issued dire warnings about what would happen to the deficit and debt as more and more people shifted into a government-run system.

The CBO forecast has health spending increasing dramatically over the next decade, the opposite of what President Obama promised the plans would bring. And as soon as it was out, moderates started jumping off the fence and heading for the hills, casting even House passage into doubt.

One reason that the House version is so expensive is that in order to shore up support with key groups, the plan puts off tough decisions on the more than $640 billion a year the federal government already pays for Medicare, Medicaid and SCHIP
Writer Greg Hitt explains:

“While the CBO storm may have set back the move for rapid action on health care, the effort also got an important boost Thursday when the American Medical Association offered support for the House proposal.

In a letter delivered to House Ways and Means Chairman Charles Rangel, a New York Democrat, the doctors’ group expressed “appreciation and support” for the bill. Among other things, the AMA welcomed a provision that would put in place a new formula for payments to doctors under Medicare, avoiding deep cuts scheduled to take place next year and in future years.”

 
New York Times — Mass. Panel Backs Radical Shift in Health Payment
 
Massachusetts is the Guinea pig for universal health care in America, and the subject is starting to mutate.

The original plan that carried a coverage mandate and set fees for certain procedures is quickly bankrupting the already-strapped state.

The complaint is that doctors ordered too many tests and procedures in order to maximize profits.

To cut that off, the state is thinking about going to a flat or “global” fee for patient care – a group of doctors gets a set amount to care for a patient, sick or well and makes money by playing the actuarial table.

This is actually care rationing by proxy. Instead of too many tests and procedures, Doctors will be motivated to perform too few, thereby eliminating even the advantages of cautious, preventative medicine. But faced with a crippling budget problem and a program ballooning in cost, Massachusetts has to find a way to deliver less health care to its citizens in a hurry.

Writer Kevin Sack explains how it will all be different this time.

“Global payments are hardly a new idea, as the concept closely resembles the capitation model that incited a backlash by consumers who accused health maintenance organizations of skimping on care. But members of the Massachusetts commission said their plan would offer financial incentives for performance that would transform physicians into care coordinators rather than gatekeepers.
‘This is not about containing costs by sacrificing quality,’ said [Gov. Deval] Patrick’s finance director, Leslie A. Kirwan, a co-chairwoman of the commission. ‘That’s been tried and rejected, and rightly so.’
 
Washington Post – Obama Speaks Of Blacks’ Struggle
 
Depending on the listener, President Barack Obama either gave a fiery lamentation about the persistence of racism in modern America or an exhortation to his fellow African Americans to embrace personal responsibility at the 100th NAACP national meeting. The president did a little of both in a speech that ended up being about him and his policies.

Writers Krissah Thompson and Cheryl Thompson reveal that the president gave substantially the same speech to the NAACP that he has in foreign capitals and here at home – everyone shares the blame for the troubled past, Obama’s election is evidence of America’s potential for redemption, which can be fully achieved by enacting his policies.

In this case, Obama suggested that helping him pass health care reform would help fulfill the unmet promises the nation once made to blacks.

“‘Make no mistake: The pain of discrimination is still felt in America,” said Obama, who was greeted with cheers and extended applause. ‘By African American women paid less for doing the same work as colleagues of a different color and gender. By Latinos made to feel unwelcome in their own country. By Muslim Americans viewed with suspicion for simply kneeling down to pray. By our gay brothers and sisters, still taunted, still attacked, still denied their rights.’”

 
New York Times — Democrats Drop Key Part of Bill to Assist Unions

It’s official. There’s no card check in the card check bill anymore. With passage of the original draft that would eliminate the secret ballot for union elections clearly impossible, labor Democrats have retrenched around a new version of the bill that may be almost as valuable to them.

Writer Steven Greenhouse casts his story as another example of moderate Democrats thwarting the will of the party’s liberal base, but that’s not what’s really happening.

The news is that the core group of six pushing the Employee Free Choice Act in the Senate have dropped the card check provision in their bill in order to get new restrictions on employers – including binding federal arbitration on all disputes at union shops. Waiting out a strike would no longer be an option for companies and federal mediators could decide pay rates, work rules and other crucial concerns in the event of a walkout or lock out after the first month.

While it may still have serious problems in the Senate, labor wants in on the party, especially in light of the current legislative smash and grab.

“Companies argue it would be wrong for government-designated arbitrators to dictate what a company’s wages and benefits should be.
“Binding arbitration is an absolute nonstarter for us,” said Mark McKinnon, a spokesman for the Workforce Fairness Institute, a business group opposing the bill. “We see it as a hostile act to have arbitrators telling businesses what they have to do.”
 
Washington Post — Senate Republicans Won’t Block Vote on Sotomayor
 
Republicans look to make it through the confirmation hearings of Judge Sonia Sotomayor with little gain and only one Ricky Ricardo joke on the minus side.

Once it was clear that Sotomayor would not answer any of the tough questions directly (never thought about the rights of the unborn, etc.) and was prepared to talk about the law as if she were the ideological twin of John Roberts, Republicans on the Senate Judiciary Committee could either do to her what Democrats do to Republican nominees and savage her personal life and record or just let the president and his party have their way.

They opted for the latter, removing the threat of a filibuster and clearing the way for a speedy confirmation. Many conservatives who want total war over judicial appointments are not pleased, but those who believe the president can appoint any qualified person to the courts are content, even if they think Sotomayor was less than honest:

“Charles E. Grassley (R-Iowa), who has voted in favor of every Supreme Court nominee in his 29 years in the Senate, said that Sotomayor’s answers were effective but that he is trying to decide whether she was “pandering” to the committee’s conservatives.
“I still got a big question mark about whether or not I really know her,” Grassley said in an interview after the hearings.