nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Sunday, September 13, 2009


Here’s the summary published by on the president’s address.  You can go here to see their extended analysis:



  • Obama was correct when he said his plan wouldn’t insure illegal immigrants; the House bill expressly forbids giving subsidies to those who are in the country illegally. Conservative critics complain that the bill lacks an enforcement mechanism, but that hardly makes the president a liar.
  • The president said “no federal dollars will be used to fund abortions.” But the House bill would permit a “public option” to cover all abortions, and would also permit federal subsidies to be used to purchase private insurance that covers all abortions, a point that raises objections from anti-abortion groups. That’s true despite a technical ban on use of taxpayer dollars to pay for abortion coverage.
  • The president repeated his promise that his plan won’t add “one dime” to the federal deficit. But legislation offered so far would add hundreds of billions of dollars to the deficit over the next decade, according to the Congressional Budget Office.
  • The president overstated the degree of concentration in the insurance industry. He said that in 34 states the "insurance market" is controlled by five or fewer companies, but that’s true only of insurance bought by small groups, not the entire "insurance market."
  • Obama said his plan won’t “require you or your employer to change the coverage or the doctor you have.” It’s true that there’s no requirement, but experts say the legislation could induce employers to switch coverage for millions of workers.”

(, Sep 10, 2009)

On illegal immigrants, the objection alleging that they will be covered (“You lie”) comes from the fact that there’s no mechanism in the bills to determine who is a legal resident when healthcare is delivered.  Also, as soon as the bill passes, the illegal immigrant supporters will file suit.  All this is academic, however; they are going to continue to receive care.  Federal law requires hospitals to treat anyone who presents to the ER.  This is why Democrats voted down amendments to enforce excluding them—it would contradict the requirement-to-treat law.  We need to press on:  so, get over it, not an issue.   I don’t know whether the President realizes this or just doesn’t know how things work.

I found two other ways that the House bill may allow coverage for abortion.  First, the Hyde Amendment, which bans public funding for abortion, purportedly applies only to funds which are under the control of Health and Human Services.  The bill establishes a different flow for a good part of healthcare reform funding.  As a corollary, the Hyde Amendment has to be re-authorized annually.  Secondly, the courts have considered abortion a “covered benefit” when the law is silent on it.  So, there’s plenty of wiggle room here to fund abortion.  I suspect Congressional Democrats know all this, and, again, this is why they defeated amendments on abortion in HR 3200.

There’s still the cost problem.  This is my biggest objection.  As I’ve written before, there is plenty of money, already in the system, for reform that would reduce cost and cover everybody…at least for 10-20 years.  We don’t need 53 new organizations and additional public funding to do it.  The President’s offer to do a pilot demonstration project in tort reform was not substantive.  I’ve seen a hundred different pilot projects during my government service.  You do them for two reasons:  either you don’t have the money to implement a program and you want to prove it works in order to get full funding, or you use it to fob off someone who’s pushing you to start a new program.  In the latter case, you do the pilot, then shelve the results; or, if they ask, drag your feet, or attempt to show the pilot didn’t work.  The first reason isn’t applicable here:  a pilot that re-coups money is not having funding problems.  So, the President’s suggestion is a political gesture only.  The data on tort reform shows it works in those states where implemented; you don’t need a pilot study.

Some commentators have noticed that the President is no longer using the term “healthcare reform”, substituting “health insurance reform.”  This is good tactics; it sounds less draconian, and gives a target that people can focus on:  the health insurance industry.   I also noted what FactCheck mentions above:  he no longer says “you can keep your plan/doctor”.  He now says “nothing in this plan requires you to change.”  That’s true, and is another good tactical change, since it seems clear that companies are already planning to dump their employees.  I suspect he knows this.

Nature note:  Did you notice the change in the number of people without healthcare insurance?  He said “30 million”.  First time I’ve heard him admit that the 47 million figure is not correct.  30 still isn’t right, but…whatever.

He’s doing better at “calibrating his words.”

But, despite my reservations, you have to hand it to the President:  29 prime time speeches on healthcare (according to one count), and more to come.  Each one is essentially the same as the last, but you have to admire the energy.  I’ve found it better to read the transcript rather than view them; it lets me concentrate on “what” he says, not “how” he says it. 

Lastly, he’s said he’s committed, and that’s something we can all believe.

Doc D



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