“Some of the same folks who have been hollering and saying ‘do something’ are the same folks who, just two or three months ago, were suggesting that government needs to stop doing so much.”

 

-President Obama

The liberal establishment likes to make the government size and scope argument a black and white discussion.  Either you are for a large government with very significant power to influence our daily lives or you are for a government that does virtually nothing but supply the military and sends out diplomats.  Once they are able to frame the discussion in that manner a conservative is instantly at a disadvantage.  Conservatives are backed into the corner the President is trying to paint us into, if you say you want limited government you shouldn’t expect the government to be there when disaster strikes.  This argument is fundamentally flawed and skewed in the liberal’s favor.

The argument for a smaller more limited government isn’t one that limits the existence of government but one that clearly defines the scope and authority of that government.  Most conservatives are in favor of a federal government that regulates natural resources and negotiates trade agreements with foreign governments but not all are in favor of a federal government that dictates education policy to the states.  The argument isn’t “either/or,” it’s a series of discrete arguments representing the many aspects of federal influence.

It is imperative that the discussion is framed in this manner.  It is much more realistic and it allows for a legitimate discussion about specific points of the government.  At a Tea Party gathering you would have a hard time finding someone who would say that the federal government shouldn’t have a hand in the recovery from a major disaster on the gulf coast.  You would find differing opinions on the extent to which they believe the government should be involved and what role it should have.  The same goes for national defense, infrastructure, trade and so on as these are legitimate and accepted roles for the federal government as outlined by our constitution.  The disagreements with liberals begin when we start talking about the extent to which the government is allowed to influence the way the States execute their own policy and the influence the government applies directly to individuals.

As long as we break the conversation down and have logical debates about specific portions of federal power we will begin to more accurately reflect our viewpoint and illustrate that we are in fact much more mainstream (and main street) than the liberals make us out to be.  This is what keeps them up late at night. They know that most Americans just want to be left alone to seek their fortune with the gifts they were born with and the sweat of their brow.  They know we like to keep our money and raise our children as we see fit.  This flies in the face of the liberal elite who prefer to think that they know better than the poor unwashed masses.  It is our job to make them argue individual issues when it comes to the federal government and in doing so we will uncover how flawed their arguments really are.

President Obama is making sure he’s getting the word out.  He traveled to Buffalo, NY to tell folks at a plant that despite what they think the economy is improving.  Why, he has even gone so far as to say that next month will be even better than last month.  Sure the national unemployment rate is at 9.9%, our trade deficit is growing, and many of the recent job gains are temporary census workers, but the President wants everyone to know that his stimulus package is responsible for the great turnaround that’s coming.  Well, most of that stimulus went to districts that supported him in 2008, ensuring the growth and prosperity of those parts of the country. Other parts are underwater, literally.

I spent the first 18 years of my life in Nashville.  It’s home to the country music industry, many colleges and universities, and even two of his predecessors: Presidents Jackson and Polk.  The people there are proud, independent and patriotic; they wear Orange on Saturdays and powder blue on Sundays.  Sitting astride the intersection of three major highways, Nashville is the gateway to the deep South. Therein lies the problem.  The South wasn’t particularly supportive of the president in 2008.  Tennessee itself has produced an increasingly Red congressional delegation and the state supported John McCain.  President Obama sees no political incentive to go into the opposition’s heartland and let them know that they have his attention and his support during this horrible tragedy – and with this President, even more than most, everything is political.

He sure made time to go down to the Gulf Coast to let his environmentalist and liberal supporters know that he was going to put the screws to BP.  He wanted the country to know that he supported those who were hurt by an evil greedy big oil company, and he would stop at nothing to avenge their loss.  I’m glad the president rushed down there so quickly.  As we’ve seen over the past few weeks the oil spill is surging upon our shores devastating the entire shoreline.  Wait, no it’s been more like watching a train wreck in slow motion.  His immediate intervention may have proved useful for firing up his base, but it did nothing toward actually solving the problem at hand.  Meanwhile he has a city of over one million people completely devastated by flood.  He probably flew over it on his way down to the gulf from DC and couldn’t be bothered to stop.  But the president’s schedule is very busy. It’s not like he can just drop everything and go give his support personally to those ravaged by flood. Oh, wait, in April he stopped off to check in on Massachusetts residents who suffered through 15 inches of rain during the previous month, as much as Nashville got in a weekend.  While he was there he managed to make appearances at two fundraisers too, how convenient!  I doubt he would have brought in as much if he stopped in at the Opryland Hotel for a party, it was under several feet of water. Some people are calling the Gulf Coast oil spill Obama’s ‘Katrina,’ but THIS is his Katrina.

So the President chose not to stop off in Nashville despite virtually flying right over the devastation on his way to the Gulf Coast.  “Why?” you may ask.  Because Nashvillians are soldiering on.  They aren’t crying to the government to bail them out and solve their problems.  They are working hard at rebuilding everything they lost and demonstrating the qualities that made this country great.  The same qualities that fly in the face of the Nanny State policies that President Obama and the liberals in our government are seeking to push down our collective throats.  It’s hard to get people addicted to government handouts when they prove that they neither want nor need government interference to overcome difficulties.  It’s for that reason – not race, like some are saying – that President Obama has decided not to make Nashville or the South a priority.  Today I’m a proud Virginian; I love the state that has taken me in and given me a wonderful home to raise my family.  But I’m also proud to be a son of Tennessee, I thank God my family and friends survived the worst of the flooding and wish them Godspeed as they begin to rebuild their amazing city.

Last week we got the Health and Human Services Actuary’s report on the estimated costs of Patient Protection and Affordable Care Act.  Ironically as the numbers show the act does neither.  Sure, the Democratic plan may reduce the Federal Deficit on paper but this report shows what many of us knew months ago.  It is not possible to add roughly 20 million Americans to the medical system and expect the system to react in a positive way.  In an effort to squeeze out every nickel and dime of funding for a good CBO score the Democrats have set the course to dramatically reduce the quality of care we receive in hospitals and doctors’ offices, as well as our ability to be seen in a timely manner.

First of all, the $311 billion increase in costs from adding the 20 million new enrollees into the federal programs is an unfunded burden in a bill that we were promised would pay for itself.  That’s bad enough on its own, but the vast majority of that increased cost comes from Medicaid, which will pass additional costs onto cash-strapped states.  The states in turn will either have to raise taxes or cut budgets to cover these new burdens – reducing the number of teachers in our schools, delaying road projects, and keeping police officers off our streets.

The second important deficiency is a corollary to the first.  Adding additional patients to federal programs dramatically reduce the profitability of providing care to all patients.  My wife works in the healthcare industry here in Northern Virginia.  Her office is now forced to charge Medicare and Medicaid patients 20% up front on the cost of their treatment because the government rate isn’t enough to keep her practice in business.  This isn’t an isolated problem either, a major nonprofit hospital in Fairfax County is running a quarterly deficit over $12 million, and can’t even hire new nurses.  These problems aren’t because of “evil corporate greed”; they are symptoms of the bigger problem that the government has created by becoming directly involved in the industry.  As the population ages, and now with an additional 20 million beneficiaries in federal programs, the increased proportion of unprofitable work requires doctors to make up that loss elsewhere from the private sector, or by spending less time and resources per patient.  This leads to a feedback loop which along with this legislation’s other deficiencies will hasten the decline of the private medical industry in this country.

Third is my favorite part of the legislation.  The 3% tax on medical device manufacturers was a master stroke of Progressive thinking.  They managed to put the screws to an evil corporate monster that is out to bankrupt innocent orphans and widows while helping to fund the purchase of those very same devices to help those poor souls.  If their ranks were populated by those of us who work for a living and have a little bit of common sense, they would have realized the idiocy of their plan.  The product these companies provide are a necessity, we cannot simply tax them and then not feel the ensuing increase in price to maintain profitability.  This tax will get passed directly on to the customer like all taxes on corporations do. In this case, that’s you and me. . .both as consumers of their products, and now, as federal taxpayers.

Finally I found one particular portion of the memo very disturbing.  There is a permanent annual adjustment to the payment providers receive.  This is pegged to a 10 year moving average based off the economy-wide private gains.  This is a measure of the overall increase in productivity in the economy at large, to include manufacturing.  The legislation links reimbursement to this average efficiency benchmark, expecting doctors to become more efficient at the rate the economy increases its efficiency.  This means that the government will gradually reduce what your doctor gets paid (which is already too low) in an effort to encourage efficiency.  I’m curious to know how the Democrats expect to make an EKG more cost efficient or improve the efficiency of knee replacement surgery.  The only way doctors will be able to maintain profitability (and the report says 15% of providers won’t) will be to cut staff or spend less time with their patients or doing procedures.  This will have a direct affect on patient care and is a very dangerous road to start down.  In 10 years we will have 15% fewer providers, those who remain will be understaffed, overcrowded, and overworked.  Our medical system, which is among the best in the world, will surely suffer, all in the name of a Progressive, big government ”solution.”

Americans desperately need to take a pragmatic look at these complicated problems and tackle them at their root cause.  We need to make medical care affordable, and we don’t do that by dumping our tax dollars into the system.  We need to work with providers and industry to identify where we can reduce the cost of procedures and services.  I’m not a fan of “comprehensive reform” and this legislation is an excellent example of why it is a horrible practice.  The rats nest of deals, hidden taxes and destructive regulation is impossible to unravel.  For example, should the States be victorious in their litigation against the Federal Government, one of the key points of this bill will fall away leaving an even worse mess for the tax payers to deal with.   I firmly believe that the best course of action is to strike it down (the good and the bad) and work with moderates in both parties to identify discrete, common sense solutions to methodically implement and evaluate before passing further legislation.  By attacking big problems in a methodical manner we will avoid more Laws of Unintended Consequences.