On Healthcare and the Courts

And so we find ourselves in the year after its passage, deadlocked at 2 decisions apiece for either side of the question of whether Obamacare is Constitutional.  The first two decisions favored the Administration, the second two favored the forces arrayed against it.  We're moving toward a  Supreme Court case of epic proportion here, certainly one of the biggest of my lifetime, and surely as big as those FDR faced while he sought to expand the role of government.  I can't wait.

I've read bits of the reasoning from all four cases, and I must say, there are coherent and interesting arguments on both sides.  Ultimately though, I do think the Supremes will find the individual mandate to be contrary to the Commerce Clause. 

I have frequently cited my support for an individual mandate here in the blog--but I want to remind readers that it was ALWAYS conditional--that is, as long as the country was going to impose the coverage of pre-existing conditions on the insurance industry--along with approaching universal coverage--the only way to affordable do so was to deepen the risk pool--a.k.a--the Individual Mandate.

Without the mandate, forced pre-existing condition coverage will go away--and I'm ok with that.  Ultimately, our society DOES want folks with pre-existing conditions to have medical care, and so such matters should be treated as entitlements carved out of general revenue--rather than upending the entire system to get at it. 

"Dr. Moe, Dr. Larry, Dr. Zoltar 6000..."

It appears the National Institute of Health (NIH) is teaming with the National Science Foundation (NSF) and the Departments of Homeland Security, Agriculture and Defense (through DARPA) to fund small business and academic research relating to robotics. Specifically, the announcement calls for:

"research directed towards innovations or advancements in robotic technologies and devices for: Robotics for Home Healthcare, Personalized Care for Special-needs Populations, and Robotic Wellness/Health Promotion; Robot-Assisted Recovery, Rehabilitation, and Behavioral Therapy; High-throughput Robotics Technologies; Better Than Biology Actuators; Patient Mobility and Rehabilitation Robotics; Dexterous Manipulators with Tactile Feedback; Multi-Agent Command, Coordination, and Communication; Robotic Co-Worker Assistive Technologies"

This probably falls under the "pass it and we'll learn what's in it" genius comment by Der Sprecher but for all you doubting Thomases who thought the Health Care Bill was going to create a serious loss of health care providers, you need not worry cause we're gettin' robots!

This has been tried before:

When The Sow Rolls Over, The Piglets Come A-Runnin'

News here of some 2000 groups--including businesses and unions--who have applied for and been approved for $5B in "bridge funding" designed to ensure that they don't drop "early retirees" from their healthcare rolls before the 2014 bennies begin to kick in.

You can read the delight with which the Post reporter mentions Koch Industries as one of the groups who have applied, as the brothers in charge of Koch have been vocal and financially active detractors from the healthcare monstrosity created by the Obama Administration.  The same delight attends to the report that some state governments who are questioning the constitutionality of the healthcare legislation have also applied for the funding.

Our entitlement addiction rolls on....and will lead to our ruin.

Is Romneycare Obamacare?

Professor Samuelson has an editorial in the Post this morning in which he 1) compares the Massachusetts healtcare rubric to that created by Mr. Obama and the Congress and 2) lays out some of the problems with the Massachusetts plan--the primary one of course being that it did nothing to control costs (sound familiar, America?).

All this is interesting as a matter of policy; but it is also interesting as a matter of politics.  On the radio show last week, caller "Laura" wondered aloud whether Mitt Romney's association with the Massachusetts healthcare imbroglio would be an albatross around his would-be presidential neck in the Republican primaries--I agreed it would be an issue, but one I thought he could overcome.

The more I think about this, the more I think Laura might be right....

Obama and the "Doc Fix"

US doctors who take Medicare patients are looking at a 21 percent reduction in their pay as a result of Congressional inaction on passing the "Doc Fix", an annual exercise in budget prestidigitation in which habitually underfunded Medicare levels are "fixed" with special legislation. Why is this all of a sudden a big issue? Why, because we just passed a trillion dollar government takeover of the healthcare system, that's why. In the "old days"--that is, before our accelerated slide into Euro-socialism--the cost of the "fix" was considered a cost of doing business, just another one of the budget tricks played with such skill on Capitol Hill. But now, the addition of $80B to the deficit starts to look like real money--as the nation falls increasingly into unsustainable debt. What must be remembered here is that the Administration healthcare proposal did not include the "Doc Fix" in its cost--even though everyone knew it had to be taken into consideration. The President is of course now hectoring Republicans for hazarding the nation's healthcare system--even as he hazards its entire system.

A Pound Of Flesh; And Soon, Your Spleen

New York State Assemblyman Richard Brodsky has introduced a measure into that state's legislature that would automatically enroll all state residents as organ donors, unless they specifically opt out the donation program.



Remember, it's for the children.

The Weekly Standard On Repeal Of Obamacare

I received my Weekly standard this week and saw the cover story--"REPEAL" in big red, bold letters. I immediately began to think that one of my favorite insightful, intellectually curious, conservative journals had lost its mind. Then I saw that the article was written by Yuval Levin, someone I've come to see as a voice of reason, depth, and information on the health care debate. So I read the article. You should too. It is perhaps the single best work I've seen on a strategic approach to dismantling this mess since it passed.

Of course, the central themes start with "win Congress and the Presidency", as would all attempts at repeal. This has been the sticking point for me, as I see those as more remote than some. But what Levin's done here is point out a number of structural elements of the bill that make it vulnerable. To use a war metaphor, this army (the bill) has extended supply lines that are vulnerable to attack--and in this case, it is the chronology of how the bill plays out over time.

I still see repeal as remote. I believe Republicans ought to be fighting for tort reform and market based enhancements. But I am persuaded that a repeal effort is not completely forlorn.

Obama The Bloviator

Classic little covert hit-piece here in the WaPost (I know--strange, isn't it?) about The One providing a 17-minute 2500 word response to a question posed at him at a Q and A session on healthcare at a North Carolina battery manufacturer. From the story: "... a woman named Doris stood to ask the president whether it was a "wise decision to add more taxes to us with the health care" package. We are overtaxed as it is," Doris said bluntly."

Obama's answer was summarized in the Post thusly: "He then spent the next 17 minutes and 12 seconds lulling the crowd into a daze. His discursive answer -- more than 2,500 words long -- wandered from topic to topic, including commentary on the deficit, pay-as-you-go rules passed by Congress, Congressional Budget Office reports on Medicare waste, COBRA coverage, the Recovery Act and Federal Medical Assistance Percentages (he referred to this last item by its inside-the-Beltway name, "F-Map"). He talked about the notion of eliminating foreign aid (not worth it, he said). He invoked Warren Buffett, earmarks and the payroll tax that funds Medicare (referring to it, in fluent Washington lingo, as "FICA")."

Fantastic. We used to say in the Navy that "you can't polish a turd". This one's a turd and no amount of The One's rhetorical skills is going to make it any different.....

More on the Anti-Business Jihad

Megan McArdle is a fascinating writer/blogger at the Atlantic (I think Robert Thorn has a crush on her) and she seems to agree with me on the reaction of some Democrats to the announced charges some large businesses will have to take as a result of the healthcare bill.

Anti-Business Democratic Jihad Continues

This story really should be bigger than it is. But it isn't, because the Bought and Paid For Media realized that this kind of "publicity" is bad for the President's new healthcare plan.

Seems that the bill closes a tax loophole granted American businesses during the Bush Administration (the younger). In order to incent businesses to keep their retirees enrolled in their own prescription drug benefit plans (rather than offload them to the new Medicare Prescription Drug benefit), companies were offered tax breaks.

This new bill eliminates the tax break.

This means taxes will rise.

Which means profits will go down, in ceteris paribus.

Which means public corporations are obligated to report balance sheet adjustments to their shareholders. Which several have done.

News is dribbling out of large US Companies taking one time "charges" against that represent anticipated costs that would not have been borne under the previous taxation regime. ATT is claiming $1B; Caterpillar, Verizon, John Deere and others have announced charges of their own. Because this does not fit the "bending the cost curve" narrative of the One and his henchman, Henry Waxman is hauling CEO's before a Congressional Committee to browbeat and intimidate these businesspeople. Here's how I'd like to hear one of them talk:

"Mr. Chairman, thank you for this opportunity to explain to you and to the other members of this body some important, fundamental facts about running a business. I don't expect you to have a firm grasp of these points, just as I wouldn't think that you would believe me well-versed in the arcana of machinery of the House of Representatives.

I am the CEO of (Company X). I must sign the financial reports that my company is duty bound as a public company to file. I am personally and criminally liable should those reports purposefully mislead stockholders or potential stockholders.

The law of the land granted my company and others a tax break to ensure that we would continue to fund prescription drug benefits for our retirees, even after a generous prescription drug benefit was passed by the Congress. This financial fact of life is reflected my corporate balance sheet in a lower tax "expense" than would have been the case in the absence of the law.

The new healthcare plan removes that tax break. I am not here to quibble with that fact--it is after all, the law of the land. But as a dutiful officer with fiduciary duty in (XXX COMPANY), I am legally obligated to inform stockholders of major changes to our financial statements. As this tax break has been removed, our tax expense will increase, which will cause a concomitant decrease in our profitability. These are the facts, and they are not in dispute.

Are our memories so short that we have forgotten the lynch mobs assembled when the management of Global Crossing, Enron, and Lehman Brothers appeared to have withheld pertinent financial data from stockholders and debtholders? Were not some of the hearings designed to reveal these crimes not held in this very room?

Mr. Chairman, I am sorry that it is inconvenient to you and others politically that legislation you supported will have wholly foreseeable consequences on American businesses. If you invite me back, I'd be pleased to spend additional time with you to explain a number of them, so that we might be educated in advance, and avoid another Stalin-like show trial. But for the time being, I wish to register with you here today, and with the American people watching and listening, my complete and utter disdain for you, this body, and your incredible short-sightedness. You haul us up here as if we are common criminals, because we are doing what the law requires us to do. You preen about a bill you believe will cut costs without having the slightest idea how it will perform such a trick.

Mr. Chairman, this is a deeply offensive moment for the country. This body has brought discredit upon itself today."

In Which I Respond to Jay Nordlinger's Defense Of David Frum

David Frum is a conservative thinker for whom I have long had respect. He's cut out of the Bill Kristol/David Brooks mold of intellectual thinkers, and he's got a wide-ranging field of view. And today, he was fired from his position at the American Enterprise Institute. Some say it was retribution for a weekend blogpost entitled "Waterloo" in which he takes the Republican Party to task for its intransigence in the healthcare battle, and warns of consequences to be paid.

In The Corner, National Review's irreplaceable blog, the irreplaceable Jay Nordlinger (along with Mona Charen) write posts in defense of David Frum. They cite his long history of conservative thinking, his service in the Bush Administration, and his general bonhomie. I take a backseat to no one in my judgment of Jay Nordlinger's good judgment (and bonhomie for that matter), but Frum's offense here isn't one of history--it's one of incredibly bad analysis. Read the Waterloo blog entry again--and then ask yourself if it comports with your memory of recent history. President Obama, Speaker Pelosi and Leader Reid never considered Republican support of any real importance--why? Because as Frum aptly put it--they didn't need it. Frum's assertion that Obama "badly" wanted Republican support is zany--he badly wanted Republican support for Democratic ideas. It wasn't just Rush and Beck who were complaining that Republican ideas were being left out of early proposals--it was the ADULTS in the Republican party. There were serious, serious policy differences between Republicans and Democrats. That Frum can now point to a bill that he believes is insubstantially different than past Republican ideas is a direct RESULT of the kind of insurgent movement among Republicans and others that Frum now seems to rail against. Without it, we would have a far different bill. And let's also not forget--it was SPLITS IN THE DEMOCRATIC PARTY that kept the fight going as long as it did--these were splits largely aided and abetted by people more in line with what Republicans were thinking.

Do I think this bad analysis was a firing offense? No. Do I think his body of work is defensible? Absolutely. Do I think this blog entry was? Absolutely not.

Democrats Think We're Stupid

Barack Obama told us he would not raise taxes on the middle class (which I believe he defined as anyone making less than $200K).

Many people consider an insurance mandate to be a TAX . A tax on people making under $200K--in many cases, substantially less than $200K.

George Stephanopolous called the President on this during an interview in September 2009, and the President got all fussy with him, maintaining stridently that it wasn't a "tax".

So--now that several state attorneys general seek to overturn the individual mandate portion of the healthcare bill---Obama Administration Spokesman EJ Dionne (aw, just kidding) informs us that the mandate is--here it comes---legal--because it is---A TAX--and not an overreach of the Congress in regulating commerce. Here's the key part: "It would take a rashly activist court to find the individual mandate unconstitutional because it is structured as a tax. No one will go to jail for not buying insurance. Starting in 2014, people who refuse will have to pay a penalty to the federal government, administered by the IRS. There are subsidies for those who cannot afford coverage on their own, as well as hardship exemptions."

Putting aside for a moment the obvious tip of the hand of the left with respect to their talking points on how this case may play out (judicial activism and such--which is only bad when protecting rights guaranteed by the Constitution), there's the fact that it reveals THE BIG FAT LIE that the Obama Administration has obviously made. The mandate IS a TAX. It will be an increase on MANY PEOPLE MAKING LESS THAN $200K.

There is a delicious quandary coming for the Obama Administration--should these cases get to the Supreme Court, the Administration's legal defense is GOING TO HAVE TO BE that the mandate is simply a TAX, a power the Constitution does in fact grant the Congress. Republicans should do all they can to get this one before the Supremes.

David Broder--Cheerleader for Congressional Democrats

In one of those columns for which the aging Broder is becoming famous, he treats us all to a walk down wistful memory lane, this time with the help of another aging Washington luminary-- Michigan Congressman John Dingell, who succeeded his father in a special election in--1955 (yikes)--when his father died in office. While Republican family connections always seem to raise talk of impending monarchy, Dems seem to get a pass on this one--Broder puts it here thusly: "It was 1955 when Dingell succeeded his late father in a special election from Downriver Detroit and took up the family business of working for health care to be guaranteed for every family regardless of income."

"Family business of working for healthcare". I'll say. John Dingell's never done a day of "business business" in his life. But I digress.

Broder's obviously a HUGE FAN of the healthcare atrocity, but even his cheerleading cannot hide the basic chicanery at the heart of this bill. Broder lightly puts it this way: "Inevitably, the cost of the guarantees embodied in this bill will confront a future Congress with hard choices these legislators finessed."

"Finessed"? I'll say. I love it when even someone on their side acknowledges that this bill is a lie.

Constitutionality of Healthcare

Big Fred and others on The Conservative Wahoo Live! radio program last night made spirited defenses of the ongoing effort by several state Attorneys General to have the insurance mandate portion of the healthcare reform bill overturned by the Supreme Court. I understand their points, but for some reason I had a feeling that the Supreme Court would likely not mess with something this big and "political"--showing deference to the political branches in the process. I'm not so sure anymore.

When the editorial pages of the Washington Post treat the effort with the respect that this piece did, it seems to me that idea may have quite a bit more merit than I thought. I'll try and educate myself further on the matter.

That said--were the Supreme Court to find the mandates CONSTITUTIONAL--I would support a mandate IF AND ONLY IF extension of "coverage" to pre-existing conditions was forced upon the insurance industry. If you--like me--wish to see insurance coverage provided by private companies, rather than the government; and if you--like me--believe that denying coverage to people with pre-existing conditions is coming to be seen as an important policy problem to be overcome; and if you--like me--see forcing insurance companies to take on people with existing conditions not as "insurance" but as an "entitlement"--than we are left without a good policy option to "deepen the risk pool"--except the mandate. If the mandate is found unconstitutional--but the requirement to cover pre-existing conditions remains--the insurance industry will be faced with a HUGE COST driver which will be passed along to those with insurance. Premium hikes are guaranteed by the bill as it is--without the mandate, the hikes will be substantial.

Bottom line--if the Supremes find the mandate unconstitutional, then the requirement to cover pre-existing conditions becomes problematic--both from a cost standpoint, and a political one. Republicans would have to be careful how they contest it, as they will assuredly be criticized for "taking away my healthcare" if they overturn (politically) the pre-existing conditions coverage requirement.

Wait, Wait, Don't Treat Me (Right Away)

I look forward to having innovative web applications like this to tell me how long I'll have to wait to get treatment.

What To Do Now?

I've been thinking a bit about the passage of the healthcare bill, Republican political prospects and the future of the US--its economy, its role in the world, and its spirit. I have a few thoughts to share, so please indulge me. This will be a long one Goldwater's Ghost, so pipe down with your complaints.

1. If you have a moment, read Ghost of Halloween Past's comments at the bottom of my post on the healthcare legislation yesterday. GHP's a great girl and all, but she's sorta at the leading edge of my whole "neo-socialism" thrust. She can--and does--write quite honestly that there isn't anything "socialist" about what will be signed today. And strictly speaking, she's right--which is why I prefer to call it "neo-socialism". This is of course, the prevailing view of the left these days--they have seen the failure of socialism as a political strategy worldwide--and they were intellectually bereft for nearly twenty years, until capitalism's latest bout with creative destruction gave them an opening. And they are POURING through it now, not armed with the theories of Marx and Lenin as in days of old, but armed with the work of social justice theorists, academics, and economists who look wistfully across the Atlantic at Europe and say, "they have it better than we". They would have us believe that capitalism and competition have failed us, and that we now need the comforting hand of the government to smooth out the inconsistencies in how Americans live their lives. Never mind that the "comforting hand" of government in our present capitalist system fails routinely to effectively and/or efficiently carry out on a small scale that which they would now have it do on a large scale. Never mind that the "comforting hand" of government--as wielded by those on the RIGHT AND THE LEFT is an un-indicted co-conspirator in the financial crisis atop which they now stand and cry "injustice" and "failure". Bottom line here? GHP is right--this healthcare legislation is not socialism. It is neo-socialism to its core, and it even more dangerous as a political force because it presents us with the "boiling frog" conundrum (NOTE TO RIDICULOUSLY LITERAL READERS--I cite this pithy little saying because of its widespread use, not because of its physiological relevance to amphibians). Put a frog in cold water and slowly raise the temperature. As the frog passes through the lovely warm water on the way to hot, he is eventually boiled without knowing what hit him. Neo-socialism is that slow boil, and it will weaken our nation over time.

2. It is possible that with this legislation--coming on top of the debt piled up by both the Bush and Obama Administrations (and with the prospect of more coming)--has created the conditions for accelerating America's decline as a world power. We simply cannot afford to spend $700B a year on defense, at the same time we greatly increase social spending and infrastructure spending, at the same time we try to cut deficits and debt, at the same time that we maintain a tax regime that fosters innovation and growth. These are incompatible ends, I am afraid. When one looks across the Atlantic at European nations and envies their high standards of living, one must also recognize that they are not the world's leading economic, military and political powers. They are comfortably numb, irrelevant diplomatically and feckless militarily. Those who would have us look to these economies as models would be horrified by their inability to do EVEN BASIC things to alleviate human suffering around the world under emergency conditions. Our military gives us the ability to change outcomes--political, military, diplomatic, and social. But it will be the bill-payer for both social programs AND debt reduction. With the loss of our military flexibility will go our influence, our capability, and our capacity.

3. I think the worst thing Republicans can do is to run around shouting "REPEAL". It seems easy, it seems right, it seems effective, it seems to be common sense. But it is a losing strategy politically. Again--GHP is right. Things COULD HAVE BEEN A LOT WORSE if she and others like her had gotten their way. But in our country, a determined majority can get things done, and that is exactly what the Democrats did. Now there are a TON of things wrong with this bill--but a good many of them won't really be apparent for YEARS. What will be apparent early? Its benefits. Just like GHP said. Extension of healthcare benefits to those without. Coverage of pre-existing conditions. Both of which are IN THE ABSTRACT very popular with the American public. When you begin to educate them (as the opposition did over the past six months), they become less enamored with the ideas. But the shouting is over, they bill passed, and guess what? Things that many Americans perceive as "good" are going to start happening RIGHT AWAY. What will be the noise heard if Republicans take the "REPEAL" strategy? "They are taking my healthcare away". "They are denying me care". There are HUGE TRAPS in pursuing this strategy--and let's face it--very few groups are as comfortable with squandering advantage as the Republican Party. Pursue this strategy and we'll find ourselves steadily declining with those we seek to influence--the apolitical, the folks in the middle, the folks who "swing elections".

4. So what to do? First, recognize that this isn't the Apocalypse. The forces of good DID have a lot of impact on the legislation (as GHP's lamentations reinforce). Are there things that are abysmal about it? Of course. So let's look REALLY hard at how to go about changing the REALLY bad things. Additionally, we need to advocate strongly for getting things INTO the system that did not make the cut--things that would actually LOWER COSTS for the 85% of people who have health insurance. Popular things--like TORT REFORM. Like SMALL BUSINESS POOLING. Like COMPETITION ACROSS STATE LINES. I know it is tempting to just "REPEAL" everything--but it is politically a non-starter, as long as a Democratic President has one end of Pennsylvania Avenue and Republicans do not possess a filibuster-proof majority in the Senate. So--when's the last time Republicans had the Presidency and a filibuster-proof majority? Not in my lifetime.

So--my advice to those who might be listening--is get in there and fight to make this "system" better. Concentrate on the inefficient and unpopular--NOT the popular--parts of the legislation. Divide it and conquer it. Take the long view--and we will all be better off in the end.

Health Reform Passes

By a vote of 219-212, the House of Representatives passed the Senate version of sweeping healthcare reform, sending the bill to the President for his signature. As part of the wheeling and dealing necessary to pass the bill, the House also passed a series of alterations to the bill that they are "assured" the Senate will accede to (wink, wink, nudge, nudge). President Obama has earned a huge legislative triumph, delivering on one of his primary campaign promises and earning a good bit of the Holy Grail of Democratic domestic politics of the last 60 years.

A couple of thoughts on the morning after.

1. This is not now, nor was it ever, about healthcare. It was about fundamentally reshaping the role of government in our lives, an alteration of the relationship between the governed and the government. The Democratic Party has seen the centrality of government in delivering healthcare as the key element of their social program, and though we have moved in the direction of socialized medicine over the years, this is a "great leap" in that direction.

2. What is done is difficult to undo. Even if the Republicans capture both chambers in upcoming Congressional elections, they will not have veto-proof majorities, rendering any attempt to overturn key portions of this legislation ineffective, as President Obama will simply veto them. Republicans MUST capture the White House in order to undo this travesty. That almost all of the revenue producing portions of the bill (read: TAXES) start immediately, and all the spending portions (read: SPENDING) start after 2014 (a gimmick designed to keep the total price down), is a good thing for Republicans--there will be two full years of taxing imposed on the American people before they see any of the promised "benefits" of the legislation.

3. I've got to hand it to my Congressman (Frank Kratovil, D-MD 1). He voted against the legislation. I didn't think he had it in him. He's made Republican Andy Harris' job even more difficult in unhorsing him.

4. I cannot even think about the photos of the Speaker, the Majority Leader and the President basking in the glow of their accomplishment. It makes me queasy.

5. But make no mistake about it. This is a HUGE legislative victory for the President and the Democratic Party. They have DELIVERED. Elections matter, they did what they needed to do in 2006 and 2008, and now we have this monstrous instantiation of creeping socialism to remind us of it.

6. If the Republican Party can't use this "loss" as a spur to great victory in November 2010, it will be guilty of political malpractice. There is a lot here to run against, and there are a lot of Democrats whose vote last night ought to be considered a political suicide note.

7. This legislative session is dead. The President may try and raise immigration reform, green jobs, cap and trade, school reform---etc--but Washington is TIRED, and all thoughts will now turn to fund-raising and November elections.

Homina Homina Homina!!

Rep. Dennis Kucinich (D-OH), Ed Norton to President Obama's Ralph Kramden these past few days, has called for a press conference this morning, where it is expected that he will publicly announce his switch from "no" to "yes" for the Senate Health Care "Reform" bill.

A ride in Air Force One is apparently all it takes - that and assurances that the public option will be put back in play.

Here's what Rep. Kucinich said just 10 days ago about the push to getting any bill passed to build upon:

"You're building on sand. There's no structure here. You're building on a foundation of privatization of our health care system. That's the problem. The insurance companies are the problem. They're nothing to build on."

He's right about one thing - I'm not seeing any structure here.

On Jack-Booted Thugs Kicking Down Doors

Yesterday, House Speaker Nancy Pelosi told a group of bloggers that the health care "reform" monstrosity under consideration by the House is only the beginning of the effort to nationalize health care financing and administration. "Once we kick through this door," the Speaker said proudly, "they'll be more legislation to follow."

Interesting choice of words, Madame Speaker.

Paul Ryan On Healthcare

Representative Ryan's got a good healthcare Op-Ed in the Post this morning. One sentence really stands out to me: "Through any analytical lens, the legislation will not address the central problem of skyrocketing health-care costs."

As I'm sure Representative Ryan knows--this has never been "the central problem" to the Democrats. The central problem to Democrats is extending healthcare to the uninsured--and therefore, the 85% who already have health insurance have NEVER been central to their schemes.