Completely Overlooked in Health Care Bill: Supply

The Wall Street Journal has an article today on something that should have been obvious to all when creating the health care bill, but was completely ignored by the Democrats: supply.

At the current rate of medical school completion, the US could be 150K doctors short in the next 15 years. The government plays a great role in medical education because Medicare funds most of the costs associated with medical residencies.

Common sense would say that the government, in concert with expanding the amount of those who will want access to health care, would greatly increase Medicare funding for residencies, so that medical schools could expand and more doctors could be trained to meet the demand of 30 million new medical consumers. Not only was Medicare funding for medical residents not raised, Medicare was cut by $500 billion in an accounting move to make the bill seem less of a boondoggle.

As a result, there will be a huge shortage of doctors and a looming supply problem in medical care that will require a huge fix in the years to come.

Something Never Discussed During the Health Care Debate: Supply

The House passed the Senate Health Care plan, as well as a series of Reconciliation measures designed to force those without health insurance to buy it (or face a penalty), as well as taxing upper income taxpayers to subsidize insurance for those who make under $88,000/year.

Regardless of whether you agree with this or not, and I clearly do not, there is one question that no one seems to be asking. Let's assume there are 45 million or so people in the U.S. who do not consume health care because they do not have insurance. This bill will insure almost all of them, so assume there will be at least 40 million new health care consumers in the U.S. in five years. Even with the influx of money that could be spent from the insurance premiums and payments by insurers to health care providers, who will be treating these patients?

As far as I can tell from cursory glances at the legislation and more in-depth study of the news reports on it, there is nothing in the legislation to support the creation of new medical schools. How will you increase the consumer base of medical care in the U.S. by 20% or more without any increase in the number of medical doctors, nurses, and other health care workers? How will the system handle all the new demand for services? Doctors are incredibly overworked as it is.

Money can build hospitals and buy equipment, but medical schools are the only way to tilt the balance of supply and demand. If the supply cannot keep up with the new artificially-inflated demand, the supply is going to get more expensive no matter what the government does. If the government was serious about cutting the costs of health care, it would provide incentives to universities to create medical schools and hospitals to create residency programs. After a few years with larger classes of new doctors, there would be more supply to meet the new demand for services, and costs would stabilize or go down.

That is how you solve a health care problem. Forcing millions more people into a health care system that operates at or near capacity on a regular basis is not going to solve any problem. Giving people insurance that they cannot use because the system is flooded with patients who cannot be seen is a disaster waiting to happen.

Even Progressives Hope Coakley Loses - And They Should

Martha Coakley, the mediocre Attorney General turned US Senate candidate, has caused quite an impression on the political world. She has made gaffe after gaffe after gaffe, claiming Curt Schilling is a Yankee fan and that shaking hands of voters at Fenway Park for the Winter Classic is pointless.

Progressives are now starting to make the argument that even the most ardent left wing Democrats should not be voting for her, in an attempt to purify the party and force them to nominate candidates that appeal to the left wing.

For liberals and Democrats, abstaining or voting against Coakley is an interesting option. If Martha Coakley wins on Tuesday, she will likely never face a primary challenger again for as long as she chooses to serve in the Senate. This conceivably means that Coakley could be scot-free for 30 or 40 years (See Kennedy, E. and Byrd, R.), never facing a challenge from another Democrat and potentially never seeing a strong Republican challenger.

But Coakley is a disaster of a candidate. By all standards of measurement, Coakley has been an absolute disaster, so much so that even if Coakley wins, she will be seen as a failure of a politician. If Democrats abstain or vote for Scott Brown, they can think to themselves that the Democratic Party can nominate a stronger challenger to then Senator Brown in 2012. In other words, the Democrats would be able to trade 2+ years of Scott Brown in the Senate for the ability to nominate a non-disaster of a Senate candidate.

The Democrats could have solved all of this by not just voting for the token woman in the December primary. However, they are Democrats, and are more than happy to vote for labels above other things, such as ideas and qualifications. The best way for Democrats to fix their mistake is to vote for Scott Brown on Tuesday and hope they do not nominate another loser in 2012.

By then, Coakley will safely be sent off to be the dog catcher in North Adams, or another similarly useless position fitting of the worst Democratic candidate for US Senate in quite a long time.

Scott Brown Gets It

The "Teddy Kennedy" seat in the Senate is wrong, as wrong as most voters in Massachusetts are, the seat still belongs to the people of Massachusetts, not Coakley or Kennedy.

This is not the Deep South in the early 20th Century, where the real election was the Democratic primary.

Scott Brown can conceivably win this race. Massachusetts can stand for America.

Scott Brown Day

Scott Brown, the Republican candidate for Senate in Massachusetts, has had quite a day today.

First off, he raised over a million dollars today. As of 11:30PM, he has raised $1,117,747 today. Outside of Mitt Romney, can you imagine a Republican from Massachusetts raising anywhere near that much money in a week, nevermind a day? The money may be mainly coming from outside of Massachusetts, but it will pay for numerous commercials until the election next Tuesday.

Secondly, he took Martha Coakley to the cleaners tonight. Not just my opinion as well. Commentators like Andy Hiller from Channel 7 and Joe Battenfeld of Channel 25 say he ran away from the debate. Coakley is a horrible debater, lacking when she needs to move off the script her handlers give her. Scott Brown showed enthusiasm, knowledge and spark, and also showed that he was not a typical GOP guy, which clearly helps in Massachusetts.

There might be a real race in the next week or so. Ignoring the predictable Globe poll on Sunday that showed Coakley up 15% (despite the fact that the day it went to press it was 4 days old, and the sample size was too small collected over a too long period of time.... but polling issues are for another day), there is another poll that shows Brown ahead, within the margin of error, 48%-47%. Coakley has turned out to be a horrible candidate for the Dems, and even if she wins, she is damaged goods.

Go Scott Brown!

Could Massachusetts Elect a Republican Senator?

A recent poll for the special U.S. Senate election on January 19 has Scott Brown down 50-41 among "likely voters" and Brown only down 2 percent among respondents who stated they would definitely vote.

Considering that in Massachusetts the Democrats have always won every statewide position (except Governor until 2006), usually by large margins, this poll must be a gut punch to the Democrats. For Senate races, the Democrat usually wins by approximately 65-70% to 30-35% (even a well-funded Mitt Romney only got 41% as a Senate candidate).

Why is Scott Brown doing so well? Well, a sinister idea is furthered by Ben Smith of Politico, that the Democrats nationally are rooting and hoping for a close race so that the Democrats can win and state that the Republican momentum is a myth. It is an idea with some supporting evidence behind it. The Boston Globe, normally the mouthpiece of the Democratic party in Massachusetts, has published articles critical of Coakley, stating that she went easy on a defendant in a 2005 case and was a poor performer before the US Supreme Court in a case Coakley lost that has made prosecution crime labs overburdened. Could the Globe be purposely trying to put the race closer on the idea that there is no way Massachusetts will elect a GOP man?

Here's hoping, if the Democrats are purposely trying to make the race closer, they overdo it and cause Coakley to lose. Coakley is a horrible candidate, and only won the primary because she was the only female. She is an awful speaker, unable to expand on anything beyond force-fed talking points, and clearly will be nothing more than an empty Democratic vote. Massachusetts could make Scott Brown a very dependable independent Senator, toning down his more right-wing views for the purpose of reelection.

Win or lose, at least the campaign commercials have gone way down since the primary ended.

Alan Grayson: Douchebag

Congressman Alan Grayson, of Florida's 8th District, wrote the US Attorney General to investigate the website www.MyCongressmanIsNuts.com, because of supposed fraud by the website author.

Apparently Grayson's beef with the website is that the author claims to live in Grayson's district but does not. Grayson thinks this horrible sin is fraud and that the website author is violating the election laws. It surely cannot be that Grayson would be trying to intimidate someone who is critical of him with the weight of the Department of Justice. I mean, surely that's an appropriate punishment for a local critic of a nobody Congressman. Has anyone ever heard of this guy? I didn't think so.

Democrats don't hate free speech at all! They hate people who have the nerve to speak different viewpoints than their own. Alan Grayson, get a pair of balls. You are in politics, and are unnerved by someone challenging you. If anyone should be investigated for breaking the law, it is Grayson, for abuse of process or some false accusation statute that the US Code almost certainly has (yes, lawyers don't know every law).

Funny the Way Edwards Is

Most likely the funniest part of this New York Times story on Sunday detailing John Edwards' affair with Riele Hunter is this:

"In the proposal, which The New York Times examined, Mr. Young says that he assisted the affair by setting up private meetings between Mr. Edwards and Ms. Hunter. He wrote that Mr. Edwards once calmed an anxious Ms. Hunter by promising her that after his wife died, he would marry her in a rooftop ceremony in New York with an appearance by the Dave Matthews Band."

Who knew John Edwards and/or Riele Hunter loved the Dave Matthews Band? While I can say with extreme certainty that I don't stand for anything that Edwards does, I do love DMB. However, given that Edwards was trying to convince Hunter that after his current wife kicked the bucket he would marry her, it's likely that Hunter really likes DMB and Edwards is a sleazebag.

Edwards, the king of plaintiffs lawyers, purportedly planned his second wedding while his first wife was recovering from cancer. Nevermind that his presidential campaign spent over $100K on "video services" that Hunter supposedly provided, that he convinced a long-time friend to take the fall for Edwards' love child, or that he has refused to admit that he fathered the kid even after the National Enquirer caught Edwards in a hotel that Hunter was staying it. Telling your mistress that you'll marry her while your wife dies from cancer is truly despicable.

But hey, he might like DMB. Unfortunately, the bass player for DMB, Stefan Lessard, had this to say on his Twitter page:

"We don't play weddings. Period. Ridiculous and wrong."

Tough break for Edwards. Edwards probably shouldn't have been a Gravedigger Digging a Ditch for his first wife prematurely, instead waiting until she was Lying in the Hands of God. Cause when you do that stuff, You Might Die Trying. Definitely not a Typical Situation. His plan clearly wasn't the Best of What's Around.

That said, any world where Edwards is getting exposed for being a sleazebag is One Sweet World. Everyday.

One Man = One Vote?

One of the tenets of our political system is the (inaccurate) concept that one person in Illinois has the same vote as one person in Mississippi. Of course, the Electoral College and the Senate make this a complete facade, but the concept is still one of the great myths of our democracy.

Now a group is trying to attack it based on unequal voter distribution by Congressional district. A group called Apportionment.US has found filed a lawsuit on behalf of a voter in five states, Mississippi, Montana, Delaware, South Dakota and Utah, claiming that these states have a Congressional apportionment that is inferior to other states, specifically Wyoming, Rhode Island, Nebraska, Iowa and West Virginia. They state that while a US House district in Rhode Island has 525K or so people in it, a district in Mississippi has 713K or so.

Apportionment.US argues that the deviation in populations between US House seats is much wider than deviations that the Supreme Court have found unconstitutional in local elections. They cite Karcher v. Daggett, and argue that if the Supreme Court in Karcher found a deviation in district populations of 0.6984% unconstitutional, the deviation currently in US House seats of 5.75% is also unconstitutional.

To remedy this, Apportionment.US would like to vastly increase the size of the US House. They offer two plans, either making the House have 932 members or 1,761 members and claim that this could cut the deviation in House seats from 5.75% to 1.48% if there were 1,761 members of the House.

Adding members of the US House is a great idea. 600K+ residents per US House District is much too high. Great Britain, a country of about 61 million people, has a House of Commons with 646 members, and they will add 4 members to the Commons by the next election. If Britain can have a legislature of 650 members for a country that size, the US House could easily double or triple its membership. Adding members to the US House would not only fix this apparent discrepancy between state populations and representation, but it would also cut the costs of elections. With fewer constituents, US House members could do more retail politicking and have less of a need to spend money on television, particularly when any television campaign will be directed at more people who are not in their district than in their district. It will make national politics more local, and cut the entry cost for new candidates. Here's hoping Apportionment.US succeeds.

Banana Republic

In 2004, the MA legislature changed the law that had previously allowed the governor to appoint an interim senator because they were worried that Mitt Romney would appoint a Republican if John Kerry won.  Thankfully, John Kerry didn't win, but his run for President is still causing trouble five years later.

The MA legislature's law allows for a special election between 145-160 days after the resignation/death of a Senator. There is no provision for an interim Senator because the legislature was worried Romney would have appointed a Republican. Now the Democrats have decided that laws are to be changed depending on who will best benefit from them. If the Republicans are going to benefit, they change the law. If they want to benefit, they'll make sure they do. Like most acts of the MA legislature, this sets a horrible precedent; why have rules and laws on what to do in certain situations when the legislature can just decide to change the law because it will advantage the majority.

The Democrats do this under the guise of "needing full representation". Garbage. When Kerry ran for President in 2004, he missed almost every vote. From the time Ted Kennedy was diagnosed with cancer to his death, he missed almost every vote. If the Democrats were serious about this, they could have convinced Kennedy to resign upon his diagnosis, and they almost certainly would have won a special election that would have been held over a year ago. MA needs two Senators because of Obama's "historical change agenda?" Garbage.

Acts like this make it clear that Massachusetts needs a second political party. Even though I'd like it to be a conservative party, even if it were the Green Party or the Libertarian Party or any other group that became viable, the majority party would be held in check. If there is a substantial opposition, the Democrats would be more likely to play by rules that they would want used if the Democrats were a minority party. Right now, that's impossible, and they can change the laws at their whim.

When a US Representative resigns or dies, they hold a special election. One vote in the Senate isn't much more important, even if there are one-fourth the Senators as Representatives. Hopefully the MA legislature shows some ethics that aren't in the mold of Wilkerson or DiMasi and leaves the law the way it is. But we know they won't.