It amazes me that there are still people who think that the government can improve their lives over the long-term by creating additional costly bureaucracies. Do you really think medical care is going to be better with the government more involved in supplying or controlling it? Then consider this: Would you prefer a public defender or a private attorney to defend you in a criminal case?

You could argue that a public defender is better than no attorney at all, and you would probably be right. You could also argue, correctly in most cases, that public medical care is better than no medical care at all. But, if you try to use this argument to defend the need for Obamacare you are way off-base. Public medical care is already available. Obamacare is being pushed because the currently available public medical care is not as good as the currently available private medical care. That is, the Obamacare proponents are admitting that public medical care is not as good as the private medical care available to those who can afford it, and they want to remake the medical care system so that this disparity is removed.

So, the real question is: How will Obamacare remove the disparity? Will it bring the public medical care up to the level of the private medical care? Will it bring the private medical care down to the level of the public medical care? Or, will they meet somewhere in the middle? This leaves out the worst-case outcome -- that Obamacare turns out to be worse than the currently available public medical care, which I think is a very real possibility.

Obama is not saying that our private system is not providing good medical care; he is saying that some people can't afford it. He is saying that the public system is not providing good medical care to those who can't afford the private care. That is, he is saying the private system is working and the public system is not working. So, he wants to replace the private system with a new public system. Go figure.

I want to emphasize that Obamacare is more concerned with leveling the availability of medical care than with improving the quality of medical care. There are three ways to level something: (1) grind off all the high points down to the lowest low points and discard the excess material, (2) bring in extra material and fill in the low points up to the highest point, or (3)  chop off the high points until you have enough material to fill in the low points so that the whole surface is even and smooth. In most cases the latter is the most efficient and inexpensive. Since Obama insists that he will lower the overall cost of medical care, don't look for him to use the second method. And God help us if he uses the first method.

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President Obama claims that his Obamacare will reduce the overall cost of medical care. There are lots of detractors, including me, who say that this is impossible without limiting the types and amount of medical care available. But, could he have in mind achieving government cost savings in another way? If Obamacare eventually leads to reductions in the medical care options available to the elderly, their life expectancy will be shortened. This will lead to reduced payouts in Social Security benefits.

I know that he claims that no such policy is included in Obamacare. Perhaps it isn't in the current bill, but what about next year? It can always be added later. Actually, it doesn't have to be spelled out in the bill itself. It can simply be implemented as a preferred practice by the policy making board that the bill does authorize.

There are also a lot of federal civil service retirees out there drawing their pensions directly from the Treasury. Although federal workers contribute a percentage of their salaries to  a "retirement fund," no such fund exists. The government just spends the contribution on something else and assumes the responsibility to pay retirees from the Treasury.

So, if federal retirees start dying at a younger age, further government cost savings will accrue. There aren't nearly as many federal retirees as Social Security recipients, but federal retirees generally draw more than Social Security recipients.

If four retirees draw an annual pension of $50,000 dollars each from federal civil service and/or Social Security, the government saves a million dollars if they die five years younger. And that doesn't even count any savings on their medical care.

Is this fear-mongering? I don't think so.

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President Obama contributed an article yesterday to the New York Times titled, Why We Need Health Care Reform. He failed to explain why. He just repeated the assertions that he has made several times recently in his appearances on television. He opened with this:

OUR nation is now engaged in a great debate about the future of health care in America. And over the past few weeks, much of the media attention has been focused on the loudest voices. What we haven’t heard are the voices of the millions upon millions of Americans who quietly struggle every day with a system that often works better for the health-insurance companies than it does for them.

Well, of course we haven't heard directly from millions upon millions of people, either for or against Obamacare. How could that happen over a period of a few weeks? The polls give us a sampling of those voices but we won't hear from all of them until the elections next year. The polls indicate that he should be glad he's not hearing from the masses.

The claim that health insurance often works better for the insurer than the insured is a good example of the many statements that pour from the president's mouth that mean nothing. Saying that it often works better for the insurer doesn't negate the possibility that it also often works better for the insured. In fact, that is what insurance is all about. With many of its policies the insurer collects more money from the insured than it pays out to the insured. On the other hand, many of its policies result in greater payouts to the insured than payments collected from the insured. Of course, if the insurer wants to make a profit and stay in business it has to do a little more of the former than the latter.

The president then gives a couple of anecdotes from people who were denied health insurance. Such anecdotes are attention grabbers but taken alone they mean almost nothing. What we need to know is, does this represent the norm or are they just extremely isolated cases? There are lots of such cases as he describes in the British and Canadian health-care systems that he cites as models for Obamacare. There are such cases in Medicare and Medicaid. There will be such cases in Obamacare if it becomes law. No system is going to work perfectly. So give us real data, not more anecdotes.

The president offers "four main ways the reform we’re proposing will provide more stability and security to every American:"

First, if you don’t have health insurance, you will have a choice of high-quality, affordable coverage for yourself and your family — coverage that will stay with you whether you move, change your job or lose your job.

Blatant assertion! No details! Just trust me to work miracles? High-quality, affordable coverage even if you don't have a job? We truly live in a marvelous time. What the man really means, of course, is that others will pay when you can't or won't. What he means is that you will not only be protected from medical costs but you will also be protected from having to pay your policy premiums. What is that, insurance-insurance?

I can't wait until we have national food-insurance, clothing-insurance, energy-insurance, communications-insurance, entertainment-insurance, housing-insurance, and then insurance on all that insurance. I mean, these are all basic human-rights, right?

Second, reform will finally bring skyrocketing health care costs under control, which will mean real savings for families, businesses and our government. We’ll cut hundreds of billions of dollars in waste and inefficiency in federal health programs like Medicare and Medicaid and in unwarranted subsidies to insurance companies that do nothing to improve care and everything to improve their profits.

He admits here that two government run health-insurance programs are fraught with waste and inefficiency -- to the tune of hundreds of billions of dollars. He says nothing about how he will eliminate that waste and inefficiency or why Obamacare won't have the same problems. He apparently wants us to believe there is something special about Obamacare that will avoid those problems. If so why doesn't he share it with us? Appointing panels, boards and czars to direct and audit Obamacare won't necessarily do it; Medicare and Medicaid have panels, boards and czars. Please tell us exactly how Obamacare is going to be different.

He thinks that it is the job of insurance companies to improve health-care? Little ol' me thought that was the job of health-care providers. Again, insurance companies are only in the business of helping people spread out their risk. Sure, they would prefer that you not get sick, not wreck your car and not have your house burn down. They might even make some suggestions on how you can avoid these misfortunes, but they aren't in the business of substantially preventing them. After all, if none of these things ever happen to you why would you need insurance?

Third, by making Medicare more efficient, we’ll be able to ensure that more tax dollars go directly to caring for seniors instead of enriching insurance companies. This will not only help provide today’s seniors with the benefits they’ve been promised; it will also ensure the long-term health of Medicare for tomorrow’s seniors. And our reforms will also reduce the amount our seniors pay for their prescription drugs.

He is going to make Medicare more efficient than an insurance company? Again, Mr President, how exactly are you going to do that? Medicare is an insurance fund. It is managed by a government bureaucracy and contracts with private firms to process claims. Where is the waste and inefficiency? Is it in the government management, in the private claims processing or in both? I can certainly believe that Medicare is fraught with waste; most, if not all, direct government services are fraught with waste (by direct I mean services provided directly to individual citizens; indirect services would include defense and foreign policy). What I don't believe is that Obamacare can substantially eliminate that; in fact, I believe it might make it worse. This point is just more assertions with no details or substantiation.

Lastly, reform will provide every American with some basic consumer protections that will finally hold insurance companies accountable. A 2007 national survey actually shows that insurance companies discriminated against more than 12 million Americans in the previous three years because they had a pre-existing illness or condition. The companies either refused to cover the person, refused to cover a specific illness or condition or charged a higher premium.

No, Mr President, please don't tell me that! An insurance company refused to insure a house after it had already burned down? And the ones that did wanted to charge a higher premium? What is this world coming to? Sarcasm aside, if the president wants people with pre-existing health problems to be insured someone will have to be charged a higher premium. That will probably be everyone who is able to pay anything, and then we've got welfare, not insurance.

Most important, we will require insurance companies to cover routine checkups, preventive care and screening tests like mammograms and colonoscopies. There’s no reason that we shouldn’t be catching diseases like breast cancer and prostate cancer on the front end. It makes sense, it saves lives and it can also save money.

I'm all for preventive medicine because it saves lives. But several people or organizations have seriously researched this and have found that it doesn't save money overall. The problem is that everyone has to be periodically tested because there is no way to know who will contract a disease. To illustrate, if 100 people have to be tested over a period of many years to find one person with a disease, the cost of the tests can far exceed the cost of treating the one person who contracted the disease.

If Obama's article were a high-school essay I would give it an F. I know he's not that dumb, so I'm left to conclude that he is being devious. He thinks we're the dummies and that he can sell us some snake-oil. But he's certainly no Billy Mayes. What I don't understand is why he put his article in the New York Times. His cohorts could have told him that the country's dummies don't read it.

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