Obamacare's bureaucratic cost

Click to enlarge and be enlightened

I saw the above sign at an interstate rest stop in Florida the other day. If you can't read it, it says: Preferred Parking for alternative Fuel "Vehicles". It was set back from the parking lot behind a row if garbage cans and no parking spots were otherwise marked. Why the word vehicles is in quotation marks is a mystery to me. 

The sign is ridiculous, and faintly obnoxious on top of that. We understand that handicapped parking spots near an entrance are for the mobility impaired, what isn't clear is just what is the possible rationale for preferred parking for Chevy Volts, Ford Nucleons or some other alternative fueled "vehicle"?

Obviously there is no good reason for the signs. It would be easy to suspect some sort of conspiratorial social engineering purpose, but I imagine that its genesis was much more haphazard.

These days, floating around every large corporation, institution and government is the notion that they need to Go Green, whatever that may be. My guess is that the committee that handles Florida's rest stops was tasked to implement such a policy, and that this was the best they could come up with. There's no Florida law or regulation mandating this, so all that comes of it is signs behind garbage cans and a checkbox checked that says their making progress toward their Green goals.

In the best case scenario having hung the signs, they'll just forget them. Then again, should Prius owners notice SUVs parking in their preferred spots no doubt complaints will fly. What then? Will laws and regulations spring from the momentum of an ill-conceived bit of ersatz rule making that the public never knew about, that was never voted on, and that was never approved by the public? Sadly, probably so.

With the unfortunate Roberts' decision on Obamacare agencies, departments, divisions, committees and working groups are being assembled. Policies, mission statements and memos of all stripes are being written and sent hither and yon through the new bureaucracies. Stupid ideas, like the sign above, will multiply and gain a life of their own.

When you ask why an absurd rule is being enforced you'll be told because it is on the books. When you asked who wrote it, you'll get no answer, unless you want to follow a maze of phonecalls from desk to desk that ultimately lead no where.

To me that's the real shame of Roberts' decision. Even if if the Republicans get control of the House, Senate and Presidency and cut-off funding to these damn groups some of them will dodge the bullet and continue to grind away in whatever corner that they've drifted off to. That's the problem with big government, these countless people fidgeting with their cell phones in meetings while they come up with half-baked ideas to answer problems posed by memos that came from who knows where.

And in the end of the day there's a sign behind some garbage cans solving a problem that doesn't exist and that's just begging to turn into a festering boil of nanny-statism. Big government is still the root problem.

Squaring the Circle

The blog The Gormogons has a post by Ghettoputer, Doctors and the CIA, that discusses an ObamaCare issue that has also been puzzling me.

Conspicuously absent from the bill is any mention of tort reform regarding medical malpractice. When Howard Dean was asked why such reform was not addressed in the bill he bluntly answered:

"Here’s why tort reform is not in the bill. When you go to pass a really enormous bill like that, the more stuff you put in it, the more enemies you make, right? And the reason that tort reform is not in the bill is because the people who wrote it did not want to take on the trial lawyers in addition to everyone else they were taking on. And that is the plain and simple truth."

It is generally accepted that the real cost of malpractice law suits is not so much the cost of settlements, but rather the need for doctors to practice defensive medicine by ordering the maximum number of tests conceivable in any diagnosis.

ObamaCare attempts to address that problem by establishing boards, agencies and the like that will review medical best practices and mandate the scope of what treatments and tests should be performed (and for those who, like me, are too lazy to read the bill The Gormorgans has a good series of posts where he live blogs his reading of the bill in 100 page chunks).

That is ObamaCare seeks to reduce medical costs by setting up a set of guidelines that will free doctors from the need to do unessential medical procedures to protect themselves from lawsuits. Ignoring for the moment any questions about the wisdom of such a remote "top-down" approach to diagnosis, I wonder how malpractice suits will be impacted by the bill, especially in light of the fact that trial lawyers are such an important Democratic constituent that no attempt to reign them in is even considered?

The obvious answer is that, while the government insurance plan will be shielded from malpractice suits, the private insurers will still be exposed to them. However, it is rather more complicated than that, because over time the private insurers will be rolled into the treatment and testing guidelines mandated by the government. Would all insurers then not be shielded?

What then of the powerful trial lawyers lobby?

I think Ghettoputer might have squared that circle when he considers Holder, and the CIA investigation. The CIA interrogators had acted under Congressional and Justice Department review, yet at this late date the rules can simply be shifted and their cases opened again. Will the doctors end up facing a similar set of fluid rulings?

If they and private insurers are allowed to layer supplemental insurance on top of a government mandated minimum, does Holder and the CIA set the precedence of the rules being redefined after the fact move them into malpractice territory? Will that be the hidden fund the trial lawyers can expect to draw their settlements from?

ObamaCare -- a return to house calls?

Obama's remarks about the postal service got me thinking... why not combine ObamaCare with the Post Office to form a new Federal Agency to handle both?

It would not only be super efficient, it would also extend much needed, and healthy, competition for not only UPS and FedEx, but also to BlueCross/Blue Shield and other major insurers.

Also, along with your mail, you could get medical house calls to aid you with your coughs, colds, bumps, bruises and end-of-life planning.

Finally, if Obama played his cards right in appointing the first Surgical Post Mistress General, he could solve the problem of African students getting yelled at for asking about you-know-who.

Win-win-win!!!