I've spent a good bit of spare time over the past week or so digging through government web sites. My intent was to show that the whole Constitutional argument for the power of Congress to create a new health care plan is based on the scoundrel's clause: that last line of Section 8 of the Constitution... the necessary and proper clause. I was planning on showing how that's exactly the same argument used to create Medicare and Medicaid. And using real life numbers, I was going to show how the last iteration was, in fact, not necessary and not proper.
And it's not like my opinion has changed. If I could have found consistent data, you would have seen some brilliant snazzy graphs showing the costs over time... the costs per participant and projected costs into the future. But the data is just inconsistent. What we do (theoretically) know is this: as of 2008 taxes no longer cover expenditures. That big nice trust fund of the original plan -- that big wad of cash that grows over time and provides for future claims -- is gone. Long gone. Medicare and Medicaid underpayments to health care providers over the years have driven up costs for all of us -- for those outside the plan -- and have created the current "health care crisis" that we all are arguing about.
I am amazed at how bad the data seems to be for this sort of stuff. You can look on multiple US government web sites and find multiple sets of numbers for the same statistic from different organizations. If they don't know how many people are in the programs and how much it costs, how in the hell do they expect to manage it? I am also amazed at the government's idea of numbers. If the enrollment for these programs grows at a rate less that it grew last year, it is deemed to be "shrinking." Growing slower is not the same thing as shrinking! What kind of math is that? Hey, my electric bill only went up 2% this year! It must be cheaper than it was last year!
So we'll continue to argue over whether Congress has the right to expand the program that is bankrupt. And this time we have the knowledge they didn't have then: We see how their previous programs have worked for us. The idea of expansion of a bankrupt program is akin to the thought that if Bernie Madoff just had a few more investors, his whole plan would have turned out a whole lot better. And just like Mr. Madoff: if you cannot explain the mathematics of how to expand coverage and reduce cost in simple 8th grade math -- you have no business investing in it.
Congressional Budget Office Director Douglas W. Elmendorf said it best when he testified before the Senate Budget Committee members on July 16 and said: "the federal budget is on an unsustainable path — meaning that federal debt will continue to grow much faster than the economy over the long run." What apparently was missing was where he must have said: "Now... go out there and expand!"