Democrats tell us they’ve been trying to nationalize health care for 65 years, but the first anyone heard of the “opt out” provision was about a week ago. They keep changing the language so people can’t figure out what’s going on.

The most important fact about the “opt out” scheme allegedly allowing states to decline government health insurance is that a state can’t “opt out” of paying for it. All 50 states will pay for it. A state legislature can only opt out of allowing its own citizens to receive the benefits of a federal program they’re paying for.

It’s like a movie theater offering a “money back guarantee” and then explaining, you don’t get your money back, but you don’t have to stay and watch the movie if you don’t like it. That’s not what most people are thinking when they hear the words “opt out.” The term more likely to come to mind is “scam.”

While congressional Democrats act indignant that Republicans would intransigently oppose a national health care plan that now magnanimously allows states to “opt out,” other liberals are being cockily honest about the “opt out” scheme.

On The Huffington Post, the first sentence of the article on the opt-out plan is: “The public option lives.”

Andrew Sullivan gloats on his blog, “Imagine Republicans in state legislatures having to argue and posture against an affordable health insurance plan for the folks, as O’Reilly calls them, while evil liberals provide it elsewhere.”

But the only reason government health insurance will be more “affordable” than private health insurance is that taxpayers will be footing the bill. That’s something that can’t be opted out of under the “opt out” plan.

Which brings us right back to the question of whether the government or the free market provides better services at better prices. There are roughly 1 million examples of the free market doing a better job and the government doing a worse job. In fact, there is only one essential service the government does better: Keeping Dennis Kucinich off the streets.

So, naturally, liberals aren’t sure. In Democratic circles, the jury’s still out on free market economics. It’s not settled science like global warming or Darwinian evolution. But in the meantime, they’d like to spend trillions of dollars to remake our entire health care system on a European socialist model.

Sometimes the evidence for the superiority of the free market is hidden in liberals’ own obtuse reporting.

In the past few years, The New York Times has indignantly reported that doctors’ appointments for Botox can be obtained much faster than appointments to check on possibly cancerous moles. The paper’s entire editorial staff was enraged by this preferential treatment for Botox patients, with the exception of a strangely silent Maureen Dowd.

As the Times reported: “In some dermatologists’ offices, freer-spending cosmetic patients are given appointments more quickly than medical patients for whom health insurance pays fixed reimbursement fees.”

As the kids say: Duh.

This is the problem with all third-party payor systems — which is already the main problem with health care in America and will become inescapable under universal health care.

Not only do the free-market segments of medicine produce faster appointments and shorter waiting lines, but they also produce more innovation and price drops. Blindly pursuing profits, other companies are working overtime to produce cheaper, better alternatives to Botox. The war on wrinkles is proceeding faster than the war on cancer, declared by President Nixon in 1971.

In 1960, 50 percent of all health care spending was paid out of pocket directly by the consumer. By 1999, only 15 percent of health care spending was paid for by the consumer. The government’s share had gone from 24 percent to 46 percent. At the same time, IRS regulations made it a nightmare to obtain private health insurance.

The reason you can’t buy health insurance as easily and cheaply as you can buy car insurance — or a million other products and services available on the free market — is that during World War II, FDR imposed wage and price controls. Employers couldn’t bid for employees with higher wages, so they bid for them by adding health insurance to the overall compensation package.

Although employees were paying for their own health insurance in lower wages and salaries, their health insurance premiums never passed through their bank accounts, so it seemed like employer-provided health insurance was free.

Employers were writing off their employee insurance plans as a business expense, but when the IRS caught on to what employers were doing, they tried to tax employer-provided health insurance as wages. But, by then, workers liked their “free” health insurance, voters rebelled, and the IRS backed down.

So now, employer-provided health insurance is subsidized not only by the employees themselves through lower wages and salaries, but also by all taxpayers who have to make up the difference for this massive tax deduction.

How many people are stuck in jobs they hate and aren’t good at, rather than going out and doing something useful, because they need the health insurance from their employers? I’m not just talking about MSNBC anchors — I mean throughout the entire economy.

Almost everything wrong with our health care system comes from government interference with the free market. If the health care system is broken, then fix it. Don’t try to invent a new one premised on all the bad ideas that are causing problems in the first place.

Obamacare quisling J. James Rohack, MD

When Norwegian politician Vidkun Quisling was tried and shot for abetting the Nazi occupation of his country during WWII, his name entered the vernacular as a synonym for “collaborator.” It is difficult to think of a more appropriate adjective to describe the health care “stakeholders” who have been genuflecting at the altar of “reform” since the Obama administration marched into Washington last January. While actual patients have protested at town hall meetings and organized demonstrations against Obamacare, the American Medical Association, the American Hospital Association, the Pharmaceutical Research and Manufacturers of America, America’s Health Insurance Plans and a variety of other industry groups have been hard at work currying favor with their new masters.

The most transparently self-serving of these stakeholders has been the AMA. The waning but still influential physician association was among the first to join with the new administration in its effort to take over U.S. health care. The President of the AMA, J. James Rohack, began parroting the empty platitudes of reform shortly after the election and jostled with his fellow quislings for a conspicuous place at the May press conference at which Obama announced his “historic” cost-cutting deal with industry players. As Rohack put it at the popular medical blog, Kevin, MD: “In an unprecedented endeavor aimed at achieving health-care reform this year, the American Medical Association stood with President Obama and other key health-care stakeholders Monday to announce efforts to ‘bend the spending curve’ on health care.”

But Dr. Rohack wasn’t there to bend the spending curve or to promote genuine health care reform. He was there to protect his paycheck. Specifically, he wants to stop an imminent and deep reduction in the amount of money the government pays doctors. Medicare’s physician payment scheme, the Sustainable Growth Rate (SGR) formula, mandates a 21% cut — and it is due to be implemented next January. It is this “curve” that the American Medical Association is truly seeking to “bend.” As it is phrased at the AMA website: “Permanent reform of the archaic Medicare physician payment system is among the core principles the AMA is urging Congress to include as part of comprehensive health system reform this year.” Dr. Rohack is obviously hoping that collaboration on the Democrat reform charade will earn the AMA a presidential pardon from SGR-mandated cuts.

The American Medical Association was not always so ready to collude with the enemy. Motivated by well-founded fears that government-run health care would inevitably lead to bureaucratic interference in the practice of medicine, the AMA actively opposed Harry Truman’s post-WWII attempt to impose nationalized health care on the country. Likewise, the organization vigorously opposed the enactment of Medicare during the early 1960s. It even launched what is often cited as the first viral marketing campaign, “Operation Coffee Cup,” featuring an LP of Ronald Reagan describing the dangers of socialized medicine. During the early 1990s, after some early flirtations with the Clinton health care “reforms,” the AMA eventually joined the coalition of health industry organizations that provided Hillarycare with its much-needed end-of-life counseling.

The once-feared organization has become far more pliant in recent years, however. Since the Sustainable Growth Rate formula was imposed in the 1990s, the AMA has repeatedly been forced to go hat-in-hand to its Beltway masters for stays of execution. Each time, Congress has issued a reluctant reprieve from payment cuts — but not without a price. In exchange for its 2008 reprieve, the AMA was forced to cooperate with congressional Democrats in their disgraceful move to gut Medicare Advantage (MA), a program that has greatly benefited poor and minority seniors. In that tawdry episode, the Dems attached an SGR waiver to a bill that cut funding for Medicare Advantage, whereupon the AMA cravenly began parroting DNC talking points about insurance company profits. This collusion helped the Democratspush through the first of several cuts in MA funding.

This year, the price of the AMA’s reprieve is support of whatever health care legislation emerges from Congress. And, so long as the final bill does away with SGR, the organization is obviously prepared to be a willing accomplice in whatever fraud the Democrats perpetrate. Thus Dr. Rohack rhapsodized about HR 3200, the widely-panned House version of Obamacare: “This legislation includes a broad range of provisions that are key to effective, comprehensive health system reform.” HR 3200 includes nothing of the sort, but it does contain a provision that would repeal SGR. Meanwhile, the absence of such a provision in the Senate Finance Committee bill produced a noticeably tepid response from the good doctor, despite a $250 billion sop to Cerberus that purports to solve the SGR problem.

There are, of course, legitimate reasons to oppose the SGR. This payment formula, like the PPS methodology to which the federal government subjects most hospitals, is nothing more or less than a Soviet-style price control system. And, as with all price control schemes, the SGR has failed to control costs and created distortions in the market. One of its most conspicuous effects has been a shortage of primary care physicians willing to treat Medicare patients. Unfortunately, the current AMA leadership has decided not to seek any real change in this perverse and counterproductive system. Instead of using the association’s leverage to force genuine free market reforms, Dr. Rohack has settled on a strategy designed to produce a special dispensation for his members, regardless of the damage it does to our health care system.

The tragic irony of this cynical strategy is that it will not work. As Vidkun Quisling discovered in October of 1945, the advantages of collaboration are always short-lived. A temporary reprieve from Medicare payment cuts is all Dr. Rohack will have gained by delivering his patients and colleagues into the hands of Washington’s health care bureaucrats. Because socialized health care systems are explicitly designed to circumvent the market mechanisms that actually control costs, they must always revert to the only remaining alternatives: rationing services to patients and cutting payments to providers. All government-run systems do both, and Obamacare will be no different. Once the President has finished using them for political cover, the AMA and the rest of the “stakeholders” will be abandoned to the depredations of bureaucrats and the revenge of an angry public. This is the inevitable fate of all quislings.

A centerpiece of the debate over ObamaCare is government coercion and the right to choose a health-care plan. So it’s worth watching a lawsuit now making its way through the federal courts that seeks to let seniors keep their Social Security benefits even if they reject Medicare. This could be a big deal.

Last week, Washington D.C. District Judge Rosemary Collyer handed a victory to three plaintiffs seeking that right. President Obama’s Department of Health and Human Services had sought to dismiss the suit challenging so-called POMS rules that say seniors who withdraw from Medicare Part A must also surrender their Social Security benefits. (Part A covers hospital and outpatient services.) The judge ruled the plaintiffs have standing to contest their claim on the merits.

POMS were imposed in 1993 during the Clinton Administration and set forth rules that aren’t in the statute or regulations governing Medicare. The three plaintiffs—Brian Hall, John Kraus and former U.S. House Majority Leader Richard Armey—all had health-care plans they preferred to the coverage they were compelled to receive through Medicare.

In her ruling this week, the judge said that “neither the statute nor the regulation specifies that Plaintiffs must withdraw from Social Security and repay retirement benefits in order to withdraw from Medicare.” Article I of the Constitution gives Congress sole power to legislate—so when agency rules conflict with federal statute, the statute takes precedence.

The Obama Administration argued that the case should be dismissed because the plaintiffs had not exhausted the available administrative remedies for challenging POMS. Judge Collyer rejected that notion, noting that one plaintiff had sought an administrative hearing but “received no response from the SSA for approximately three years.” Exhaustion of remedies was therefore “futile.” A three-year wait is precisely the kind of bureaucratic hassle, or deliberate stonewalling, that government is famous for.

Keep in mind that the plaintiffs are merely asking for the freedom to spend their own money for their own health insurance. With Medicare careening toward bankruptcy, letting seniors opt out could help save the taxpayers money. The plaintiffs argue, and reasonably so, that they have paid a lifetime of taxes into Social Security and shouldn’t have those benefits denied merely because they are willing to pay for their own medical care. Social Security and Medicare are separate programs, and both are financed by separate payroll contributions.

The response of the Obama Administration to this lawsuit is revealing about its principles, as opposed to its rhetoric. President Obama says his plan for a “public option” wouldn’t be coercive, saying that “If you like your health-care plan, you keep your health-care plan. Nobody is going to force you to leave your health-care plan.” But here is a case where federal bureaucrats are using their power to force Medicare on seniors. Let’s hope the courts restore a genuine right to choose.

by Gary Varvel

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Former President Jimmy Carter departed from his usual habit of condemning America from abroad and did it from the homeland last week. Dealing the race card from the bottom of the deck, he charged that opposition to President Obama is “based on the fact that he is a black man, that he’s African-American.” And not just some of the opposition but “an overwhelming portion,” as he phrased it. In the absence of documented mind-reading, this is nothing more than a glib, unverifiable assertion. To paraphrase Al Gore, a convenient untruth.

Grasping for evidence, Carter described a sign he claimed he saw at the Sept. 12 March on Washington which read: “We should bury Obama with Kennedy.” In fact, the sign said: “Bury Obamacare with Kennedy.” This is a vital distinction. Carter’s imagined wording would have been personal and threatening. The actual wording, while in poor taste, expressed a difference in policy, since universal health care was Ted Kennedy’s pet issue.

Where do liberals come off being so mean-spirited and cynical when it comes to policy differences? Since my longstanding opposition to Kennedy on health care, taxation or foreign policy was on philosophical and political grounds, why couldn’t I disagree with Obama for the same reasons? Conservatives disagree with Gore on cap and trade and with labor bosses like Andy Stern and John Sweeny on the card check bill. Why is it automatically racist if you disagree with Obama on these same issues?

Alan Keyes, who is black, is an uncompromising conservative on economic, defense and social issues. He ran for president in 1992, 1996, 2000 and 2008. Were white liberals who opposed him motivated by racism? It gets even sillier: Maybe the blacks who opposed him were racists, too? How about Democrats who favored Obama over Hillary Clinton in the 2008 primaries? Are they misogynists? Can you disagree with half of Obama’s policies because he’s only half black?

I agree with conservative Supreme Court Justice Clarence Thomas, who is black. I like Walter Williams and Thomas Sowell, two black, free-market economists. I support the school voucher program for black, low-income kids in Washington, D.C. Does all that exempt me from charges of racism?

There are, no doubt, some racist Americans. But when Carter claims that the racism factor is “overwhelming” among Obama critics, does he mean 51 percent, 75 percent or 99 percent? The latest Rasmussen poll reports that only 12 percent of voters believe that Obamacare opponents are racists; 67 percent disagree with that accusation. The breakdown by party affiliation is revealing: 88 percent of Republicans and 78 percent of independent voters reject the racist charge, while only 39 percent of Democrats do. Apparently, the capacity for liberal guilt runs deep, indeed.

It’s ironic that Obama, the candidate who ran as the avatar of a post-racial America, is now cast by his supporters and his cheerleaders in the liberal media as a martyr to intractable racism. This is absurd. He got 53 percent of the vote in 2008, only a small fraction of which was from African-Americans. He couldn’t have been elected in a truly racist America. Political analyst Charlie Cook reports that support for Obama from independent voters, approaching 70 percent in the spring, has fallen off the most sharply, down to just the mid-40s now. Are we to believe that they’ve somehow become racists since Election Day?

Jimmy Carter and other Democrats playing the race card may find that this backfires. Independents who swung to Obama, seduced by his promises of hope and change and who now have some honest policy differences with him, might resent being branded as racists. In the next election, they may find Republicans more acceptable — and accepting.

U.S. Senate Republican Leader Mitch McConnell made the following remarks on the Senate floor Tuesday regarding free speech in the health care debate:

“I rise to call my colleagues’ attention to a disturbing development in the health care debate.

“A colleague of ours has called for an investigation into a major health care company because this company informed its customers of its concerns about health care legislation that this colleague of ours introduced.

“As a result, the federal government has now told all companies that provide Medicare Advantage to seniors to stop communicating with their clients about the effects of that legislation — even telling them what they can and cannot post on their websites. This gag order, enforced through an agency of the federal government at the request of a Senator, is wrong.

“It started when a company based in my hometown of Louisville — Humana — had the temerity, in the eyes of some of our colleagues, to explain to its customers that if Medicare Advantage is cut, as the chairman’s mark requires, it may have to reduce benefits, which, of course, is a common sense conclusion.

“Mr. President, this is America: Citizens, either as individuals or grouped together in companies, have a fundamental right to talk about legislation they favor or oppose. That is the core of the First Amendment’s protections on speech. Unfortunately, this is part of a troubling trend of efforts to dismiss the concerns raised by the American people over the past few months.

“Over the summer, we saw American citizens who raised concerns about the health care proposals before Congress dismissed as ‘un-American’ by leaders in Congress. That’s bad enough, but using the full weight of the federal government’s enforcement powers to stifle free speech should trouble all Americans — and all of us — even more.

“We cannot allow government officials to target individuals or companies because they do not like what they have to say.

“This latest effort to squelch free speech raises several serious questions:

“Is this what we have come to as a country — that an individual or company can no longer factually advocate their position on an incredibly important public policy issue?

“Shouldn’t customers have a right to know the potential impact of a Congressional action?

“Is this what we believe as a Senate — that this body should debate a trillion-dollar health care bill that affects every American while using the powerful arm of government to shut down speech?

“Is this how citizens and companies can expect to be treated if health reform passes? That any health provider that disagrees with a powerful Senator will be subject to an investigation and a gag order?

“How is this any different than what the Washington Post and New York Times have done in lobbying for a reporter shield law? Would we stand by if the Judiciary Committee asked the FBI to investigate the media for taking positions on pending legislation we don’t agree with? Of course not.

“Humana is headquartered in my hometown of Louisville, and yes, I care deeply about its 8,000 employees in Kentucky. But this gag order now applies to all Medicare Advantage providers.

“I would remind my colleagues that I have spent my career defending the First Amendment rights of people to criticize their elected officials, including me. I would make the same argument if this were a company based in San Francisco or Helena or Chicago.

“The right to free speech is at the core of our democracy. Free citizens have a First Amendment right to petition their government for a redress of grievances. This gag order on companies like Humana and those in all our states, in my view, is a clear violation of that right. It’s wrong.

“Employers that warn their customers about the effects of legislation aren’t the ones who should be getting warnings here. Senators who threaten Americans’ First Amendment rights are.”