And so it is done.

The health care bill is on its way to President Obama for his signature, at which point it becomes the law of the land. Then, this week, the Senate will take up a series of changes that Democratic House members demanded in exchange for passing the Senate bill.

Reaction from our two go-to sites on reader health care commentary:

User comments on Ezra Klein’s policy blog on the Washington Post

A lot of Democrats voted for the Iraq war and then when things didn’t go as planned, they claimed that “Bush Lied” as a way to explain their vote. A few years from now when this health care legislation causes health care costs to soar and the deficit to explode, these same Democrats will claim that Obama lied and point to his speech tonight to prove it.
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1) No government healthcare program, here or in any other country, has even remotely stayed in the neighborhood of what it was originally projected/guessed to cost. Many overshoot by factors of 5 or 10. So talking about what this “will” cost in 2028 or even 2016 based on its proponents is dubious at best. Everyone knows those figures are stage managed just to get the law passed, because afterwards we’re stuck with it even as it skyrockets.

2) This bill is just the thin edge of the wedge, not the end of the story. President Obama has been candid when before sympathetic audiences that this is just the first step towards single-payer and government control over the entire healthcare system. We’ve left base camp, but we’re nowhere near the summit — yet. Costs to get there will fall somewhere between hilarious and ludicrious. Nobody seems to know what comes after ‘trillion’ but we’ll find out soon.

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People seem to act as if extending coverage to 32 million uninsured is like letting everyone into their private country club. As if they don’t crash it anyway.

In other words, I think it’s important to note what health care those newly 32 million Americans would normally consume if left uninsured. Do they just disappear when they get sick? Do they simply get better on OTC medications? Or are they somehow immune to all diseases and illnesses?

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From the Library of Economics and Liberty, libertarian Bryan Caplan, Associate Professor of Economics at George Mason and an adjunct scholar of the Cato Institute, offers 15 books that influenced his thinking:

1. Friedrich Nietzsche, Thus Spoke Zarathustra. While I ultimately didn’t learn much of substance, this book got me very excited about about ideas. Nietzsche’s vision of discovering the truth, whatever is may be, and proclaiming it, no matter how much it offends others, is still with me.

2. Ayn Rand, Atlas Shrugged. An old libertarian adage says that “it usually begins with Ayn Rand,” and in my case it’s true.

3. Ayn Rand, The Virtue of Selfishness. While I ultimately decided that her central arguments were actually incompatible with moral realism, this book nevertheless sparked my obsession with meta-ethics.

4. Murray Rothbard, Man, Economy, and State. It’s full of gross logical errors and sophistry, but still taught me at least half of what I know about econ – and 90% of what I know about how economists ought to write.

5. Ludwig von Mises, Human Action. In terms of pure economics, it’s just a poorly organized (but still beautifully written) version of Rothbard’s MES. But Mises’ implicit political economy made a huge impression on me – and I eventually realized that it’s a lot more empirically grounded than standard public choice.

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…let’s start the new week with a pair of Ridiculous Job Posts.

Professional Psychic Tarot Readers

Professional Psychic Tarot Readers PROS ONLY (worldwide)
Date: 2009-12

Professional Psychic & Tarot Readers PROS ONLY. Upscale and Ethical Network seeks professional readers. This is a professional network – not a 900 line nor PRN. Clients are given the best because readers on APN are screened and passed testing prior to hire. Unlike other networks hiring anyone and/or hiring masses, APN offers added incentives, bonus and yearly pay raise increases.

Commentary:

Can someone tell me what an upscale or ethical Psychic Tarot Reader is ? I mean I am reliable enough to tell people they’re gonna have money problems, might lose their job, may not find another one soon and that they have a crush on someone totally unattainable. Bring on the hard problems…Will I find a mustard yellow pair of skinny jeans before Christmas?

Real Bearded Santas Wanted

Santa Claus Entertainer needed multiple parties (Atlanta and more)
Date: 2009-12-14

We are looking for an actor/entertainer who can play Santa Claus this November and December throughout Atlanta . You will go to consumer homes and businesses, read stories, talk to families and entertain the guests. You must have reliable transportation, be able to pass a background check, and have a REAL white beard.

Pay depending on experience is between $75 to $125 per hour.

We are a professional entertainment company that has been booking Santa’s across the globe since 1999. If you are open to this event or other locations across the USA and in China, please let us know.

We have over 300 professional REAL BEARDED Santa’s. Please email us a resume along with a current photo to Marcus@Santaforhire.com or feel free to call us .

Commentary:

Apparently, even in the recession it pays to be a Santa, and really damn well in the ATL. How would like $75 to $125 dollars an hour to fill your empty pockets or even better pay your electric bill? What you must be able to do is pass a background check, get your chat on and have a reliable ride to work. What it doesn’t mention is any kind of confidentiality agreement. Cha- Ching! Oh to be a Santa Claus in an Atlanta house this year. Tyler Perry, The Real Houswives of Atlanta, Atlanta Braves, Anderson Cooper, NBA stars…wow… Santa Claus could be double dipping and working for the tabloids while he’s working with the kids. Work smarter not harder kids.

From the Kaiser Family Foundation site, the Health Reform Subsidy Calculator, which figures out health insurance premiums and government subsidies toward paying them for purchasers of individual insurance under the House, Senate, and Obama compromise plans. Not applicable to those who already receive coverage through an employer.

Who’d have thought CSPAN was going to be the most dramatic thing on TV this weekend?

Some assorted commentary on the impending health care bill vote in the House, which is slated for Sunday and which will in part resolve the long-running issue one way or the other.

Managed Care Matters: Unsustainable, irrational, unaffordable health reform

The Republican Congress passed and then-President Bush signed into law Medicare Part D which added about $8 trillion to our national debt. Now the Democrats want to one-up the GOP by passing what would be a massive entitlement expansion, with no meaningful cost containment. They want us to believe we can expand coverage now and fix the cost issue later.

No, we can’t, and no, we won’t. It is far more difficult to get people to give things up they already have than to convince them they can’t afford those things in the first place.

The health care reform debate has provided all the evidence we need to see how hard it is to get physicians, or insurance companies, or unions, or voters, or employers, or state regulators, or pharma, or device companies to agree to give back business/rights/revenue/coverage they have today.

Bob Laszewski said it well in his post today – “adding 30 million more people to an unsustainable system expecting it will create an even bigger crisis and thereby force real reform is tantamount to reboarding the Titanic in the hopes it will sink faster. It is also hard to see how doing such a thing is the politically courageous thing to do.

Just where is the moral imperative in ramming a trillion dollar entitlement expansion through knowing full well it will make our long-term deficit nightmare even worse–for those now uninsured and for everyone else?

The Democratic health care bill makes little if any systemic changes to the health care system–certainly not at the level we need.”

Neither party is acting in the best interest of the nation, or of their own constituents for that matter. And anyone who believes we can pass it now and fix it later is living in a fantasy world.

Insureblog: Obamacare in a Nutshell

Let me get this straight……we’re trying to pass a health care plan written by a committee whose chairman says he doesn’t understand it, passed by a Congress that hasn’t read it but exempts themselves from it, to be signed by a president that also hasn’t read it and who smokes, with funding administered by a treasury chief who didn’t pay his taxes, all to be overseen by a surgeon general who is obese, and financed by a country that’s broke.

What could possibly go wrong?

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From the blog Running a Hospital, a post about Boston Democratic Congressman Michael Capuano’s letter to constituents about the upcoming health care vote. Capuano is still in the “undecided” column. The special election that sent Republican Scott Brown to the Senate in predominantly Democratic Massachussetts has sent the state’s political establishment into a semi-frenzy.

Who is a wise man? He who learns from everyone.

In these days of cynicism about our elected representatives, I more often find reason to believe the opposite about them. One example is Congressman Michael Capuano, a Democrat representing a portion of the Boston metropolitan area. I have known Mike since his days as Mayor of Somerville, and his commitment to doing the public good has been admirable and consistent.

So, Mike now faces a tough vote on the national health care bill. I was not surprised to see an email from him to a broad group of constituents seeking their input on the matter. He asked specific and detailed questions about various provisions in the bill, and yesterday reported back to all of us.

Here are some excerpts from his note, leaving out several sections about the details of the bill. Although he gave me permission to include the whole, I wanted to focus here on his major themes.

I am so impressed with how Michael is handling this issue. Whichever way he votes, I know he will have the country’s and the state’s interests at heart.

Dear Friends,

Health Care reform is as important an issue as I have dealt with in my life and it is of great interest to many people.

In my last communication I shared a detailed letter expressing some concerns and seeking input. Since that time, I have received many calls, emails and letters. Most calls merely express support or opposition to the proposal. Others have more detailed points to make. I value this input and I thank you. I am still weighing my vote.

I decided long ago that this is one of the few issues I will decide without regard for political impact – it is too important. I will cast my vote on the basis of what I think is in the best interest of our country, state and district; if there is a political price to pay for that vote, so be it.

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On Intrade, a futures exchange in which people can place bets on whether specific events will occur or not, the wager titled “Will ‘Obamacare’ health care reform become law in the United States before midnight ET 30 Jun 2010″ is now priced at about 78.

That means the market for this bet has judged the likelihood of passage to be 78%.

From The Journal of Private Enterprise, an extract from the paper “Homer Economicus: Using The Simpsons to Teach Economics.”

Bureaucrats and bureaucracy

As Gwartney, Stroup, Sobel and Macpherson (2003, 135) state, “Economic analysis suggests a strong tendency for bureaucrats and public-sector employees to favor expanding their budgets beyond what would be considered economically efficient.” The Simpsons episode titled “Trash of the Titans,” provides a great example of this tendency. After getting into an argument with the garbage men and refusing to apologize, Homer decides to run for Sanitation Commissioner. Running on the slogan “Can’t someone else do it?” Homer wins and institutes a sanitation program that does just about everything for the residents of Springfield, from collecting diapers inside the house to cleaning their ties. This excessive spending leads to the following exchange between Homer and Mayor Quimby.

Quimby: Simpson, you idiot! You spent your entire year’s budget in a month! Your department’s broke!

Homer: [panics) Uh...oh no! Wait! I think I've got the perfect solution.

Quimby: You'd better! 'Cause those garbage men won't work for free!

Homer: D' oh!

Later, Homer and Marge are going over the sanitation department's expenses to figure out how he could have spent so much in such a short
period of time.

Homer: Oh... [the previous commissioner] was right! I’m crashing and burning! Crashing and burning!

Marge: How could you spend 4.6 million dollars in a month?

Homer: They let me sign checks with a stamp, Marge! A stamp!

Although a bit over the top in that few (if any) bureaucrats are as stupid as Homer is portrayed to be, this episode of The Simpsons does provide a humorous beginning to a discussion of the incentives facing bureaucrats and bureaucracies.

Click on an image to see it full size.

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More photos here

When I was a kid, I once stumbled upon the movie The Ten Commandments on TV. Exposed mostly to cartoons and sit-coms, I sat there in bleary-eyed awe as the 3 hr 40 minute film just kept on going and going and going. Characters disappeared, story arcs rose and resolved, and the thing still wouldn’t end. By the time Moses parted the Red Sea, I half-believed that this was the only movie ever made that went on forever; that I could go to bed, flip on the TV the next morning, and there would be Yul Brynner, eating an Egyptian breakfast while fulminating about that damn Moses.

That’s a little how I feel about the drive for a health care bill. Rationally, I know it is going to climax one way or the other, but there’s also a part of me that thinks it’s never going to end.

Not quite a year ago, on another project, I remember writing that we were approaching the legislative “end game.” Hah! Not quite. First, we had to suffer through thousands of headlines involving Max Baucus, Olympia Snowe, Nancy Pelosi, the public option, death panels, tea parties, town hall tirades, Bart Stupak, the abortion issue, Ben Nelson, the Nebraska giveaway, the Medicare compromise, Joe Lieberman and the death of the Medicare compromise, Scott Brown and the Massachussetts Democratic smackdown, the reconciliation controversy, and dozens of Barack Obama campaign-style events, as he desperately tried to lead his followers to the promised land of enacting a bill that many observers think will make or break his presidency.

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