Forward?

So now that President Obama has won another four years to fundamentally transform America as he promised in 2008, running to retain that office on the simple premise that he wanted to go forward, the question which should have been answered in the campaign but wasn’t even asked, now looms: To where and what are we headed?

To some knowledgeable analysts, it looks a whole lot like backwards.

Will 2013 be 1937? This is the question many analysts are posing as the stock market has dropped after the U.S. election. On Nov. 16, they noted that industrial production, a crucial figure, dropped as well.

In this case, “1937” means a market drop similar to the one after the re-election of another Democratic president, Franklin D. Roosevelt, in 1936.

The drop wasn’t immediate in that case; it came in the first full year after the election. Industrial production plummeted by 34.5 percent. The Dow Jones Industrial Average dropped by half, from almost 200 in early 1937 to less than 100 at the end of March 1938.

It’s hard to imagine stock indexes dropping by half today, or unemployment rising past 15 percent, as they did in the “depression within the Depression.” But the parallels are visible enough to be worth tracing. They have to do with the danger of big government, and can be captured in a few categories.

Amity Shlaes neatly lines them up:

— Pre-election spree that sets records. In the old days, federal spending amounted to about 19 percent or 19.5 percent of gross domestic product. That ratio was so reliable that economists took it as a given, the American normal, from which divergence was unnatural and temporary. By the old 19 percent rule, federal spending would have dropped back once the worst of the 2008 economic crisis passed.

That didn’t happen. Instead the federal government continued to spend. Most important, even in 2012, when the crisis was long past, the government went on a spree, spending the equivalent of 24.3 percent of the economy, more than the 24.1 percent for the year earlier…

— Bath of cold water afterward. After this year’s election, President Barack Obama made it clear that budgeting was his priority: “I’m ready and willing to make big commitments to make sure that we’re locking in the kind of deficit reductions that stabilize our deficit, start bringing it down, start bringing down our debt. I’m confident we can do it.”

Roosevelt too opened his second term on a sober budget- cutting note. The president, wrote journalist Anne O’Hare McCormick in 1937, was like “the Dutch householder who carefully totes up his accounts every month and who is really annoyed now that he is bent on balancing the budget, that Congress can’t stop spending.”

— Fearsome attack on the status quo. In his first news conference on Nov. 14, Obama went out of his way to make clear his tax increases would fall on the rich: “What I’m concerned about is not finding ourselves in a situation where the wealthy aren’t paying more or aren’t paying as much as they should.”

Roosevelt was also ferocious, telling the old guard: “I should like to have it said of my first administration that in it the forces of selfishness and of lust for power met their match. I should like to have it said of my second administration that in it these forces met their master.”

When Roosevelt followed through in 1937, both with high taxes and his effort to pack the Supreme Court with more progressives, markets shivered.

— Fallout from first-term legislation. Obama signed his health-care act in 2010, postponing much of its enforcement until 2013, after the election. Now that the effects of the act are so proximate, markets are wondering whether they or investors can handle the changes demanded.

That’s looking doubtful, as WaPo captures pretty well here.

After surviving a Supreme Court decision and a presidential election, the Obama administration’s health-care law faces another challenge: a public largely unaware of major changes that will roll out in the coming months.

States are rushing to decide whether to build their own health exchanges and the administration is readying final regulations, but a growing body of research suggests that most low-income Americans who will become eligible for subsidized insurance have no idea what’s coming.

Part of the problem, experts say, is that people who will be affected don’t realize the urgency because the subsidies won’t begin for another year. But policy decisions are being made now that will affect tens of millions of Americans, and the lack of public awareness could jeopardize a system that depends on having many people involved. Low enrollment could lead to higher premiums, health policy experts say. Hospitals worry that, without widespread participation, they will continue getting stuck with patients’ unpaid medical bills. And advocates say the major purpose of the Affordable Care Act – extending health insurance to more Americans – will go unmet if large numbers of vulnerable people don’t take advantage of it.

It’s a mess, actually.

Even though the subsidies for currently uninsured people won’t go out until Jan. 1, 2014, the state exchanges that will offer health plans are being set up now, and participants will need to start signing up next Oct. 1. Supporters of the health-care law say the plan won’t be a success without a massive public relations campaign to build awareness.

“That part is a going to be a real challenge,” said Rich Umbdenstock, president of the American Hospital Association, one of Enroll America’s funders. “If we want to see high enrollment achieved, we have to figure out how to get the word out.”

Work with the Obama re-election team. They managed to convince a slight majority of voters that he cared about them and would provide for their needs. Time to deliver, because a whole lot of people don’t really know what lies ahead.

Obama administration mandates contraceptive coverage

The Department of Health and Human Services, which is taking on an Orwellian context come to think of it, has just added a new twist to healthcare law.

In the form of more mandates.

Following recommendations by the Institute of Medicine (IOM), the Obama administration announced this morning that insurance plans will be required to cover contraceptives, which include abortion-inducing drugs such as Plan B and Ella, as well as elective sterilizations.

Health and Human Services (HHS) Secretary Secretary Kathleen Sebelius in a news release included the drugs as part of an essential “preventive care” package. “Historic new guidelines that will ensure women receive preventive health services at no additional cost were announced today by the U.S. Department of Health and Human Services,” she said.

The HHS release notes that “contraception methods and contraceptive counseling” are to be covered, while CNN notes that the preventive mandate will include sterilizations.

The mandate comes after a massive, months-long push by abortion giant Planned Parenthood to establish free birth control for American women, a campaign strongly opposed by the U.S. Conference of Catholic Bishops.

Pregnancy is not a disease, they said, and this is not “preventive health”, which Congressman Jeff Fortenberry said on my radio show Friday evening just after the House voted on the debt deal. He’s co-author of the Rights of Conscience Act, even more under threat Monday than it was on Friday.

The spin has been interesting. Early on Monday, the Associated Press carried the story at this link with the headline “Insurers must cover birth control with no copays.” I printed it at the time to use in my show prep materials, so I have the original version. It opened with this:

Health insurance plans must cover birth control as preventive care for women, with no copays, the Obama administration said Monday in a decision with far-reaching implications for health care as well as social mores.

The requirement is part of a broad expansion of coverage for women’s preventive care under President Barack Obama’s health care law.

Etc., etc.

Then that same link took you to a story that morphed into this, headlined “Coverage with no copay extended to health care”. Here’s how it opened:

A half-century after the advent of the pill, the Obama administration on Monday ushered in a change in women’s health care potentially as transformative: coverage of birth control as prevention, with no copays.

Services ranging from breast pumps for new mothers to counseling on domestic violence were also included in the broad expansion of women’s preventive care under President Barack Obama’s health care overhaul.

Since birth control is the most common drug prescribed to women, health plans should make sure it’s readily available, said Health and Human Services Secretary Kathleen Sebelius. “Not doing it would be like not covering flu shots,” she said.

Yes, she really said that. It’s tortured logic (apply critical thinking skills to that one). Or it’s  Orwellian. Whichever is worse.