Mon Aug 10, 2009 at 07:16:03 AM PDT
These are times that try a progressive healthcare blogger’s soul. It shouldn’t be a surprise that a political establishment that looks at the fact that the Bush administration, led by Dick Cheney in every venal step, decided to start torturing people picked up in Afghanistan to amass false confessions about connections between bin Laden and Saddam so that they would have their “justification” for their war on choice, with nothing more than a yawn can report as straight across “news” that Sarah Palin thinks Obama is coming to kill her baby. But it still astounds that this is the new “normal.” Just unfathomable. And that’s what last week was.
The image that will be indelibly linked in my mind I saw in one of the reports on the Rachel Maddow show with video from a townhall meeting held by Rep. John Dingell, and referenced in gdunn’s diary. There’s a young, disabled woman (pictured in the diary), speaking to the group propped up by her crutches, trying to explain what she’s been through since her insurance company dropped her last year and her inability to get coverage now because of her “preexisting condition.” She’s trying to tell her story, and an older woman stands a few rows back from her and screams, her face distorted and ugly in it’s anger and ignorance and selfish extremism, “I shoudn’t have to pay for your health care.” And these are normal, patriotic, “concerned” citizens? The ones abusing disabled people, hanging people in effigy, destroying property, making death threats. (Oh, and also insurance and pharmaceutical industry shills and Republican operatives.) This is political discourse now, and Cokie Roberts says it’s the liberals’ fault. I guess she and Rahm Emanuel have that in common.
That’s the week we had.
Other stuff happened, too. The obscene amounts of money was in the news again. Hmmm, suppose there’s a link between the $1.4 million plus spent per day by industry trying to kill this and the townhall screamers?
Max Baucus set deadline number 578 for when he’d be done with his bill, September 15. Jon Kyl took his turn as the GOP concern troll to say that there’s no way. And to add to the bipartsan fun, Chuck Grassley, in an extreme display of Senate comity and decorum, used his colleague Ted Kennedy’s illness to lie about the proposed public option. So Democrats want to kill granny, Sarah Palin’s kid, and Ted Kennedy, for those of you keeping score at home.
Bipartisan negotiations in the Baucus committee seemingly continue unabated.
Billy Tauzin created a stir when he leaked a White House/Baucus deal with PhRMA that would have blocked proposals in the legislation to extract cost savings from them beyond an agreed-upon $80 billion through price negotiations or rebates. Then it got confusing, with some Dem Senators saying that the White House told them there was no deal, while at the same time the White House was reaffirming it. The week ended with the White House backing out of a chunk of the deal, and with many Dems (those not named Baucus) with a bad taste in their mouths. The most disturbing aspect of this story is the extent to which the White House is using Baucus, knowing what we already know about what is going to be lacking in the Baucus plan: namely, a public option.
This week, the primary media story is likely to continue to be the townhalls, since they’ll make good copy. The behind the scenes story will be the fight for a real public option, and not some watered down co-op system. Stay tuned.
By Steven Pearlstein
Friday, August 7, 2009
As a columnist who regularly dishes out sharp criticism, I try not to question the motives of people with whom I don’t agree. Today, I’m going to step over that line.
The recent attacks by Republican leaders and their ideological fellow-travelers on the effort to reform the health-care system have been so misleading, so disingenuous, that they could only spring from a cynical effort to gain partisan political advantage. By poisoning the political well, they’ve given up any pretense of being the loyal opposition. They’ve become political terrorists, willing to say or do anything to prevent the country from reaching a consensus on one of its most serious domestic problems.
There are lots of valid criticisms that can be made against the health reform plans moving through Congress — I’ve made a few myself. But there is no credible way to look at what has been proposed by the president or any congressional committee and conclude that these will result in a government takeover of the health-care system. That is a flat-out lie whose only purpose is to scare the public and stop political conversation.
Under any plan likely to emerge from Congress, the vast majority of Americans who are not old or poor will continue to buy health insurance from private companies, continue to get their health care from doctors in private practice and continue to be treated at privately owned hospitals.
The centerpiece of all the plans is a new health insurance exchange set up by the government where individuals, small businesses and eventually larger businesses will be able to purchase insurance from private insurers at lower rates than are now generally available under rules that require insurers to offer coverage to anyone regardless of health condition. Low-income workers buying insurance through the exchange — along with their employers — would be eligible for government subsidies. While the government will take a more active role in regulating the insurance market and increase its spending for health care, that hardly amounts to the kind of government-run system that critics conjure up when they trot out that oh-so-clever line about the Department of Motor Vehicles being in charge of your colonoscopy.
There is still a vigorous debate as to whether one of the insurance options offered through those exchanges would be a government-run insurance company of some sort. There are now less-than-even odds that such a public option will survive in the Senate, while even House leaders have agreed that the public plan won’t be able to piggy-back on Medicare. So the probability that a public-run insurance plan is about to drive every private insurer out of business — the Republican nightmare scenario — is approximately zero.
By now, you’ve probably also heard that health reform will cost taxpayers at least a trillion dollars. Another lie.
First of all, that’s not a trillion every year, as most people assume — it’s a trillion over 10 years, which is the silly way that people in Washington talk about federal budgets. On an annual basis, that translates to about $140 billion, when things are up and running.
Even that, however, grossly overstates the net cost to the government of providing universal coverage. Other parts of the reform plan would result in offsetting savings for Medicare: reductions in unnecessary subsidies to private insurers, in annual increases in payments rates for doctors and in payments to hospitals for providing free care to the uninsured. The net increase in government spending for health care would likely be about $100 billion a year, a one-time increase equal to less than 1 percent of a national income that grows at an average rate of 2.5 percent every year.
The Republican lies about the economics of health reform are also heavily laced with hypocrisy.
While holding themselves out as paragons of fiscal rectitude, Republicans grandstand against just about every idea to reduce the amount of health care people consume or the prices paid to health-care providers — the only two ways I can think of to credibly bring health spending under control.
When Democrats, for example, propose to fund research to give doctors, patients and health plans better information on what works and what doesn’t, Republicans sense a sinister plot to have the government decide what treatments you will get. By the same wacko-logic, a proposal that Medicare pay for counseling on end-of-life care is transformed into a secret plan for mass euthanasia of the elderly.
Government negotiation on drug prices? The end of medical innovation as we know it, according to the GOP’s Dr. No. Reduce Medicare payments to overpriced specialists and inefficient hospitals? The first step on the slippery slope toward rationing.
Can there be anyone more two-faced than the Republican leaders who in one breath rail against the evils of government-run health care and in another propose a government-subsidized high-risk pool for people with chronic illness, government-subsidized community health centers for the uninsured, and opening up Medicare to people at age 55?
Health reform is a test of whether this country can function once again as a civil society — whether we can trust ourselves to embrace the big, important changes that require everyone to give up something in order to make everyone better off. Republican leaders are eager to see us fail that test. We need to show them that no matter how many lies they tell or how many scare tactics they concoct, Americans will come together and get this done.
If health reform is to be anyone’s Waterloo, let it be theirs.
Steven Pearlstein can be reached at email@example.com.