Blue Mass Group

Reality-based commentary on politics.

Saving money, saving health care reform

By

Read Bill. Especially if you're a member of the media, go read Bill.

There's a funny thing that's happening with health care politics:

  • See, “moderates” of both parties want to be seen as pro-private sector. They certainly don't want to be seen as antagonistic to the insurance industry.
  • They also want to be seen as fiscally moderate, stingy with the taxpayer dollar.

These two things are not compatible. A plan with a strong public option would save $1 trillion over 10 years. You cannot serve two masters: You can either serve the taxpayers and premium-payers — the broad general public; or, you can serve the lobbyists of one particular industry. You cannot claim to want to save money in health care reform, and still be against a strong public option.

And let's also be clear: You can either cut costs from the consumer end (less coverage), or from providers (paying less). The way the Senate is going about things, it's all from the consumer end. Why?

This is our era's test case in how politics affects policy. Judging by the polls, the public is way, way ahead of our political establishment. Now we will see if we've turned the corner from special-interest politics, towards a grassroots-dominated politics. Now we will see if the public can shake up the Senate into doing the right thing. Now we will see if a grassroots-elected President can use his considerable leverage to get this thing done, finally.

As JimC has mentioned, Democrats got elected to reform health care. That is their raison d'etre in office right now. And if “moderate” Dems in the Senate scotch health care reform, *it is Democrats* who will suffer — quite possibly including the obstructionists.

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  1. So long as Democrats, even non-responsive ones, are the only electoral alternative refusal to pass health care will have little consequence. Where will people go? Rush Limbaugh? That is the situation we face.

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    p>If no public option is included in whatever health care reform is enacted, it will be yet more evidence that what the country needs is not more Democrats, but more progressive Democrats.

    • A progressive candidate, running solely on the issue of whether there should be a government-administered insurance plan, might get 72% of the vote.

    • not turn out to beat the bushes (hah), make phone calls, and generally generate enthusiasm for a Democratic candidate, if they feel that candidate is no better than a Republican on a major issue like this. And there’s a ripple effect — if the obstructionists prevent good progs from getting popular legislation done, then the progs suffer as well.

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      p>I mean, let’s look at the upside: The polls demonstrate that there really is very, very little to fear from supporting a strong public option. If a progressive deal happens, they’ll all share in the credit. No one, but no one is going to get bounced from office from pissing off the insurance industry. Just not gonna happen.

      • Very few incumbent U.S. Senators or Representatives ever get “booted” from office at all and almost never is it possible to point to one particular “pissed off” constituency.

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        p>But it is naive at best to assume that there are no political consequences to supporting socialized mediciin, i mean a “strong public option.”

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        p>Many of us have not forgotten that the Republicans gained control of both the House and the Senate in the 1994 elections.  Republicans had not held the majority in the House for forty years and 1994 was also the first time in 50 years that the GOP controlled a majority of state legislatures.  W. beat Richards that same year.

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        p>There’s many different reasons for the many lost elections, of course, but the fiasco that was Hillary Care certainly was a factor.  
        Yet, few seasoned observers doubt that the national health care debate (in which many Democrats pissed off the insurance companies) were a major factor in the defeat of people like then- Senator Jim “almost majority-leader ” Sasser by then-relatively-unknown Bill “HCA millionaire” Frist.

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        p>Polls change.  The people are fickle.  Money matters more than most think.

        • But health insurance costs way more, even accounting for inflation, than it did back then.

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          p>It’s a different time. People hate HMOs now and that’s not going to change. People could sour on a public option, but only if progressive Democrats allow others to co-opt it and make it set to fail from the start. A strong, robust public option that covers anyone at an affordable price will remain politically popular far into the future.

          • I can’t cite a source right now, but I recall hearing in 1993-1994 that when respondents were asked about various health plans, given the details of the plan but NOT who was initiating it, the Clinton plan won handily.  Hillary became a lightening rod and both the public and Congress shied away from her, but on the merits it seems that is what the people wanted.

        • WASHINGTON (AFP) – The overwhelming majority of Americans support substantial changes to the country’s health care system, including a government-run health insurance option, a new opinion poll found.

          The survey by The New York Times and CBS News also indicated most Americans would be willing to pay higher taxes so everyone could have health insurance.

          Eighty-five percent of respondents said the health care system needed to be fundamentally changed or completely rebuilt, according to the poll.

          In addition, the survey found that 72 percent of those questioned supported a government-administered insurance plan — something like Medicare for those under 65 — that would compete for customers with private insurers.

          Twenty percent said they were opposed.

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          p>http://www.google.com/hostedne…

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          p>Hillary care lost, but it started the debate. the decline in affordability and accessibility have increased the momentum.  

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          p>I think the politicians are lagging behind public opinion as often is the case.

  2. If ever there were a time it was safe to be anti-private sector this would be it.  Besides, polls overwhelmingly favor these reforms from what I can tell.

  4. Click through and you’ll find many useful links within article as well. http://www.huffingtonpost.com/…

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    p>

    The Policy That Dare Not Speak Its Name,  June 21, 2009, HuffPo

    excerpts:

    “…Congress will soon decide whether to include the so-called “public option” in the Obama health reform bill. As drafted by three House leaders and unveiled last Wednesday, the 852-page bill would include a government-sponsored, Medicare-like public plan.

    Republicans and the health industry have been kicking and screaming that this is socialistic. But the [Times-CBS] poll suggests that defenders of the public plan have nothing to fear politically, and that Republicans are in danger of getting on the wrong side of a popular issue.

    The public option is a not-very-good second best–because our leading liberal politicians lack the nerve to embrace the one reform that simultaneously solves the problem of cost, quality, and universal inclusion. The policy that dare not speak its name is of course comprehensive national health insurance, or Medicare-for-All. I try to avoid using the term “single payer,” because a technical, policy-wonk phrase not understood by most civilians has become insider shorthand for national health insurance. Let’s call the thing by its rightful name. Medicare-for-All is something regular people understand.

    The Times-CBS poll is evidence that this is what more than two Americans in three really want. Most voters have not followed the nuances of how the public option in the Obama plan would compete with private insurance. The poll simply indicates that voters want access to a straight-up, Medicare-style plan to be available to one and all. In past polls, when Times-CBS pollsters ask whether people favor national health insurance, responses generally favor Medicare-for-All by margins of about two-to-one….

    So what’s the matter with our politicians? Why are the people so far ahead of their elected leaders on this one? One reason, as usual, is money.

    The second reason that liberal politicians wimp out on single payer is that the self-styled realists in this debate have decided that Medicare-for-All, even if it’s the first-best system, is too hard politically. But think about it. Has the administration picked up one Republican vote by supporting the present system plus a public option? Hardly. The current House leadership bill, offering a mixed system, with a robust public option, a requirement that employers provide good insurance or pay a tax, and that insurers not discriminate against pre-existing conditions, is just as heavy a political lift as national health insurance–and far inferior policy. So why not just go for the first-best?…

    Only by having a comprehensive system can we marry quality, cost-effective care, and universal access. One of these days, a national leader will have the nerve to embrace national health insurance and fight for it. Until then, we will keep paying more money for less care, and liberals will defend reforms they themselves scarcely believe in.” http://www.huffingtonpost.com/…

    • Thank you, Ann! Every person deserves quality health care and we will only get that with a national single payer plan.

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      p>A public option is not a solution because it does not address lowering the costs of health care or ensuring that every person is covered. What will naturally happen with a public option is that all the well-off healthy people will be lured into private health insurance plans that will gladly take their money with little risk, while all the poor, sick, pregnant, and elderly people will end up bankrupting the public plan. Then the government will start cutting services in the public plan to reduce costs, meaning those newly-insured will become sorely under-insured and that will be a disaster. Just look at the failed MA model to see how things will go.

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      p>Clearly the public option is Obama’s ill-conceived compromise to achieve a short-term political “win”, but if we really want to fix our health care system, we need the one true solution – single payer national health care. Call or write your senators and reps.

  5. Of course there is a place in politics for compromise and moderation.  Our Party is not a monolith.  But if there is another issue more essential to what it means to be a Democrat than health care reform and universal access I’d like to know what it is.  

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    p>We’ve been trying for this since Truman sat in the Oval and each time the vested interests of the health care status quo have broken momentum.  When we Democrats consider our past achievements what comes to mind if not the social and health reforms we have championed – Medicare, Medicaid and Social Security – programs that have stood the test of time and have helped millions of elderly, disabled and low-income Americans to a decent and healthier life.

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    p>Now, we have the best chance we have ever had to build on the foundations of social insurance laid down in America by the New Deal and Great Society and it seems that a few members of our own Party stand between us and the holy grail.  

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    p>And for what?  It would be one thing if I felt like our so-called centrist brethren were developing real solutions of their own to ensure universal access and a reduction in long-term health care costs.  But so far it seems like all they have to offer is watered down half answers that will do little to change a status quo that most Americans think needs fundamental changing.  The moderates seem to want to protect the private health industry and yet don’t even propose market-based reforms that would entail more competition (because of course the insurers don’t want that either).  The moderates are for more public intervention (they all supported more health care funds for kids because its a nice vote) – but just not too much.  Its bullshit.  

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    p>Gimme a dyed in the wool free-market conservative to argue with anyday of the week versus our weak-kneed so-called centrists.  Its like they are a bunch of magnets.  Whenever a big issue comes up they are pulled like metallic drones straight to the fence.  Then when they get there and cling to the poles against the progressive headwind they claim their actions are part of some principled bipartisan stand – bucking their Party on core issues as a profile in courage.  When the reality is more like fear of the ads the insurers may run against them in their red states.

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    p>And of course some of these folks represent some pretty red territory – Nebraska, Arkansas, Louisiana, North and South Dakota.  But if they just wanted to vote their States why the heck did they become Democrats in the first place?  I gotta figure health care was one of the reasons.

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    p>And these moderates also misunderstand the politics here.  Weakening Obama and fellow Democrats, thereby making a health care defeat more likely, will do more to hammer the nails into their politics coffins than supporting comprehensive reform.  Obama is a pillar of strength for Democrats now.  Its moderate Democrats with the most to lose if Obama’s popularity fades due to lack of progress in making change.  They’ll be exposed like they were in 1994 when they took the brunt of the voters wrath during the Gingrich revolution

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    p>And hell, if you’re skating on thin political ice anyway, as moderates in red states always are, how would you rather go down – scratching the surface or breaking the glass.  Its time for moderates to stop scratching the itch and finally support something that will make it go away.

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