Aug 10 2009
A Reasonable Plan Forward For Healthcare
Update: As usual some of those stupid “true conservative” hot heads on AM Radio came out today and did their usual smart mouth, counter productive, ego-stroking schtick. Specifically, the moronic Sean Hannity was on his show today insulting the very people this nation needs to stop the Obamacare government takeover of our health care system (which is why I have no reservations returning the favor). Hannity has got to be the symbol of the “Great American Eff-Up”. When talking about the blue dog democrats who were instrumental in stopping the DC liberals this rolling conservative disaster called them “lap dogs”, which I am sure made his ego feel bigger well beyond its natural capability, but also did more to push the centrist democrats back into the fold of Obama, Reid and Pelosi. Hannity’s self absorption is why the GOP will probably, in the end, snatch defeat once again from the jaws of victory. He is doing for Reagan coalition what the Clintons did for the democrat governing coalition in Congress back in 1993-1994. – end update.
I listened with interest this morning to AM Radio pondering the question of whether the GOP should simply plan to stall any health care reform or work to provide a reasonable path forward. As with most ‘either/or’ false choices the answer is ‘yes’ and ‘yes’.
Simply being a blockade to progress is the wrong answer which was the strategy the GOP used to lose their governing coalition and allow the liberal old dogs in Congress to get into power in 2006 and 2008. Nature (and problems) abhor a vacuum. Leaving ‘nothing’ allows others to propose anything.
What the GOP should be doing is cultivating a centrist compromise that attracts a broad coalition of opposition to the radical liberal concept of a government option – which would consume and destroy all private health care options over time as the liberals have openly admitted many times. As everyone knows, the liberals want to destroy private health insurance and have it all run out of DC by bureaucrats. That is the path to ‘nothing’ and there is a broad and growing consensus in the country this option is not acceptable. Â Rassmussen illustrates this fact quite nicely today:
Among those who have insurance, 53% fear the government more than insurance companies while 39% take the opposite view. Those without insurance fear the insurance companies more.
80+% of the country is insured. Most of the people who fear government rationing are the remaining World War II generation and the retiring Baby Boomer generation – plus their immediate families. That is the largest, most politically active, richest and I would say most experienced element of the American electorate bar none. You lump that group together with a common goal of fixing health care without any hint of a government run system and you have the makings of one of the most powerful political forces this nation has seen since 9-11.
What the GOP should be doing is drawing the line in the sand on government intervention and then ALSO proposing the valid centrist option (with centrists who extend all the way to center left). If the GOP tries to dictate from the far right, they will fail and that vacuum will be filled with a mess.
The basic aspects of a centrist approach are this:
- A minimum universal coverage requirement: as with all sorts of insurance from homes to autos to disability, it is OK for the government to say insurance companies need to offer a common suite of low cost plans that cover check ups, preventive care, dentist, prescriptions emergency care, etc. One option could be a catastrophic plan that requires more out of pocket costs be born for the mundane services but covers large expenses. Basically this is the minimum all plans much offer – but it is not the only plans to be offered. From this minimum floor of options insurance plans can layer up all the options they want to offer for those who can pay.
- Tie insurance to the consumer, not the employer. Allow the employer to offer options and subsidize premiums, but do not tie the insurance to the job. Once in a plan the plan goes with the insured. This would allow the greatest choice of options (something everyone agrees would be nice to have) and eliminate pre-condition barriers.
- Allow for small businesses and individuals to buy into pools to spread the cost and lower premiums. Combined with 2 above this would allow a lot of people to gain access to quality health care.
- Feds must pay their bills. We the privately insured right now subsidize the cheap bastards in Congress who keep mandating services under various programs like Medicare but refuse to pay full cost. No unfunded mandates. If the government offers service they pay for them and stop forcing us to (which we will do under any damn plan proposed, even government run options).
These 4 simple goals, removed from any hint of a government run plan, would gain a lot of support. It won’t solve everything – no plan will. It won’t give power to DC as well, it will leave the decisions to consumers and their doctors.
There are lots of nice to haves we could add into this, but they tend to cause rifts. I am no fan of providing health care to illegal immigrants, but the GOP foiled all efforts to get illegals out from the underground economy. Leave that for the next round when there is a consensus. Same thing with Tort reform. I am all for it, most people are not.
Stop looking for perfection and agendas. Start looking for opportunities and consensus and build out from there. Get what you can get, leave the rest for later. If the Dems in DC had done this they would not have ignited the backlash.
Listen to the Seniors and their families and those 80+% with coverage who want fixes but not radical and dangerous ideas. Governing is the act of coming together over common ground. The first party that takes this approach on Health Care will be the one who wins big in 2010 and 2012.
You’ve described a proposal I could easily support, and I think it is a good idea to for the Senate Republicans to try and work toward this. I live in a state that has implemented the full tort reform program, and (contrary to the trial lawyers propaganda) it has been a marvelous success, to the extent that it is now unthinkable to roll things back to the way they were.
However, this probably demonstrates why it isn’t necessary to include this in a national health care bill – since tort reform can be done on a state by state basis, that is probably the preferable way to approach it.
Of course, if the legal liability rules are going to vary state by state then there will have to be an allowance for premiums to vary state by state.
Now the danger in all of these proposals is that the House Dem’s under Pelosi have gone so far over the edge that they have no concept of compromise or dialogue or negotiation. They will not see this as what it is – a true compromise proposal – but instead they will call it a far right wing proposal and then they will attempt to pile it down with all of the government controlled and supporter favoring baggage that they’ve been larding into everything. If that is the case – if they cannot be reasoned with, and I do not believe they can – then it is better to just kill the entire process untill a slightly more sane and less cancerous Congress is seated.
AJ:
We need a name. How about instead of Nationalize Health Care, we call it:
National Insurance & Litigation Health Reform or NAILHER.
WWS has a good point in that the center left always betrays the center when the heat is on and runs back to the left. I also agree that tort reform needs to be included in any health care reform. But tort reform and market reform will show which center left politicians want to move to the center and which ones only care about themselves. I would not hold your breath.
The idea of a national health insurance market is the only way to make universal coverage cost effective. The portability can come when we have specialized firms handling the admin functions for small business.
I would add that self-insurers can get the same tax benefit as companies.
What is really needed here is a truly national health insurance market and the requirement for even the youngest teenagers in the job market to have health insurance becuase actuarially you need all the youngins to pay in to support the seniors or else you just have to let the the seniors die on the cheapest pill you have available.
Then you will need to privatize Medicare or phase out Medicare and keep people in the National Health Care private market after 65. Along with tort reform the center left is going to go awfully squishy on any centrist bill.
All of the above proposals will be DOA as far right extremist. Because anything a millimeter right of Pelosi is conservative.
That’s a good point, Mark, the plan does need a catchy name.
I had wondered about “Compromise Legislation Intended To Openly Reform Insurance Safely”, but I suppose that acronym just wouldn’t fly.
AJ, did you see this when it came out? The Republicans alternative health care plan. That was back in May.
Patients’ Choice Act. PATCHA. Somebody come up with a better acronym than that, please.
It is a nationalized health insurance program through tax credits. Not a bad idea except you make the tax code more complicated. The person with an employer plan will now have taxable income offset by a tax credit. Twice the paperwork.
This is the GOP plan.
Right now about 18 million of the uninsured make more than $50,000 a year. Some people just do not want health insurance. A friend of mine is concerned about what Obama will come up with and he is looking for health insurance. He is not a young man, but he says he can get a high deductible plan for about $200 a month. So far, he is still putting it off. That is the way some people are.
note on the update – I don’t think Hannity has nearly as much influence as he believes he does or as you’re giving him credit for. I gave him up some time ago – he’s too interested in shouting and being a showman than he is in coming up with any useful ideas.
On the other hand, I’m not sure his claim this time is wrong – the “blue dogs” sure laid down and played dead for cap and trade, and there’s still no guarantee they won’t do it again on this one. I’m not condemning them, but I’m not to the point of giving them too much credit yet, either. Let’s see what they do in September.
Terrye, I can’t imagine for $200 if he is not young. I had a $700+ for a 5,000 deductible for several years. That was over 10-12 years ago. That stops them from paying for all tests, MRI’s, etc. A minor surgery always ended up taking me for at least $6,000. Then they went up. The choices were keep the same deduct with double premiums or double the deduct to 10,000. Some choice. You end up cussing the insurance company. That is what the DIMS are counting on to carry this along. There are real holes in the system but thankfully, they could be fixed if they would.
What is going on in DC has nothing to do with fixing the problems. Been there, done that and I say NO to any fix in this climate. WWS described the problem with a fix. Most sane people could agree with AJ’s plan. You see many sane people in DC these days?
Obama doesn’t have a plan he has ideas. The house has a plan that makes Obama look like a liar. And the plans specifics will be decided later by his group of deciders of everything medical in the White House.
Nancy has put the Blue Dogs in a terrible situation. They will lose all power in congress if they don’t follow her, but they are likely to lose an election if they do.
Obama says that some are demonizing Canadians (in Mexico with Harper standing next to him), he doesn’t know why, because he never talks about Canadians, and quite likes them. Why can’t the guy just say what he is for with out putting down something? I’m finding his style so predictable and dishonest.
“he’s too interested in shouting and being a showman than he is in coming up with any useful ideas. ”
When he isn’t pitching cars for General Motors. He should be pitching Fords, or better, Toyota … a fine American made car.
“I’m not sure his claim this time is wrong – the “blue dogs†sure laid down and played dead for cap and trade”
I agree with you, WWS. They are in quite a double bind. If they don’t do Pelosi’s bidding, they are threatened with the DNC running an opposition candidate in the primary. If they do vote Pelosi’s way, they are going to get tossed out in the general election.
Each one of those Blue Dogs is going to have to look at their own situation and see what the odds are in their particular district. If they are in an open primary state they might be tempted to take their chances and stand up to Pelosi. If they are in a closed primary state, they will probably, eventually, do as Pelosi demands. Else they will probably never face their voters again unless they switch party.
AJ,
Enough, already! I have visited your site on and off for a while, but you get annoying when you bash conservative commentators. Cut the holier-than-thou crap. I know you mean well, but you’re misguided. I don’t understand why you dump on conservative commentators (and everyday conservative people) so much. A little dumping is warranted, sure, but you get way over the top. People like Sean Hannity and Mark Levin make me cringe sometimes, too, but I love them hammering Obama day after day. Your “fever swamps†are the only source of serious criticism of the Democrats in the mass media that I hear.
Virtually all significant change (both good and bad, in my view) in our country’s history (starting with the Revolution) was brought about by people who, while perhaps not always on the fringes of political opinion, were decidedly on one side or the other. The Founding Fathers were definitely not in the political middle of their day. You probably had a quarter of the population fighting for independence, a quarter siding with the Crown, and the rest somewhere in the middle.
Of course, this reality is not just confined to the Revolutionary War. And more often than not, the “middle†is something that emerges in public policy as the right and left duke it out. It’s also where the majority of people fall, that’s true. But the middle has many people in it (me included) that have “extreme†(by your reckoning) views on at least some issues. This is where you’re approach falls apart. You don’t recognize this. The political “middle†doesn’t exist, at least not in the sense you think of it. The large “middle†gets pulled around frequently because the people who have more cohesive political ideologies are in a stronger position to sway opinion and push an agenda.
Get off your high horse, AJ! Politics has always been tough, and things often get said on all sides that are excessive. You yourself argue that Obama’s policies are running the country into the toilet. I believe that the Democrats are trying to dismantle our economy so they can build their Euro-socialist utopia. We’re talking about our entire economic system as we have known it. A little excessiveness in the defense of THAT is alright, isn’t it? Get down in the mud with the rest of us! One thing’s for sure- Obama’s there, as are Gibbs, Axelrod, Pelosi, Reid, etc. If you think you can fight them from up on the sidewalk, you’re sadly mistaken.
I still like your site. I love it when you stick it to the global warming crowd. You were “fringe†on that issue (and I was with you). But I think people like you are pulling the “middle†to you. Funny how that can work sometimes, huh?
It’s good to know what George Soros wants. He is always looking out for us?????
Soros Pledges $5 Million for Obama Healtcare Marketing Push
I do not trust ANY health care iniative from this congress or the government at all. They will pass some innocuous bill and add everything devastating back in in committee. They are determined to have this power over all of us. Health care is just the first step. They will add to any bill they enact to take over more and more of our lives.
Hannity is an idiot. I used to watch Hannity and Colmesfor a few months. I got to the point where I couldn’t stand to see Colmes’ face and Hannity groveling before the dems trying to appeal to their better nature (ha! as if such a thing exists). I was embarassed for him.
If this health care bill passes what is to stop the government from giving you a shot to kill you when you refuse to commit suicide. From the way the bill is written you can’t choose your own doctor but have to accept their selection. And maybe you can’t trust that doctor. I certainly don’t trust the government and definitely not Obama.
I have a pacemaker-defillabrater that has to be changed out every four years. I am afraid that with this health plan one day the government will decide I am too old and useless to have it replaced. And then where will I be? Dead, I guess. I fully understand the people at these townhall meetings. They are facing a life and death situation and that is no exaggeration.
You know, I disliked Bill Clinton because I saw what a shifty character he is but my dislike of Clinton pales beside the absolute hatred I feel for Obama. The dislike I felt for Hilary pales beside that same hatred I feel for Obama. It’s not because he is black. It is because of his arrogance and inept policies. He has surrounded himself with ignorant fools. However, I get the idea that it is his arrogance that is paramount. That he is the last word and that he will brook no dissention. That he, after all, won and has a mandate to do as he damn well pleases. I felt during the campaign that he would try to turn this country into a communist one and I was right.
Another way of looking at this. Obamacare would mean the hiring of a huge number of government employees. Those employees would be represented by the SEIU (most government workers are represented by SEIU affiliated unions). This results in a huge windfall in union dues. Guess who the SEIU donates to?
So it becomes a funding mechanism for the DNC.
Obama says he doesn’t find Canadians particularly scary, and thinks that by September we will reach that same conclusion and have a more reasoned discussion about health care.
Who said anything about the Canadian people? How dare he stand in Mexico and pretend that Americans have a problem with the Canadian people. But then he does this with every subject. I’m beginning to feel like Barbara. Life is complicated enough with out having to feel that a man is representing me who constantly disrespects, belittles, and makes it seem that what I think is beneath his moral superiority, and with a little time I will come to a reasonable conclusion.
This man, Mr. Obama, is tone deaf to the heart of the American people.
National survey finds more support for tort reform than Obama-style health care
http://www.breitbart.com/article.php?id=prnw.20090810.LA59787&show_article=1&catnum=0
Hannity isn’t alone. Centrist John McCain had some pretty biting words about the “blue dog” Dems himself a few days ago. He basically said they had a lot of bark; but no bite and eventually rolled over. He warned not to depend upon the blue dogs.
Conservatives have talked about both the GOP plan and a bi-partisan plan that don’t include the public option. However, it is hard to get that info out because the liberal Dems in control of Congress plan to steamroll over them. This is their chance to get that “socialism” train moving.