Categories
Barack Obama Health care Politics

Our Unhinged Debate on Health Care Reform

Or, Large Majorities of Americans Support the Specific Reforms Obama Is Proposing, But the Debate Going On Now Has Confused Them Into Opposing It

[digg-reddit-me]Andrew Sullivan provides a pretty good summary of the policy questions at stake in the health care debate – slightly modified by me to make it a list:

  1. Should we demand that insurance companies provide policies to anyone regardless of pre-existing conditions?
  2. Should we help the working poor buy that insurance with subsidies?
  3. Are competitive exchanges for health insurance a good or bad thing?
  4. Would a public option or a co-op help bring down healthcare costs?
  5. Does it make sense for the government to study the effectiveness of various treatments as a guide for doctors?

These are the basic questions Democrats are trying to answer. The only real presumption Democrats made in creating these policies is that the government can be effective. The proposals on the table now are modest – tinkering even – in which market mechanisms, government regulation, and a government plan together are designed with three goals:

  • to provide more security and choice to those Americans already covered by banning abusive insurance company practices and allowing individuals to buy insurance on a health care exchange;
  • to institute certain incentives that will hold down the growth of health care costs – using market mechanisms in the Health Insurance Exchange, spreading information with the Independent Medical Advisory Committee, and with the public option;
  • to cover the 47 million Americans without health insurance (whose use of health care, which we already provide as a matter of right, creates a de facto $1,100 tax on each individual).

The various bills under consideration are so long and complicated because they attempt to make slight adjustments to the system we have – and to remain true to Obama’s promise that if you like your health insurance you can keep it.  They prohibit certain practices by insurance companies, they set up a Health Insurance Exchange, they may or may not allow citizens to choose a publicly run health care plan, they subsidize individuals who currently cannot afford insurance, they set up committees to study best practices. What they certainly do not do is attempt radical change.

This isn’t about the free market versus communism, or radicalism versus moderation. The anger at Obama’s health care reforms has little to do with what he or other Democrats are proposing. There are those with reasoned objections. But the Republican Party has instead embraced and encouraged the inchoate rage of people frustrated with the direction our country is headed, with the various moral dilemmas George W. Bush left for his successors, with the massive failure of the markets that caused our current recession, with the failures of the visceral politics and policies of George W. Bush. On Slate’s Political Gabfest today, this exchange captured pretty well the essense of the hyperbolic debate going on now:

DAN GROSS: In college, we had the primal scream where at a point in time people would open their windows and just yell randomly. It was done to relieve stress but you weren’t yelling a set of statements about how your workload was too high. You were simply yelling. And it strikes me…that the things they are yelling are not the reasoned case for doing health care reform in a different way. They’re saying things like, “Let’s take our country back!” or “Lies, lies, and socialism, communism, fascism.”

JOHN DICKERSON: Yea – it is a sort of Tourette’s of the political…

I want to repeat that there are reasoned cases to make against the various policies Obama is proposing – but aside from an odd blog post by a libertarian economist every now and then, I don’t see them made. Instead, we get the approach Jon Stewart described: “You know, the individual mandate is going to hurt small businesses by…aw, fuck it: YOU’RE ALL GOING TO DIE!!!”

That’s what we’re dealing with: cynical manipulation of an inchoate public anger by entrenched interests and the primal screams of a minority of people frustrated with the direction of the country – both of whom are trying to scare the majority into indecision and intimidate the Democrats into submission. Then there are the many – some of whom are wary of action on health care right now; some of whom are concerned about government spending;  some of whom support reform, but aren’t clear on the issues; some of whom are frustrated with Obama’s moderation. Very little of the public debate has to do with the issues addressed above. Instead, we have anonymous lies spread by email, we have right-wing organizations claiming that “Obamacare=Gov’t Funded Abortion and Euthanasia,” we have Sarah Palin claiming Obama would make her son go before an evil “death panel,” we have Senator Jim DeMinto comparing America under Obama to Germany under Hitler, we have people on the streets and in town halls  and on the radio claiming that Obama is instituting Nazi policies, we have protestors deliberately trying to shut down debate (pdf) and silence those in favor of reform. And I’m not cherry-picking the most egregious examples here – these are the tactics used by mainstream opponents of health care reform.

The response and the debate going on now is unfortunately unhinged from reality and has very little to do with any bill being considered. Americans started out in favor of Obama’s health care proposals – expressing support for both him and the policies he had campaigned on. Polling shows they still support the policies: 72% of Americans are in favor of the public option; 74% of Americans believe that health insurance companies should not be allowed to exclude those with pre-existing conditions; 71% of Americans believe that the fact that 47 million Americans are uninsured is a “very serious” problem, with 49% willing to accept higher taxes to cover these individuals. When Obama’s plan was described in neutral terms, 56% of Americans still supported it today (with 38% opposed). But as Obama and Republicans and Blue Dog Democrats all raised concerns about deficit spending and soaring health care costs, many in the public became wary of increased spending. And as Republicans and entrenched interests began to spread rumors of the health care reforms being proposed, Obama’s support dropped.

But now this debate has broken out into the open – and amid  all the accusations of Nazi policies and “death panels” and rationing and socialism! and “killing Granny” the American public can see what is really going on. Republicans will soon learn the truth of Abraham Lincoln’s aphorism:

You can fool all of the people some of the time, and some of the people all of the time, but you can’t fool all of the people all of the time.

[Image not subject to copyright.]

Categories
Health care Politics

The AARP Pushes Back Against What It Calls Crazy Rumors About Health Care Reform

Late last week, I was forwarded this email in which the AARP – which has not endorsed Obama’s health care reform plan, or any other plan – deliberately pushed back against the what it called crazy rumors. They encouraged their members to email, Facebook, or tweet the truth about health care reform.

Here’s the full text of the email:

From: Barry Jackson, AARP [mailto:[email protected]]
Sent: Wednesday, August 05, 2009 4:02 PM
To: *****@**********
Subject: MUST READ: Don’t believe them

Dear [Name of AARP Member],

If your inbox is anything like mine, you’re getting a lot of emails about how SCARY health reform is. From allegations about rationing care to wild reports of government-sponsored euthanasia, the rumors just keep getting crazier.

And I’ve had enough. Enough of the fear-mongering. Enough of the myths and unfounded rumors. Enough of the interest groups twisting the truth to stop health reform.

I’m fighting back – and I’m asking for your help!

Below I’ve debunked some of the common myths going around. Will you forward this email to your friends and help get the truth out about reform?

The truth is real reform is at risk because opponents are using scare tactics and slogans to gin up fear and misunderstandings. Don’t let that happen.

Sincerely,

Barry Jackson
AARP Online Advocacy Manager

P.S. Let’s make sure everyone gets the truth. After you’ve forwarded the message below, please share these myths and facts on Facebook if you have an account, or post them on other networking sites. If you’re active on Twitter, please tweet the truth now.

******Delete the text above and forward this message to friends and family ******

Hi,

My inbox has been flooded with emails spreading crazy rumors about health reform so I wanted to share some facts from AARP about what’s really going on. Please join me in forwarding these facts to everyone you know. Print them out and pass them around at your social gatherings and other places where people are discussing the issues of the day.

FACT #1: Medicare will not be ended, and no benefits or services will be cut.

Your services will not be ended, nor will your benefits be cut. AARP’s position on this could not be clearer. And we have sent this message loud and clear to Congress. While the current proposals include savings in Medicare by cutting out fraud, abuse, waste, and inefficiency, we’re standing up and making sure benefits for Medicare recipients are not only fully protected, but are improved.1

FACT #2: No legislation currently in Congress would mandate the rationing of care. Period.

Our staff has read all of the legislation circulating in Congress and there are no provisions in these bills that would ration care for our members. None. If any ever did, we would vigorously fight to stop that legislation.2

FACT #3: There is no provision of any piece of legislation that would promote euthanasia of any kind.

The rumors out there are flat out lies. Right now Medicare does not cover counseling for end-of-life care. The portion of the bill in question would simply provide coverage for optional end-of-life consultations with doctors, so that the patient can be aware of all of the treatment options on the table. It is not mandatory and it has nothing to do with euthanasia.3

FACT #4: We have not endorsed President Obama’s plan.

In fact, we haven’t endorsed any plan. We are supporting reform of our health care system, something that AARP has pushed for many years. We’re working closely with Republican and Democratic members of Congress to lower health care costs and to ensure quality affordable coverage for older Americans – and we want reform legislation passed and signed by the president this year.4

So what is AARP fighting for in health reform?

  1. Stopping insurance companies from charging older Americans unaffordable premiums because of their age.
  2. Ending the practice of excluding people from insurance because of pre-existing conditions.
  3. Holding down health costs and making insurance coverage more affordable for all Americans.
  4. Making prescription drugs more affordable by narrowing the Medicare doughnut hole, bringing generics to market faster, and allowing Medicare to negotiate better drug prices.

Find out more and take action at HealthActionNow.org.

Thanks,

[First name of AARP member]

——————————————

1. “AARP to Congress: Don’t Make Medicare More Expensive,” AARP, July 30, 2009 http://www.aarp.org/aarp/presscenter/pressrelease/articles/rand_medicare_statement.html

2. “Debunked: Health Reform Means Rationed Care For Seniors,” AARP, August 4, 2009 http://blog.aarp.org/shaarpsession/2009/08/debunked_health_reform_means_r.html

3. “AARP Responds to Health Reform Scare Tactics,” AARP, July 24, 2009 http://www.aarp.org/aarp/presscenter/pressrelease/articles/mccaughey_statement.html

4. “Obama Vows No Cuts To Medicare Benefits,” AARP, July 29, 2009 http://bulletin.aarp.org/yourhealth/policy/articles/
obama_fields_tough_questions_on_health_care_reforms_at_aarp_tele_town_hall.html

[This image is believed to be trademarked. It is being used to identify the organization AARP, a subject of public interest.]

Categories
Barack Obama Health care Politics The Bush Legacy The Opinionsphere

Gog et Magog, Hypomania in the White House, Reuters!, The Most Interesting Man in the World, and the NRLC

1. Gog and Magog. James A. Haught breaks some news – at least in American papers – explaining one line of “reasoning” George W. Bush attempted to use to convince Jacques Chirac to support the invasion of Iraq:

Gog and Magog are at work in the Middle East… The biblical prophecies are being fulfilled… This confrontation is willed by God, who wants to use this conflict to erase his people’s enemies before a New Age begins.

Chirac was so confused by this reasoning that he actually called in a Swiss theologian to explain. Just last week, Chirac confirmed this in an extended interview in France.

2. Hypomania in the White House. John Gartner for Psychology Today profiles Rahm Emanuel and the Emanuel family that shaped him. He describes Emanuel as hypomanic – which he stresses is not a psychological disorder, but a condition. Some of the more interesting tidbits:

Emanuel says f*ck more frequently than “if, and, or but,” insists political scientist Larry Sabato. Obama himself regularly jokes about Emanuel’s profanity: “For Rahm, every day is a swearing-in ceremony.”

Gartner also discusses how Emanuel’s family shaped him:

Stuck with each other, the brothers created their own subculture—unlike most gifted high-energy kids, who must deal with the confusing feelings that come with being different. Like the X-Men at the Mutant Academy, the brothers felt most normal in one another’s presence, where they could be themselves—with a vengeance.

The brotherhood may have been instrumental in curbing another hallmark of hypomania. If you’re hypomanic and gifted, you always have the feeling of being the smartest guy in the room. But if you have two other guys just as smart and aggressive in the room who say, “That’s a stupid idea” and start to pound you, it’ll knock some of the grandiosity out of you.

And this:

While Rahm has called the verbal combat that took place there “gladiatorial,” Zeke described it to me as more of a Talmudic debate—the Jewish tradition of argument where one’s opponent is viewed as an ally in the search for truth. “It’s a sign of love to take someone’s view seriously,” says Zeke, who has fostered at NIH a style modeled directly on the Emanuel dinner table; he calls it “combative collegiality.”

3. Reuters! Reuters believes in a link economy. Suck on that AP.

4. The Most Interesting Man in the World. I was going to link to an article at AdAge by Jeremy Mullman on Dos Equis’s spectacularly successfuly “Most Interesting Man” campaign – but as the article went viral, AdAge has apparently attempted to limit its distribution and now placed it behind a firewall. Google does have a cached version here. For now. It’s an interesting story of how the ad campaign broke all of the rules of beer advertising – and led Dos Equis to buck the trend of declining imported beer sales and actually notch a double digit rise.

5. The NLRC: Not about abortion any more. William Saletan explains why certain pro-life Democrats are having their loyalty questioned by the National Right to Life Committee despite their unchanged anti-abortion stance:

In 2007, Ryan began to flunk the scorecard because the scorecard was no longer primarily about abortion. It wasn’t Ryan who changed. It was NRLC.

[Image by me.]

Categories
The Web and Technology

Brief Thoughts for the Week of 2009-08-07

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Categories
Health care Politics

Zeke Emanuel on the Health Insurance Exchange

Noam Scheiber profiles the man he calls the nicest Emanuel brother, the eldest,  Zeke. Zeke is one of the nation’s leading bioethicists and works – along with Cass Sunstein and Peter Orszag in the Office of Management and Budget. Even with all the intellectual firepower in that normally staid department, Zeke stands out – and as someone who has been working for health care reform his entire life, he is one of those taking the lead on this issue. His focus – unlike most progressives – is not on the public option, but on the Health Insurance Exchange:

[N]ot surprisingly, Emanuel digs deepest into his healthy reserve of enthusiasm for the parts of the plan that dovetail with his own ideas. At the top of this list is a so-called insurance exchange – a regulated market in which people who lack coverage through their employer (and maybe people who work at small companies, though that’s still being negotiated) could choose from a variety of private plans, which would offer at least a minimum level of benefits and could not discriminate by health status. “He’s a key thinker on the exchange. How it operates. How it interacts with insurance market reform,” says the administration official.

On the one hand, the exchange is absolutely central to the Obama plan–it’s how the uninsured get covered. So it’s worth having Emanuel’s considerable brainpower on the problem. On the other hand, one can imagine a future in which the employer-based system gradually withers away, leaving everyone to purchase insurance on the exchange. Though Emanuel scrupulously avoids such discussions, it’s hard to believe the thought has never occurred to him.

I’d like to hear more about his thinking on “How [the exchange] operates. How it interacts with insurance market reform.”

Categories
Reflections

Ezra Klein: I would rather be drinking…

Ezra Klein sums up my feelings about blogging:

On a moment-to-moment basis, I sort of loathe writing this blog. I would far rather be drinking a beer on my porch. But in the aggregate, I’m much more satisfied with my life when I’m writing this blog.

Categories
Economics Financial Crisis

Theories of the Financial Crisis: Deference to the Financial Sector

[digg-reddit-me]Closely related to the previous theory of the financial crisis – that Goldman Sachs did it – is the more generalized version of this idea – that the financial sector itself – whether through political donations, lobbying, corruption of politicians, respect, fear, or any other means at their disposal – was able to demand and receive undue influence over the political processes affecting them.

Since Ronald Reagan took office in 1980, the financial industry has been growing more quickly than the rest of the economy – whether because of this or as a result of this, politicians of both parties have given the industry about every policy they wanted. The financial industry began to feel its oats when a cultural revolution swept America – the Reagan Revolution – which removed the various moral stigmas from money and profits just as the 1960s had from sex. Reagan also instituted several policies which served to concentrate wealth (thus enlarging the financial sector) and removing regulations. He cut taxes – especially for the wealthiest; he instituted a de facto Bretton Woods II agreement in which the savings of East Asia were transferred to America, thus enlarging the financial sector further and decimating our manufacturing sector; he ran massive deficits, thus super-charging the economy – from which the financial sector was a main beneficiary; he deregulated various industries thus allowing private enterprises to capitalize on the investments of the public in them; he reduced regulations overall, especially those on the financial sector.

Bill Clinton came into office with various plans to help out the middle class – to pass a stimulus bill, to tackle health care – but was forced by an unruly bond market to back off. Bob Woodward quoted Clinton realizing the power of Wall Street a few days into office:

You mean to tell me that the success of the program and my reelection hinges on the Federal Reserve and a bunch of fucking bond traders?

But Clinton came around and designed an agenda that would win Wall Street’s approval. He brought down the deficit – running surpluses even. He reformed welfare. He pursued free trade agreements – especially NAFTA. The Committee to Save the World – consisting of Treasury Secretary Robert Rubin, Assistant Secretary Lawrence Summers, and Federal Reserve Chairman Alan Greenspan (with an assist from Timothy Geithner) organized emergency interventions committing taxpayer dollars to help Mexico, the Asian markets, Russia, and domestic markets with the collapse of Long Term Capital Management in order to keep the markets stable and growing. By the end of his presidency, Clinton was a major proponent of deregulatory measures – signing the repeal of the New Deal era Glass-Steagall Act, forbidding the regulation of derivratives, and allowing off-balance sheet accounting. All of these changes greatly benefited the financial sector and were much sought after by the industry.

And then of course came further deregulation under George W. Bush and his proposal of various housing initiatives under the rubric of an Ownership Society. The deregulatory fervor was probably best symbolized by the efforts of the Office of Thrift Supervision (OTS) to bring more financial institutions under its authority. (Regulators were funded based on what companies they oversaw, so the various regulators began to compete to be more lax.) The head of OTS brought a chainsaw to the photo-op in which the heads of the various regulatory agencies attacked a stack of paper representing bank regulations to demonstrate their commitment to reducing oversight. As Simon Johnson wrote in The Atlantic regarding these many causes of the financial crisis:

[T]hese various policies—lightweight regulation, cheap money, the unwritten Chinese-American economic alliance, the promotion of homeownership—had something in common. Even though some are traditionally associated with Democrats and some with Republicans, they all benefited the financial sector.

His thesis is essentially this:

In its depth and suddenness, the U.S. economic and financial crisis is shockingly reminiscent of moments we have recently seen in emerging markets (and only in emerging markets): South Korea (1997), Malaysia (1998), Russia and Argentina (time and again). In each of those cases, global investors, afraid that the country or its financial sector wouldn’t be able to pay off mountainous debt, suddenly stopped lending. And in each case, that fear became self-fulfilling, as banks that couldn’t roll over their debt did, in fact, become unable to pay. This is precisely what drove Lehman Brothers into bankruptcy on September 15, causing all sources of funding to the U.S. financial sector to dry up overnight. Just as in emerging-market crises, the weakness in the banking system has quickly rippled out into the rest of the economy, causing a severe economic contraction and hardship for millions of people.

But there’s a deeper and more disturbing similarity: elite business interests—financiers, in the case of the U.S.—played a central role in creating the crisis, making ever-larger gambles, with the implicit backing of the government, until the inevitable collapse. More alarming, they are now using their influence to prevent precisely the sorts of reforms that are needed, and fast, to pull the economy out of its nosedive. The government seems helpless, or unwilling, to act against them.

Top investment bankers and government officials like to lay the blame for the current crisis on the lowering of U.S. interest rates after the dotcom bust or, even better—in a “buck stops somewhere else” sort of way—on the flow of savings out of China. Some on the right like to complain about Fannie Mae or Freddie Mac, or even about longer-standing efforts to promote broader homeownership. And, of course, it is axiomatic to everyone that the regulators responsible for “safety and soundness” were fast asleep at the wheel.

But these various policies—lightweight regulation, cheap money, the unwritten Chinese-American economic alliance, the promotion of homeownership—had something in common. Even though some are traditionally associated with Democrats and some with Republicans, they all benefited the financial sector. Policy changes that might have forestalled the crisis but would have limited the financial sector’s profits—such as Brooksley Born’s now-famous attempts to regulate credit-default swaps at the Commodity Futures Trading Commission, in 1998—were ignored or swept aside.

Whether politicians of both parties deferred to the financial sector because of their massive contributions to both parties or because the financial sector became the leading driver of GDP growth doesn’t really matter.

What’s clear is that when the financial sector wanted something, they got it. They blocked reforms; they got deregulation, free trade agreements, business consolidations, and policies that led to market inefficiences and bubbles they could exploit. The financial sector was pushing virtually every policy which contributed to the economic collapse – and politicians of both parties went along.

Categories
Politics

The Perks of Princes

Randy Cohen – as an ethicist writing for the New York Times – tackles the vexing question of Congressional vacations. He comes down hard – and while I don’t endorse his message, I think that if more people expressed this attitude, our country would be better off:

In an egalitarian society, lawmakers do not exploit their office to vote themselves lavish perks but live much like the people they represent. Congress should get the same health coverage enjoyed — can that be the right verb? — by a typical American. Congressional pay should be pegged to the median for a family of four, currently $70,354. And Congress will receive the same vacation time as an average American, which right now is 37 days. No, wait, I’m thinking of France, that terrifying example of all that is to be shunned — attractive clothes, delicious meals, widespread human happiness. American workers average 12 days a year of vacation.

Categories
Criticism Politics The Opinionsphere

Stop Whining, Congressman Issa

[digg-reddit-me]Congressional Republicans got their knickers in a bunch this week sending off a quite nasty letter in response to what they allege (citing the Politico) to be hardball political tactics of Rahm Emanuel pushing back against Senator Jon Kyl.

This all supposedly started when Senator Kyl on This Week With George Stephanopoulos took on the stimulus bill:

KYL: Yes. And with respect to the stimulus, I think it’s now acknowledged, it hasn’t done what it set out to do.

STEPHANOPOULOS: But your government says it has in Arizona.

KYL: No. What our – look, all governors like “free money” coming to the state. My governor is no different. But the reality is that it has added to our deficit. We’re now going to have a $1.8 trillion deficit this year.

It seems more plausible that these rather mild remarks aren’t what started this, but the general push by Senator Kyl to cancel the stimulus bill that included an op-ed published a week before this in which he explained:

With the results now in, it’s not a surprise that a recent Rasmussen poll found that 45 percent of Americans want to cancel the rest of the stimulus spending.  I agree.

In response to Kyl’s attempts to cancel the stimulus bill, Rahm Emanuel – according to Politico – had several department heads responsible for distributing stimulus funds write to the Republican Arizona governor, who is on the record as supporting the bill and saying it is working for her state, asking her if she agreed with Senator Kyl and wished to cancel any future funding from the stimulus. In some variation or another, the letters made this point:

On Sunday, Arizona Senator Jon Kyl publicly questioned whether the stimulus is working and stated that he wants to cancel projects that aren’t presently underway. I believe the stimulus has been very effective in creating job opportunities throughout the country. However, if you prefer to forfeit the money we are making available to your state, as Senator Kyl suggests, please let me know…

Darrell Issa, a California Republican Congressman, accepted Politico’s characterization that it was an “assault” on Kyl, as well as a “fist to the nose,”  and a message to “Back off.” In a letter to Emanuel (pdf), Issa asked:

At what point do you believe your practice of Chicago-style politics violates a public official’s right to speak out in favor of alternative policies?

All of this seems fair and good to me – it’s politics. If Issa thinks he’ll win points whining, then all the power to him. If Emanuel thinks he can get the Republican governor of Arizona and potential presidential candidate and Senator from Arizona Jon Kyl squabbling, then all the power to him.

But on style points, Issa loses. His letter which implies that Emanual is violating the right of public officials to speak out in favor of alternative policies. This is the same Issa who sided with Dick Cheney’s office after they outed an undercover CIA agent because her husband spoke out against the Iraq war; and the same Issa who obstructed debate on the reauthorization of FISA until a fellow Congressman withdrew his comments that the Bush administration had broken the law. Over his career then, not much attention given to the right of public officials to speak their minds – unless they agree with him. Blatant hypocrisy while whining about objective standards always loses you style points.

I have a question for Congressman Issa (congressman.issa@mail.house.gov): At what point does your arugula-sniffing, California-style oversensitive, politics of umbrage idiocy get old?

You’re in Congress. Grow up. If you’re in Washington trying to play hardball, don’t whine when someone on your team takes a hit.

[Image not subject to copyright.]

Categories
Health care Politics

A Jumble of Health Care Related Points

I’ve been collecting a number of interesting points regarding health care that I haven’t yet found a way to incorporate into a post. So to stop lugging this paper around, here’s a jumble of different facts, arguments, and stories:

Robert Borsage explains one argument for “going all in” on health care reform. He explains that bringing everyone into the health insurance system would remove the hidden tax the uninsured levy on the rest of society:

This removes the hidden charge – estimated at $1,100 per person – we each pay for the 47 million who aren’t insured and are forced to use the emergency room as their doctor, often putting off treatment that results in higher costs when the untreated illness becomes critical.

The Boston Globe points out that the Romney-backed health reform there is actually working, despite headlines that seem to suggest the contrary:

In the myth that these critics have manufactured, this state’s plan is bleeding taxpayers dry, creating nothing less than a medical Big Dig.

The facts – according to the Massachusetts Taxpayers Foundation – are quite different. Its report this spring put the cost to the state taxpayer at about $88 million a year, less than four-tenths of 1 percent of the state budget of $27 billion. Yes, the state recently had to cut benefits for legal immigrants, and safety-net hospital Boston Medical Center has sued for higher state aid. But that is because the recession has cut state revenues, not because universal healthcare is a boondoggle. The main reason costs to the state have been well within expectations? More than half of all the previously uninsured got coverage by buying into their employers’ plans, not by opting for one of the state-subsidized plans.

Ezra Klein follows up to say that the Massachusetts plan “has come in at about the cost predicted” and – in the most important point for him: “Doing coverage actually pushed Massachusetts to begin addressing cost.”

Greg Mankiw questions the need for a public option in an interesting post.

Several progressives have pointed out the irony of seniors angrily telling Congressmen to “keep the government’s hands off of their Medicare.” Harold Pollack in taking on the euthanasia scare tactics of the right muses:

The irony of yammering to seniors about the evils of government-financed care is always notable, as is the selfish appeal. In 1965, liberals enacted Medicare, perhaps the most radical social engineering project in American history.

Paul Waldman in The American Prospect makes a similar point:

Forty-four years after its passage, the success of Medicare — just to review, a big-government program that has provided health care to tens of millions of seniors who would not have otherwise had it, does so more efficiently than private insurance, has seen costs grow at a slower rate than private insurance, and is smashingly popular with its recipients — has not seemed to fundamentally alter the public’s receptiveness to anti-government arguments. Ditto for Social Security. Ditto for the Veterans Administration, which is the only truly socialized health-care system in America, and one that is considered by many health-care experts to provide the best health care in the country.

Ezra Klein points out that our media-political system does not respond in the same way to all types of grassroots pressure – and that the right is benefiting from this now. He explains how single-payer advocates are organized, loud, and present (and have been present) at these town hall meetings and other health care events for years. Yet no one seems cowed by them – and they get virtually no media coverage. On the other hand, complain about socialism and you’re the story of the day… Klein reflects:

[It’s] worth keeping in mind as people begin to focus on the anti-health-care tea parties. The political system does not have some sort of consistent reaction to grassroots pressure. Rather, it picks and chooses when it wants to listen to the views of the very, very non-representative groups of people who sit through at town halls and panel discussions

Paul Krugman details a story with a similar message:

I was tentatively scheduled to be on a broadcast dealing with — well, I won’t embarrass them. But first they had to find someone to take the opposite view. And it turned out that they couldn’t — which led to canceling the whole segment.

In a way this goes beyond my original point, which was the unwillingness of the news media to referee a controversy by actually reporting the facts. Now it seems that a fact isn’t worth reporting unless someone is prepared to deny it.

And finally, I’ve already linked to this post by Ezra Klein maybe two or three times, but I haven’t cited this passage yet which almost but didn’t quite fit into my the Health Insurance Exchange is like ebay post:

The Health Insurance Exchange, combines the benefits of choice that are theoretically available on the individual market with the bargaining power and scale that’s generally accessible only in large employers (and the exchange will, in theory, have more bargaining power than even the largest employers, as it will have a much larger base of customers). You also have a space to test out innovative ideas that might make the market better, like Sen. Jay Rockefeller’s (D-W.Va.) insurance rating agency, or the public insurance option. You can standardize billing and payment methods and force the adoption of electronic medical records.

[Image by romanlily licensed under Creative Commons.]