Domestic issues Health care McCain Politics The Opinionsphere

What Would Republican Health Care Reform Look Like?

Edit: I see a few people have linked to me since Obama’s little debate with the House Republicans in which he backed up the point I’m making here, that his health care plan is:

similar to what many Republicans proposed to Bill Clinton when he was doing his debate on health care.

That’s the point I was making with this post as well. But some people have apparently taken this post as some sort of evidence of Obama’s nefariousness – as proof that he’s selling out. pm317 wrote on Hillaryis44 that people should, “Tell your bluest of blue friends who are still supporting Obama to read this little piece…” I think they should read this piece – but it stinks of partisanship to presume any Republican suggestion is wrong.

This piece points out that Obama has adopted much of the Republican framework for dealing with health care – picking up on the work of liberals such as Jacob Hacker and Peter Orszag. This framework was broadly endorsed by John Edwards, and then Hillary Clinton, and then Barack Obama during the campaign. The plan Obama is pushing attempts to combine the best elements of the conservative Republican plans with the goals and certain important elements of liberal alternatives. As a liberal, I acknowledge that this plan is modest – tinkering even – but this is its strength rather than weakness.


[digg-reddit-me]Yesterday, the Republicans released their health care plan. However, as Ezra Klein points out it isn’t an actual plan to fix health care as much as a plan to get people to stop asking them what their plan is:

The bill is framed in terms of Republican attacks on the Democratic bill, not in terms of its own aims or methods. Which is fine, and to be expected. If I were a Republican, I wouldn’t spend my time crafting a health-care reform plan, either. Republicans don’t have the votes to pass a bill, and they know it.

So what is the Republican approach to health care reform?

In an interview with the German weekly Der Spiegel, Charles Krauthammer gives a typical response, lecturing Obama:

On health care, the reason he’s had such resistance is because he promised reform, not a radical remaking of the whole system.

Though this is a common claim by right wingers attacking Obama, it clearly isn’t true. Obama’s health reforms take great pains to preserve the current system – and is indeed based largely on two conservative attempts to reform health care in the past. The hope of liberals is that this reform could establish a structure: health insurance market with a public option, that could gradually be opened up to the rest of the population if it was successful. But that isn’t what we’re talking about now.

Given that his criticism of Obama’s health care position is that it is “a radical remaking of the whole system,” you would think Krauthammer would offer a few conservative measures. But if that is what you think, then you have misunderstood the right wing. Krauthammer proposes to entirely tear down the current system: “It is absolutely crazy that in America employees receive health insurance from their employers,” he says, and proposes we gut this system by eliminating the tax break for health insurance and eliminate the prohibition on interstate insurance (which would effectively strip any regulation from insurance companies as the state with the least regulation could attract these companies in a race to the bottom…) By any standard, and whether you agree with them or not, these are radical measures that would completely remake our system of health insurance – and they were also the two cornerstones of the proposal by the McCain campaign.

What Krauthammer either doesn’t know or attempts to elide is that Obama’s health care plan has two prominent historical predecessors: Richard Nixon’s proposal in 1974 and the Dole-Chafee bill sponsored by the Republicans as an alternative to Bill Clinton’s approach in 1993. If you want to figure out what Republican health care reform might be, this is where to look. One of the key things to realize when looking at these plans is that we currently have a hybrid system: with the elderly, veterans, and the poor receiving government-provided health insurance; many of the employed receiving employer-provided health insurance; and those left out either without health insurance or using the much more expensive and less stable individual health insurance market.

1974: Nixon’s Plan

At the crest of the liberal era, Richard Nixon attempted to reform health care. He called his plan CHIP, or Comprehensive Health Insurance Plan, and its goal was to solidify the hybrid system that existed. He proposed expanding eligibility for Medicaid, expanding Medicare to cover prescription drugs, subsidizing the poor to get insurance, incentivizing employers to provide health insurance, and eliminating discrimination on the basis of preexisting conditions.

Specifically, Nixon’s plan included:

  • A form of the Indepedent Medicare Advisory Council called the Professional Standards Review Organization, both being independent technocratic bodies composed primarily of doctors which would be charged with ensuring quality care while “helping to bring about significant savings in heath costs,” to use Nixon’s phrase. (Under Obama, this group would be significantly checked by Congress, and Obama has specified one way that excess treatments could be minimized – by compiling medical knowledge about best practices into a non-binding database.)
  • A commitment that health insurance would “cost no American more than he can afford to pay,” in Nixon’s words, which specifically meant subsidizing health insurance for the poor who could not afford it and were not provided it through their employers.
  • A commitment to build “on the strength and diversity of our existing public and private systems of health financing” and to harmonize “them into an overall system,” as Nixon said.
  • The banning of discrimination on the basis of preexisting conditions.
  • The standardization of a basic level of health insurance including setting maximim out of pocket costs per year and setting a minimum level of what would be covered.
  • A federally issued “Health-card” which would be “similar to a credit car” and “be honored by hospitals, nursing homes, emergency rooms, doctors and clinics across the county” and would include “identity information on blood type and sensitivity to particular drugs.” (Obama’s plan contains no such thing, probably to avoid concerns of federal overreach and the hysteria which accompanies talk of a national identification card.)

One of the great regrets of Ted Kennedy’s life was that he did not take the deal Nixon offered him on health care. It’s also noteworthy that Nixon at this point was insistent on strengthening the employer-provided health insurance system and the government-provided health insurance system. He also pushed the idea of HMOs which Bill Clinton’s plan was later demonized for encouraging as well.

1993: The Dole-Chafee Bill

In 1993, some Republicans believed they needed to come up with an alternative to Bill Clinton’s health care plan (in contrast to the, “Just Say No” approach advocated by Will Kristol at the time, and again today) – with 20 Republican Senators eventually introducing to great fanfare the Dole-Chafee bill. This bill was flawed and politically impossible to get through Congress given the many interests it offended – from labor to the elderly to big corporations. This was because it’s main goal was to undermine the employer-provided health insurance system and to a lesser degree the government-provided health insurance system. The Republicans saw these as distancing individuals from the cost of their health care decisions and thus as two of the main drivers of increasing costs – though they did not acknowledge or attempt to fix any of the problems which made the individual health insurance market untenable for most. This bill included:

  • An individual mandate enforced by a penalty imposed on those who did not comply.
  • A government voucher to purchase health insurance for individuals to up to 240% of the poverty line. (Which is more generous than the Senate Finance bill which only offered subsidies for families up to 200% of the poverty line.)
  • A cap on how much health insurance could be deducted as a tax credit (similar to what the Senate Finance Committee proposed recently, which Republicans denounced as raising taxes.)
  • The removal of the tax credit for all private health insurance plans that did not provide a “federally guaranteed package of health care benefits.” (Which is more radical than anything Obama is proposing – and a greater reach of the government into the private sector.)
  • The elimination of discrimination on the basis of preexisting conditions.
  • Financing through cuts in Medicare Part B and the limits in tax credits discussed above.


Compare the above to the plans now circulating in Congress and backed by Obama.

They have many of the same goals:

  • reducing the growth of health care spending;
  • eliminating the holes in our insurance system and insuring the uninsured;
  • eliminating abuses by the health insurance industry.

They have some similar mechanisms to achieve these goals:

  • regulation of health insurance industry;
  • individual mandate;
  • subsidies for those who cannot afford insurance;
  • technocratic panels.

The health care reforms being proposed today are based on the same framework as the two Republican plans of the past with one main exception: they provide a mechanism to allow the individual market to work more effectively. The health care reforms today attempt to preserve the current system – which is deteriorating year by year as more and more people are priced out of health insurance – while alleviating the worst problems and providing a separate and regulated market in which individuals could choose between different health insurance models.

While both the Nixon and Dole-Chafee bills sought to change the health insurance industry through pure government regulation and intervention. The Democratic proposal working its way through Congress now adds two elements – one from the left and one from the right. They propose creating a Health Insurance Exchange – a market for health insurance. On this exchange, one could choose a publicly-run insurance plan.

The model the Democrats are working on now clearly owes a great deal to these two Republican attempts at health care reform. It’s a shame that Republicans have now taken to demonizing Obama’s plan on many of the very grounds that would necessarily be at the core of an actual conservative attempt to tackle health care.

[Image by Civil Rights licensed under Creative Commons.]

1,321 replies on “What Would Republican Health Care Reform Look Like?”

In addition, it is also good to have map attached with the website as that guides in the proper navigation and
so is by preferred by all customers. Armed with your domain and keyword, you are now ready for the second stage.
Finishing touches to think about include: A large entry shelf is
a platform where the water depth is 8 to 12 inches deep.

Flash web designers will like the cost and the creativity of the Trendy Flash Site Builder.
It’s a good idea to have separate email promotions for prospects and customers, too, because you typically need to send different information to the different groups. Html form builder renders efficient service to online business companies to create any sort of online form to integrate it into their website and receive incoming information from online visitors.

Cheers to your PROFITmatic Turnkey Automated Internet Profit Center,.

Rather, they’re designed to help spark possibilities in your own mind. You can make corrections directly instead of having to search mistake through the code, if something does not seem OK for you.

Make sure you put your keyword in the web page title, first paragraph and once or twice
in the main body. Wouldn’t it be easier if we could be able to save changes ourselves whenever we want. Net’s builder has been out for
a little more than a year, yet it already helped more than 5,
000 webmasters to create their online forms.

Hey there just wanted to give you a quick heads up.
The text in your post seem to be running off the screen in Safari.
I’m not sure if this is a formatting issue or something to do with internet browser compatibility but I thought I’d post to let you know.
The design and style look great though! Hope you get the issue solved soon.

For this piece, you want a sturdy piece that is not
too glossy or byzantine: a nice simple oak or maple cabinet-with glass or without.
At the same time there needs to be plenty of room for them to
move about. When possible, a small heat lamp that is rated
for outdoor use that is pointed toward the rabbit hutch can raise
the temperature inside of a covered rabbit hutch to that of a
very comfortable climate.

Easy to use VPN software for internet access and VPN may
possibly provide with any kind of network functionality that
is established with any of the network, like as contributing or sharing
of data and admittance to network possessions like, printers, databases,
websites, etc. Because nobody can study what you’re sending or what you’re getting, you don’t
have to fear about people spying on yoour on tthe internet accessibility.
It provides protection against online ID and creit card thefts.

Feel free to surf tto my blog post En iyi vpn

I’m amazed, I have to admit. Seldom do I come across a blog
that’s equally educative and amusing, and without a doubt, you have hit the nail on the
head. The issue is something too few men and women are speaking intelligently about.
Now i’m very happy that I found this in my hunt for something relating to

Consumers can search the Internet for Bali vacation holidays,
or contact their local tracel agency # to secure reservations.

A party schedule offers different bars the chance to stay open unbtil 4 am,
but only one per night, giving Gili T a strog reputstion like
a party island. Many peopole could see journeys just like the
one taken by Elizabeth Gilbert inn Eat, Pray, Love
as impossible of their lives.

When buying the outdoor LCD TV enclosure, yoou will discover
several options available and while here is the case,
it is vital that youu weigh your choices carefully.
Best Buy: Westinghouse 60-inch 1080p LCD TV VR-6025Z), $800.
With respect to reaction time, what we have too know is when a specific TV
Repair in Gurgaon – Whether you’ll need TV Repair Services in Gurgaon, Lcd tv
repair in Gurgaon, Lccd tv install in Gurgaon, Repairs
on ledd tv plasma tv, we keep it uncomplicated to schedule all brands TVs repair services in Gurgaon.

This mmay very well be czlled “The Feeder” mainly because it
feeds off everything around it, adapting responding to its environment.
This Summer is no exception and many men and women be wondering things to buy for their Summer wardrobe.

Oh and Britney Spears wrote a thanks note sayying she
loved tthe t-shirts.

If you experience overwhelmed by the decisions or merely need
a little guidance, examine HIT Virtual’s Businesss Consulting packages.
The pre business advertising should be equally accustomed
an internet-based for an business online suhh as yours.

Much on the information you can find online is aimed towards affiliate marketers:
Make millions online.

Today, it truly is estimated that almost 50,000 people daily try to
ind an invisible caller’s namje and address. No alarm coimpany contracts to
get rid of and no negotiating with all the new owners.
If you are planning to work with some oon the Sprint wireless broadband services plans, book the coverage with your area.

Here is spmething to keep in mind when searching.
It is realoy much easier onl to poop the DVD or perhaps the Blu Ray dosk in the tray and press the PLAY button. The tickets are obtainable in advgance and
also the user can book film tickets with the upcoming 6 days with the movie of his choice running the theatres though his credit and
debit cards.

Choose products which are “certified organic” which implies:
. An organic cosmetic method iis made from aall of the ingredients that havbe grown naturally convoyed that hass a free pesticide certification.
Make an effective and inexpensive moisturize by blending together equal quantities of
honey, fresh lemon juice and oil.

Don’t bring rollerblades or bikews as the roads are
extremely narrow in Barbados. Barbados is recognized for its beautiful beaches and happening nightlife.
* Pack your quality of life insurance information or have a picture from the frot and back with the card and store with your phone.

Although this can sound hard to do, thinking about the mzny home based companies you aree likely too find from a Google search,
there are particular ways to learn about thhe quality of a typical given ofrfer about the net.
Herre a feww very vital tips that caan assist you to successfully begin your onloine
marketing campaigns. Say the wife and I opt to go down tto Mexico for just a get away.

Comments are closed.

%d bloggers like this: