Posts Tagged ‘Dole-Chafee Bill’

The Difference Between Obama’s Health Care Reform and the Republican’s Health Care Reform

Wednesday, March 3rd, 2010

David Brooks, struggling to find some coherent ideological distinctions in the messy struggle over health care:

[A]s Yuval Levin has pointed out in National Review, the Democrats believe the answer is to create a highly regulated insurance system with inefficiencies eliminated through rational rules. The Republicans believe that the answer is to create a genuine market with clear price signals, empowered consumers and an evolving process.

If only it were so clear. It’s worth pointing out again how similar the current Obama-backed bill is to the Dole-Chafee bill proposed to counter Bill Clinton in 1993 (as I have before.) Both that 1994 Republican bill and this one seek to create a genuine market with clear price signals – as, it seems, does the main Republican proposals today. The difference between the Dole-Chafee bill and Obama’s bill on the one hand, and the current Republican efforts today isn’t that one sees government bureaucracy as the answer and the other sees the market as the answer. The difference is that one holds that the government can and should provide clear rules to prevent corporations from abusing their position and their customers, and the other assumes that the market will sort it all out eventually. It’s the difference between an open but regulated market and an unregulated one. It’s the difference between as much reform as the insurance industry can abide by and insurance executives’ wet dreams of glorious profits without red tape making them actually provide something of value to their customers.

[Image not subject to copyright.]

Obama: You’re Calling Me a ‘Bolshevik’ for Using Republican Ideas for Democratic Ends

Monday, February 1st, 2010

I wrote a post a few months ago listing some similarities of the Dole-Chafee bill presented as an alternative to Bill Clinton’s 1994 reform effort to the health care reform effort today which has recently started to get some attention thanks to Obama’s referencing exactly this fact in response to questioning by the House Republicans on Friday:

[I]f you were to listen to the debate, and, frankly, how some of you went after this bill, you’d think that this thing was some Bolshevik plot…

[But] if you look at the facts of this bill, most independent observers would say this is actually what many Republicans — it — it’s similar to what many Republicans proposed to Bill Clinton when he was doing his debate on health care.

So all I’m saying is we’ve got to close the gap a little bit between the rhetoric and the reality.

I’m not suggesting that we’re going to agree on everything, whether it’s on health care or energy or what have you, but if the way these issues are being presented by the Republicans is that this is some wild-eyed plot to impose huge government in every aspect of our lives, what happens is you guys then don’t have a lot of room to negotiate with me.

Obama adopted this Republican framework to meet some Democratic goals. (Though I shouldn’t give all the credit to him, as his general framework was created by a number of liberal thinkers including Jacob Hacker, Peter Orszag, &tc, and was adopted by John Edwards and Hillary Clinton in the 2008 primary.) Obama’s approach represents a synthesis of the core conservative critique of Reagan, Hayek, &tc with an empirical approach towards government generally favored by liberals. In other words, Obama saw the limits of centralized planning and the power of markets that lay at the core of Reagan. But he did not adopt Reagan’s visceral hatred for government. Instead, he believed government could be useful. Rather than seeing government as something that needed to be attacked, he adopted Hayek’s view that “we needed to think of the world more as gardeners tending a garden and less as architects trying to build some system.”

While I described this as evidence of Obama’s attempt to seriously grapple with Republican ideas while pursuing Democratic ends, a number of commentators – specifically pm317 on Hillaryis44 and Ann Althouse’s blog, seemingly a PUMA – used the post as proof that Obama is a sell-out, encouraging people to:

Tell your bluest of blue friends who are still supporting Obama to read this little piece…

My piece was actually positive in its description of how Obama was grappling with Republican ideas – but pm317 read it to mean the opposite, seeing it as yet another proof of Obama’s awfulness. pm317 wants Obama supporters to reject ideas because they are labeled “Republican” or once were supported by Republicans – and while this may happen,  she presumes these Obama supporters are driven by the same politics of ressentiment and identity that seemingly motivate him/her. Confronted with the fact that I am an Obama supporter, and that I wasn’t condemning Obama for using Republican ideas, pm317 responded:

Obama’s base supporters cheerleading his GoP stunt ARE highly partisan and they want single payer system or at least a public option and don’t want any of the republican ideas. They must see how Obama is sneaking in republican ideas into his plan.

Which is just an odd response. Do he/she presume that “Obama’s base supporters cheerleading his GoP stunt” didn’t notice that he explicitly said in that same event they are “cheerleading” that his health care plan is “similar to what many Republicans proposed to Bill Clinton when he was doing his debate on health care” – which is what started this whole conversation in the first place? How is that “sneaking”?

It seems likely to me, given the evidence available to me, that the accuser is describing themself – describing someone motivated by the politics of ressentiment and someone who is extremely partisan and rejects the ideas of Republicans and Obama supporters out of hand.

I only bring this particular example up to illustrate the seemingly visceral reaction against Obama and his health care plan – and how in this instance at least – it seems motivated primarily by ressentiment rather than any attempt to grapple with the issue.

The problem, in other words, is about politics rather than policy.

[This image is not subject to copyright.]

Limbaugh claims Obama is a radical leftist because he supports programs Republicans proposed a generation ago.

Thursday, November 5th, 2009

Rush Limbaugh, Dick Cheney, Glenn Beck, Sarah Palin, Charles Krauthammer, and other right wingers have begun to converge on a unified theory of Obama – a systematic critique of who he is, what he stands for, and what he is trying to do. Part of this theory – one of the core themes being developed – is that Obama is the most far left American leader ever. Rush Limbaugh expresses this as well as anyone – and I’ve spliced together two clips from his interview this past Sunday with Fox News. (Full interview here.)

Let’s take two of these quotes out for a moment:

We’ve never seen such radical leadership at such a high level of power…

I don’t know of any Republican who would try to take over one sixth of the U.S. economy. I don’t know one Republican who would put forth this…this…irresponsible cap and trade bill. I don’t know one Republican who would actually do that.

To understand why this is such a bizarre thing to say you need to look at some history.  It illustrates what I mean when I call the Republican Party and the right wing – and much of our public debate as it attempts to find the middle ground between the right and left – unhinged. Take a minute to look at the history of the policy proposals regarding the two examples Limbaugh cites – health care and cap and trade.

Health Care

The plans moving through Congress now have an historical precedent in most of their aspects in the two serious Republican attempts to reform health care after LBJ’s introduction of Medicare and Medicaid – Richard Nixon’s health care proposal in 1974 and the Dole-Chafee bill in 1993. Between the two bills, they contained a technocratic institution to reign in health care spending by looking at medical practices – similar to the IMAC that Sarah Palin called a death panel (Richard Nixon’s proposal); an individual mandate, an extension of Medicaid eligibility (the Dole-Chafee plan); an end to insurance industry abuses – for example, banning people with preexisting conditions, subsidies or vouchers for individuals who couldn’t afford health insurance to purchase it, and the creation of a standard minimum level of benefits for health insurance plans (both plans.)

Those who developed the base model that of health care reform now – used these models as the base onto which they grafted a health insurance exchange and a public option. They combined market forces with decentralized decision-making – the exchange on which private companies would offer health insurance – with a more top-down centralized approach – the public option which would compete with the private companies. Clearly, though the plan is distinctly liberal, it was developed by people who have a deep appreciation for some of the central conservative critiques of government planning and New Deal/Great Society-style liberalism. The plan is also clever politically – as a great majority of the American people, in their wisdom, see great value in having a choice between public option and a private one. Michael F. Cannon of the libertarian Cato Institute accidentally justified the rationale behind this popular sentiment:

Any payment system creates perverse incentives…which is why we need competition between different payment systems to temper the excesses of each.

Unlike the Dole-Chafee bill which sought to undermine the current system with the hope that something else would develop, the plans working through Congress now are more conservative as they seek to preserve the status quo while introducing an alternative model that people could opt into if it works.

You wonder how far to the right the Republican Party Rush imagines is if he claims he doesn’t know any Republican who would propose anything like this.

How about Mitt Romney, Bob Dole (who incidentally endorsed a version of the bill currently moving forward), Richard Nixon?

The one thing that makes this plan distinctly liberal is the public option. Yet, if anyone believes that after dropping it, the Republicans would support a health care bill, they haven’t been paying attention.

(For more on the similarities on health care, see this post from yesterday.)

Cap and Trade

On climate change, the story is even more dramatic.

Cap and trade started out as a hair-brained scheme to solve the problem of acid rain thought up by a Reagan administration lawyer, C. Boyden Gray. Environmentalists and liberals hated the idea. They saw it as a license to pollute, a “morally bankrupt” “license to kill,” or more reasonably as a “scheme for polluters to buy their way our of fixing the problem.” They preferred the more “command-and-control” approach of top-down regulation. Regulators resisted the idea – as it forced them to surrender “regulatory power to the marketplace.” Industry opposed it, claiming it “was going to shut the economy down.”

But George H. W. Bush thought that free market principles could realign the incentives to fix this problem – and he wanted to placate the Canadians who were bearing the brunt of the acid rain.

So he pushed through a cap and trade scheme to eliminate acid rain over these strong objections. It beat all expectations. Eventually environmentalists came around and industry continued to thrive. This Republican success on solving a major environmental issue without top-down regulation made cap and trade a popular, bipartisan idea. Eventually, Bill Clinton saw it as a way to tackle global warming. But as a significant minority of Republicans continued to question whether or not global warming was real and whether or not it was man-made (along with every other scientifically moot question that industries raised) any possible deal was postponed. Still, as late as 2008, the Senate had strong bipartisan support for a cap and trade program – with Joe Lieberman and John McCain taking the lead. Now McCain is a major opponent of the cap and trade legislation, complaining about the lack of support for nuclear reactors in the bill as a reason to oppose it. This when as late as a year ago, he reiterated his statements of the past eight years in saying that global warming demanded “urgent attention” – that we must “act quickly” to “dramatically reduce our carbon emissions” with a “cap-and-trade” program.

As I said regarding health care, if anyone thinks that McCain will come around to support this legislation that is so similar to what he supported as essential a year ago if the Democrats just tossed some more money into nuclear energy, then you haven’t been paying attention. McCain will likely start calling it a “power grab” and a “government takeover” of the world, echoing Cheney and Krauthammer by the time the bill is up for a vote.

Conclusion

In both cases, Republicans proposed ideas based on core conservative principles – on a respect for the free market, on avoiding rapid change, on avoiding top-down regulation. And now Democrats led by Barack Obama have taken up these proposals – amending them somewhat to take into account liberal ideas such as a distrust of large corporations and a concern for community goods – hoping to pass bipartisan legislation.

What they are met with instead is screams of “Socialism!” and “Government takeover!” and “Unprecedented!” “Attacks on liberty!” and “Why do you hate America?”