Posts Tagged ‘ObamaCare’

The Unhinged Anger on the Right Leads to An Ill-Advised and Unhedged Bet Against Reform.

Monday, March 22nd, 2010

There are 2 broad lessons to take from last night:

1. Unhinged Anger Makes For Great Ratings.

Hell no!” John Boehner frothed, spittle flying as he cursed on the floor of Congress yesterday.

“This health care bill will ruin our country. It’s time to stop it…We’re about 24 hours from Armageddon,” Boehner had claimed earlier.

Baby killer!” an as yet-unnamed Republican congressman screamed at pro-life Democrat Bart Stupak on Sunday.

Nigger!” a chorus of protesters chanted to Rep. John Lewis, who also heard such things while being beaten nearly to death fighting for civil rights in the 1960s on Saturday.

Faggot!” screeched other protesters at Barney Frank that same day.

Just a few days earlier, a disturbing video recorded a man barely able to walk due to Parkinson’s disease being mocked and ridiculed by anti-health care Tea Party protesters.

A short time before that, a conservative millionaire was promising guns to “patriots” concerned about “what was coming.”

This overheated Manichean good-vs-evil rhetoric in which slight changes in wording transform you from a pro-lifer to a “baby-killer,” in which subsidies for the uninsured constitute a “government takeover,” or in which America is about to be overrun by destroyed yet again eventually must discredit it’s purveyors. At least, it must decrease in its effect over time.

Common sense has taught people that “when there’s smoke, there’s fire.” And Republican operatives epitomized by Karl Rove have taken advantage of this. Top-line Republican operatives have adopted with more vigor than the left ever did the tactics of the radical New Left of the 1960s: from attacks on the legitimacy of political institutions (from the CBO – which Rove accused of Madoff-style accounting this weekendto the Senate Parliamentarian to Congress to the Courts to the media to presidency) to the maxim that the “personal is political.” Unlike the New Left, they have virtually no agenda but to hold onto power and to, having lost it due to incompetence, tarnish the other side enough to get it back. Their hysteric charges represent the triumph of moral relativism. Their escalating outrage is an attempt to fool the American people.

This is how the rage has been created over a bill whose provisions are broadly popular and that is based on a plan offered by Republicans a generation earlier. David Frum cogently explained last night how even those Republicans “who knew better” were driven to bend before this unhinged anger that led the Republican Party to take an unhedged bet against reform, how it provoked them to declare this fight a make-or-break fight, and to take out all stops to their opposition, even though they stood little chance of succeeding:

There were leaders who knew better, who would have liked to deal. But they were trapped. Conservative talkers on Fox and talk radio had whipped the Republican voting base into such a frenzy that deal-making was rendered impossible. How do you negotiate with somebody who wants to murder your grandmother? Or – more exactly – with somebody whom your voters have been persuaded to believe wants to murder their grandmother?

…Yes [such talk] mobilizes supporters – but by mobilizing them with hysterical accusations and pseudo-information, overheated talk has made it impossible for representatives to represent and elected leaders to lead. The real leaders are on TV and radio, and they have very different imperatives from people in government. Talk radio thrives on confrontation and recrimination. When Rush Limbaugh said that he wanted President Obama to fail, he was intelligently explaining his own interests. What he omitted to say – but what is equally true – is that he also wants Republicans to fail. If Republicans succeed – if they govern successfully in office and negotiate attractive compromises out of office – Rush’s listeners get less angry. And if they are less angry, they listen to the radio less, and hear fewer ads for Sleepnumber beds.

That’s point #1: Cynical politicos out for short-term partisan gain and entertainers trying to get ratings foment unhinged anger to push their party to make a suicidal unhinged bet against reform.

Point #2. This Was Waterloo.

The Republican Party made a huge wager that they could block health care reform, and lost. Senator Jim DeMint rather infamously declared in a secret call to anti-reform advocates:

If we’re able to stop Obama on this it will be his Waterloo. It will break him.

Newt Gingrich echoed this point:

This could be the bill that drags his whole presidency down and they look back on it and suddenly the whole thing is unraveled.

Ralph Reed wrote in an email last week:

Our goal: To shock Congress into abandoning Obamacare (which will also effectively end the Obama Presidency and save freedom in America).

That was their game plan, their goal. They wanted a repeat of 1994. Their strategy in opposing the bill presumed it would never be able to pass. They escalated the rhetoric to insane levels. The less hysterical merely called it the “government takeover of 1/6th of the economy.” Bent on manipulating public opinion, the more cynical asked “innocent” questions:

Will America become another failed Cuba-style Socialist state? [Source.]

Do you think your political affiliation might eventually play into the decision on whether you get the life-saving medical treatment you need? [Source.]

A nation of Terri Schiavos with a National Euthanasia Bill? [Source.]

The more hysterical began to panic about legislation containing death panels, killing grandma, forcing government-mandated abortion, euthanasia, and reparations for slavery, authorizing government jackboots invading your home to take your children for socialist indoctrination, and overall, destroying America as we know it unless we arm ourselves and “prepare for what is coming.”

As the American people find out the answer to all of these questions is a resounding, “No!” – as they find out that the claims were made to monger fear for partisan gain – and that the bill that a plurality of people oppose contains mainly provisions that most people support – as the reality of this reform sinks in, the Republican Party will lose traction. As David Sanger quoted David Axelrod in the New York Times:

“This only worked well for the Republican Party if it failed to pass,” David Axelrod, one of the president’s closest political advisers, said at the White House as he watched the vote count for the final bill reach 219 in favor. “They wanted to run against a caricature of it rather than the real bill. Now let them tell a child with a pre-existing condition, ‘We don’t think you should be covered.’”

Now that the bill has been passed, we can focus on whether the health care plan’s tinkering with our dysfunctional system is making things better or not – as Ross Douthat says. And we can focus on the 10 things health care legislation will do right away. Obama can make his case for what he is doing (again to Sanger): “to sell the government’s oversight role over doctors and insurance companies the way he is trying to sell financial regulation: as a leveling of the playing field, in favor of consumers.” The passage of the bill re-shapes the coverage from “what could happen” to “what it is doing.” And the Democrats are more comfortable with that argument. Perhaps most frightening of all for Republicans, if this bill accomplishes what its supporters claim it will, it will re-shape the political landscape – as Bill Kristol explained in warning Republicans against cooperating in 1994:

It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle-class by restraining the growth of government.

This won’t necessarily benefit the Democrats. Republicans don’t need to keep doubling down on their anti-government rhetoric; but for the present, it seems they will.

Today, the most profound effect though is a different one. By passing this bill, Obama has proved he has yet again broken the backs of the idiocrats who threw every rhetorical, legislative, and political obstacle at him. He has showed the patience and passion which won him the presidency can be translated into presidential achievements. The bill only tinkers. It isn’t dramatic reform. But it’s core accomplishment is dramatic: a change to our core social bargain; as explained by James Fallows:

[T]he significance of the vote is moving the United States FROM a system in which people can assume they will have health coverage IF they are old enough (Medicare), poor enough (Medicaid), fortunate enough (working for an employer that offers coverage, or able themselves to bear expenses), or in some other way specially positioned (veterans; elected officials)… TOWARD a system in which people can assume they will have health-care coverage.

This is an historic achievement. It is a moral one, and it is, counter intuitively, an important step towards controlling societal spending on health care.

[Image not subject to copyright.]

What Would Republican Health Care Reform Look Like?

Wednesday, November 4th, 2009

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.

———————-

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.

“Obamacare”

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.]

Stop ObamaCare Before Obama Murders Your Comatose Wife and Infant Daughter!

Wednesday, July 29th, 2009

I received an email this morning from Townhall.com entitled, “ObamaCare Equals Government Funded Euthanasia” with the above image. I’m sort of curious why they couldn’t have just shown a picture of Obama with a gun to the baby’s head. It would have been more effective at getting their message across. But then again, they might be concerned about losing the white male gun owner vote – ’cause after all, its hard to maintain that Obama is both a liberal pansy (who’s the next Hitler and therefore is going to take away your guns) and that he carries a Glock around so he can take out any infants he sees.

But I take this email to demonstrate that the right is now stepping up its blizzard of lies about the Democratic health care reform bill over the August recess. Here’s some context for the photo:

Everyone knows that nationalized healthcare is a terrible idea but everyday we unearth even more awful details in what is in the proposed government-run plan.

A nation of Terri Schiavos with a National Euthanasia Bill?

In 2005, a COURT ordered the removal of a feeding Tube from Terri Schiavo. It outraged a nation. If the Government takes over health care, bureaucrats will decide who lives and dies in America. In the name of “creating efficiencies,” they will delay – or deny – treatment to critically ill patients because it costs too much.

We will have a NATION of Terri Schiavo’s, with a faceless Federal Bureaucracy pulling the plug instead of a Court.!

Sound crazy? It happens every day in Great Britain.

You can STOP what will in effect be government sponsored euthanasia in America if you ACT NOW.

If you care about the Sanctity of Life, the proposed Government Takeover of Health Care is an attack on your values.

It’s quite interesting that Town Hall would bring up Terri Schiavo – the pinnacle of right-wing overreach that helped alienate libertarians from the Republican camp – and that led the public to near unprecedented levels of agreement over the matter. 62% of Americans favored removing the feeding tube – and 82% of Americans believed that Congress and the President should have stayed out of the matter. Yet Town Hall – speaking only to its base – sees Schiavo as a rallying cry. And not just to their base – they claim that the removal of the feeding tube, “outraged a nation.” I wonder what it accomplishes to lie to your base and tell them that they are the real majority, aside from radicalizing them and alienating them from the American system.

But getting back to the substance of what they are claiming, they bring up a repeated right-wing canard – that:

If the Government takes over health care, bureaucrats will decide who lives and dies in America. In the name of “creating efficiencies,” they will delay – or deny – treatment to critically ill patients because it costs too much.

So many inaccuracies – as, to start, the Democratic health care reform doesn’t lead the government to take over health care. At worst, it would lead to a government-provided health insurance. And any health insurance – private or public – will deny treatment on occasion due to expense. The problem with our status quo is that rationing occurs both by cost – depending on what insurance plan you have and by health insurance company bureacrats whose job it is to deny as many treatments as possible and/or to rescind your policy if they can’t deny the treatments. That sounds a lot less like rationing and more like a war that health insurance companies are waging against the sick of America – a war in which their goal is to maximize their profits regardless of the cost to society or their paying customers.

As to the Democratic health care reforms endorsing government-funded abortion and euthanasia, I truly wonder who actually buys this load of crap. Clearly, it is an attempt by Town Hall to manufacture outrage – but who is stupid enough to believe this? Too many people, I’m sure.

Edit: On reddit, criswell improves the image, writing:

Man, look at his eyes! Obama sure hates that baby!

That pic is all kinds of win…. But it could be better… It may be too subtle for your average American… It needs… something….. Hmmmm….

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