Assertions, assertions…

Monday, February 8th, 2010 @ 9:12 pm | Health Care

Say whatever you want about Fareed Zakaria, the man can generally lay pretense to being well informed. Then he writes something like this:

True, the Republican Party has decided to be utterly uncooperative (although on health care Obama never really reached out to them with serious compromises).

Great job paying attention, Zakaria. When’s the vote on single payer scheduled again? How’s that public option compromise doing?

-jb

11 Responses to “Assertions, assertions…”

  1. Yorkshire Says:

    Right, jb, the Republicans did nothing, had no ideas, but that’s a lie since this was introduced last year and promptly dismissed by Queen Pelosi:
    http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3400:

    And it had 52 co-signers.

  2. jonezy Says:

    Because after the CBO looked at the proposals it turned out that their plans would only expand coverage to 3 million Americans by 2019 and did absolutely nothing to curb costs. That probably won’t keep you from whining about being shutout by nasty liberals though will it?

  3. REI Says:

    Obama had a televised meeting with House Republicans where all of the complaints were answered in detail. It’s not like your ideas haven’t been considered. They just don’t work.

  4. mike g Says:

    Does explaining the rationale even make a difference at this point? How many times do we have to go over this?

  5. jeromy Says:

    Not to mention the Senate Bill is essentially Mitt Romney’s health care plan for Massachusetts. It’s a mostly private hybrid that doesn’t give Democrats everything they want by any stretch of the imagination.

    But it doesn’t give (modern) Republicans everything they want, so they stand united against it, afraid of getting tossed out by people yelling “Keep your government hands off my Medicare!” Democrats have compromised themselves into near submission, and the GOP is still demanding that we essentially drop everything and just vote on their plan.

    You guys have no plan to cover everybody, and as Dana Pico has pointed out, you’re actually opposed to covering everybody. What does your plan accomplish? It actually cuts the deficit less than either the House or Senate bill.

    You’ve got ideas! Yes, terrible ones.

  6. Yorkshire Says:

    jb
    You guys have no plan to cover everybody, and as Dana Pico has pointed out, you’re actually opposed to covering everybody. What does your plan accomplish? It actually cuts the deficit less than either the House or Senate bill.

    The Dem bill didn’t cover everyone also.

  7. REI Says:

    Why are you advocating a bill that has been shown to cover fewer people and cost more money? Is that what Democrats have to do in order to appease Republicans?

  8. jeromy Says:

    Yorkshire: You’re right. My choice is between thirty million people or three million.

    It’s an easy decision.

  9. AJKamper Says:

    Has there even been anything approximating a hint that more than, oh, ONE Republican is willing to take into account even the smallest part of Democratic ideas? This is why they can legitimately be called unwilling to compromise–while Democrats back all the way from a strong single-payer to some ridiculous opt-out co-ops idea that no one really likes who isn’t Kent Conrad, the Republicans just assert their ideas over… and over… and over. It’s the epitome of bad-faith bargaining.

    If a half-dozen Republicans had been willing to say, “Okay, we’ll have some sort of public-supported health care plans, but only if you give us X and Y,” then that would look like a compromise. Hell, Obama breached the idea of actual tort reform, and as soon as it looked like the Republicans were getting something, they said “Not good enough.”

    They had no intent of cooperating on a bill. None. It would have been a Democratic/Obama victory, and was therefore unacceptable, NO MATTER WHAT the actual material was. And because there were enough Democrats who needed to look moderate to their base, or were corrupted by corporate money, or were just frankly insane (ahem, Lieberman), they managed to implode instead of getting anything done. It’s shameful.

  10. jeromy Says:

    Top Reasons Republicans should support the health care bill:

    1. REPUBLICANS ASKED FOR – DEFICIT NEUTRAL BILL: “Do the American people believe that this almost 2,000 page bill won’t add to the deficit?” [Rep. Eric Cantor, 10/29/2009]

    HOUSE BILL – DEFICIT NEUTRAL BILL: According to the Congressional Budget Office, the House bill costs $894 billion over 10 years and actually reduces the deficit by $30 billion and continues to reduce the deficit over the second 10 years.

    2. REPUBLICANS ASKED FOR – REDUCE COSTS OVER LONG TERM: “Nevertheless, House Republicans recognize the need to lower health care costs.” [Rep. Mike Pence (R-IN), 9/9/09]

    HOUSE BILL – REDUCES COSTS OVER LONG TERM: Encourages payment reforms that can help lower costs. Requires the Department of Health and Human Services to establish specific benchmarks for expansion of the Accountable Care Organization, Payment Bundling, and Medical Home pilot programs. The bill will also slow the rate of growth of the Medicare program from 6.6% annually to 5.3%.

    3. REPUBLICANS ASKED FOR – POLICIES ACROSS STATE LINES: “Interstate competition allowing people to buy insurance across state lines.” [Sen. John Thune (R-SD), 9/8/2009]

    HOUSE BILL – POLICIES ACROSS STATE LINES: Allows for the creation of State Health Insurance Compacts – permits states to enter into agreements to allow for the sale of insurance across state lines.

    4. REPUBLICANS ASKED FOR – MEDICAL MALPRACTICE REFORM: “Why not bring about reasonable restrictions and limits on medical malpractice claims to end the era of defensive medicine?” [Rep. Mike Pence (R-IA), 9/9/2009]

    HOUSE BILL – ENCOURAGES MALPRACTICE REFORM: The bill establishes a voluntary state incentives grant program to encourage states to implement “certificate of merit” and “early offer” alternatives to traditional medical malpractice litigation.

    5. REPUBLICANS ASKED FOR – HIGH RISK POOLS: “Senator McCain has a proposal sometimes called high-risk pools at the state level…These are efforts I think we can have bipartisan agreement on and deal with the question of pre-existing conditions.” [Rep. Eric Cantor (R-VA), 9/10/2009]

    HOUSE BILL – HIGH RISK POOLS: To fill the gap before the Exchange becomes available in 2013, the bill creates an insurance program with financial assistance for those uninsured for several months or denied policy due to preexisting conditions.

    6. REPUBLICANS ASKED FOR – ALLOW YOUNG PEOPLE TO STAY ON PARENTS’ POLICIES: “Recognizes that not all high school and college graduates are able to find a job that offers health care coverage after graduation. By allowing dependents to remain on their parents’ health policies up to the age of 25, the number of uninsured Americans could be reduced by up to 7 million.” [Republican Health Solutions Group]

    HOUSE BILL – ALLOW YOUNG PEOPLE TO STAY ON PARENTS’ POLICIES: The bill requires health plans to allow young people to remain on their parents’ insurance policy until they turn 27.

    7. REPUBLICANS ASKED FOR – NO PUBLIC MONEY FOR ABORTION: “The American people will not stand for government-run insurance that uses taxpayer money to fund abortions in this country.” [Rep. Mike Pence (R-IN), 10/16/2009]

    HOUSE BILL – NO PUBLIC MONEY FOR ABORTION: The bill prohibits abortion services from being made part of essential benefits package and prohibits federal funds from being used to pay for abortion (except in cases of rape, incest, and to save life of the woman).

    8. REPUBLICANS ASKED FOR – PROTECT SMALL BUSINESSES: “Helps employers offer health care coverage to their workers by reducing their administrative costs through a new small business tax credit.” [Republican Health Solutions Group]

    HOUSE BILL – PROTECTS SMALL BUSINESSES: The bill exempts 86% of businesses from the requirement to provide coverage. Businesses with payrolls below $500,000 are exempt while firms with payrolls between $500,000 and $750,000 would pay a graduated penalty. Small businesses would also receive a tax credit that helps cover 50% of their health care expenses.

    9. REPUBLICANS ASKED FOR – PROMOTE JOB WELLNESS PROGRAMS: “Promotes prevention and wellness by giving employers and insurers greater flexibility to financially reward employees who seek to achieve or maintain a healthy weight, quit smoking, and manage chronic illnesses like diabetes.” [Republican Health Solutions Group]

    HOUSE BILL – PROMOTE JOB WELLNESS PROGRAMS: The bill establishes a grant program to help small employers create or strengthen workplace wellness programs.

    10. REPUBLICANS ASKED FOR – DELIVERY SYSTEM REFORM: “Uses new and innovative treatment programs to better coordinate care between health
    care providers, ensuring that those with chronic disease receive the care they need and do not continue to fall through the cracks.” [Republican Health Solutions Group]

    HOUSE BILL – DELIVERY SYSTEM REFORM: The bill requires the Department of Health and Human Services to establish specific benchmarks for the expansion of the Accountable Care Organization, Payment Bundling, and Medical Home pilot programs.

    Update 11. REPUBLICANS ASKED FOR – HELP AMERICANS 55-64: “To help those aged 55 to 64, the plan increases support for pre- and early-retirees with low- and modest-incomes.” [Republican Health Solutions Group]

    HOUSE BILL – HELPS AMERICANS 55-64:: Creates a reinsurance program to help cover expensive health claims for employers that provide coverage to Americans 55-64.

    And that’s the more liberal House bill.

  11. jeromy Says:

    More from Ezra Klein, who makes a list of six big Republican ideas he finds in the Senate bill:

    (1) “Let families and businesses buy health insurance across state lines.” This is a long-running debate between liberals and conservatives. Currently, states regulate insurers. Liberals feel that’s too weak and allows for too much variation, and they want federal regulation of insurers. Conservatives feel that states over-regulate insurers, and they want insurers to be able to cluster in the state with the least regulation and offer policies nationwide, much as credit card companies do today.

    To the surprise and dismay of many liberals, the Senate health-care bill included a compromise with the conservative vision for insurance regulation. The relevant policy is in Section 1333, which allows the formation of interstate compacts. Under this provision, Wyoming, Colorado, Arizona, Utah, and Idaho (for instance) could agree to allow insurers based in any of those states to sell plans in all of them. This prevents a race to the bottom, as Idaho has to be comfortable with Arizona’s regulations, and the policies have to have a minimum level of benefits (something that even Rep. Paul Ryan believes), but it’s a lot closer to the conservative ideal.

    (2) “Allow individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, the same way large corporations and labor unions do.” This is the very purpose of the exchanges, as defined in Section 1312. Insurers are required to pool the risk of all the small businesses and individuals in the new markets rather than treating them as small, single units. That gives the newly pooled consumers bargaining power akin to that of a massive corporation or labor union, just as conservatives want. It also gives insurers reason to compete aggressively for their business, which is key to the conservative vision. Finally, empowering the exchanges to use prudential purchasing maximizes the power and leverage that consumers will now enjoy.

    (3) “Give states the tools to create their own innovative reforms that lower health care costs.” Section 1302 of the Senate bill does this directly. The provision is entitled “the Waiver for State Innovation,” and it gives states the power to junk the whole of the health-care plan — that means the individual mandate, the Medicaid expansion, all of it — if they can do it better and cheaper.

    (4) “End junk lawsuits.” It’s not entirely clear what this means, as most malpractice lawsuits actually aren’t junk lawsuits. The evidence on this is pretty clear: The malpractice problem is on operating tables, not in court rooms. Which isn’t to deny that our current system is broken for patients and doctors alike. The Senate bill proposes to deal with this in Section 6801, which encourages states to develop new malpractice systems and suggests that Congress fund the most promising experiments. This compromise makes a lot of sense given the GOP’s already-expressed preference for letting states “create their own innovative reforms that lower health care costs,” but since what the Republicans actually want is a national system capping damages, I can see how this compromise wouldn’t be to their liking.

    (5) To stop there, however, does the conservative vision a disservice. The solutions the GOP has on its Web site are not solutions at all, because Republicans don’t want to be in the position of offering an alternative bill. But when Republicans are feeling bolder — as they were in Bush’s 2007 State of the Union, or John McCain’s plan — they generally take aim at one of the worst distortions in the health-care market: The tax break for employer-sponsored insurance. Bush capped it. McCain repealed it altogether. Democrats usually reject, and attack, both approaches.

    Not this year, though. Senate Democrats initially attempted to cap the exclusion, which is what Bush proposed in 2007. There was no Republican support for the move, and Democrats backed off from the proposal. They quickly replaced it, however, with the excise tax, which does virtually the same thing. The excise tax only applies to employer-sponsored insurance above a certain price point, and it essentially erases the preferential tax treatment for every dollar above its threshold.

    (6) And finally, we shouldn’t forget the compromises that have been the most painful for Democrats, and the most substantive. This is a private-market plan. Not only is single-payer off the table, but at this point, so too is the public option. The thing that liberals want most in the world has been compromised away.

    On Sunday, John Boehner and Mitch McConnell responded to Barack Obama’s summit invitation by demanding Obama scrap the health-care reform bill entirely. This is the context for that demand. What they want isn’t a bill that incorporates their ideas. They’ve already got that. What they want is no bill at all. And that’s a hard position for the White House to compromise with.