Patterico's Pontifications

6/4/2009

Obama Driving Dems Left on Healthcare Takeover

Filed under: General — Karl @ 2:50 pm



[Posted by Karl]

Pres. Obama apparently has decided on a partisan takeover of America’s healthcare system:

President Obama on Tuesday affirmed his support for the creation of a government-sponsored health insurance plan, but he acknowledged that such a plan would sharply reduce the chances for Republican support of legislation to overhaul the health care system, Democratic senators said.

Senate Finance Chairman Max Baucus (D-MT) and centrists like Sen. Ben Nelson (D-NE) are clearly feeling the White House pressure. Baucus had been trying to play down the notion of a public plan, in hopes of finding compromise with Republicans.

The Obama administration is also looking to empower the Medicare Payment Advisory Commission to set Medicare payment rates, conduct trial programs, and fund policy initiatives — perhaps even as an annual up-or-down package vote in Congress, akin to the military base closure commission. It is a backdoor way of enforcing comparative effectiveness research of the sort that kills cancer patients and requires real colonoscopies instead of virtual ones.

Obama has become fixated enough on trying to ram through a government takeover that he is now willing to consider mandates on individuals and employers, and taxing employer-sponsored health benefits.

The problem for Obama — and the Dems he is pressuring — is that none of this is popular with voters. The Wall Street Journal summes it up nicely:

Democrats are trying to rush the largest entitlement expansion since LBJ into law with a truncated debate and as little public scrutiny as possible. At this point all they’ve released are the vaguest “policy options,” not concrete specifics. Yet the Senate plans to begin marking up legislation next week, maybe hold a hearing or two, then have something to the floor by the end of the month, votes by the August recess and a bill to the Oval Office by Thanksgiving. On the seventh day, they will rest. Mr. Obama had 24 Senate Democrats over for a White House chat yesterday to drive the calendar ahead.

It’s not hard to see why Democrats are trying to hew to this full-speed-ahead timetable. Their health overhaul will run up a 13-figure price tag at a time when spending and deficits are already at epic levels and hook up the middle class to an intravenous drip of government health subsidies for generations to come. These are not realities that Democrats want the American people to mull over for very long.

This is especially true for the majority of Americans who are generally satisfied with their coverage and doctors but worried about cost. They might get scared off if they were allowed the chance to realize that Democrats will do almost nothing to restrain rising health spending.

That last paragraph outlines the main obstacle over which the Clintons — and others before them — have stumbled. Polls almost always show a plurality of people say they want big healthcare reform and think it is a government responsibility. But when Democrats try to takeover the system, the same polls showing that people like their coverage and do not want government making it worse tend to foreshadow the outcome. This time, the Democrats are trying to sell reform cost-containment, but only 19% of voters believe it will reduce costs. Ironically, the big-government, high-tax proposals Obama is advocating (or willing to accept) now will only result in greater public resistance to the bills that emerge from the Congressional committees.

–Karl

30 Responses to “Obama Driving Dems Left on Healthcare Takeover”

  1. I’ve run into a number of well meaning people who think health care should be “reformed” but then say their coverage is great. But they think others need it, friends or relatives maybe, or just..those Others.

    I’d suspect that kind of support could be pretty soft.

    cassandra (5a5d33)

  2. As I have said, the very minute Obama care comes to being, I am dumping all my employees into the Gov.t plan.

    Hope and change indeed.

    HeavenSent (1e97ff)

  3. i want his plan to go forward, just as i want him to get cap & trade, his budget, and everything else he wants, and as quickly as possible…..

    painful lessons teach the best, and it’s time the coddled masses met reality, on the end of a well swung Clue by Four.

    give’em what they want, and give it to them good and hard.

    redc1c4 (fb8750)

  4. The problem with that, redc1c4, is after it blows chunks how do we take it back?

    luagha (5cbe06)

  5. There is a chance that they will fuck it up so bad that real reform might have a chance. It will take a series of unlikely events. I am very interested in the phenomenon of doctors, especially surgeons, dropping out of Medicare and charging cash prices. One barrier to a real market in health care has been the dishonest pricing of care. Every Tom, Dick and Harry who starts an HMO or PPO or other health care plan wants to promise discounts. You will even see these fake plans advertised on TV in some states. They are not real insurance, they just try to sign up doctors to give “discounts” to the members of this scam.

    Medicare has made this even more difficult by setting fee profiles and punishing providers who give discounts for cash. That has made IRAs not very useful because you are paying an inflated “retail” price for services unless you go through an insurance company. Insurance companies have tended to follow Medicare’s lead in this discount matter with the consequence that nobody knows what medical bills really are.

    You may get a bill for a short hospital stay that says it’s for $100,000. You are horrified and relieved when your insurance pays most of it. In some cases, especially outpatient surgery, you may have to pay a 20% “deductible.” What you don’t know, and can’t find out without a spy, is that your 20% may be more than the 80% the insurance company paid in real dollars. You are charged the 20% on the “retail” bill but the insurance has negotiated a huge discount.

    Now the point of this repetitive lecture on health economics is that physicians are getting so disgusted with Medicare reimbursement and red tape that they are dropping out and saying “the hell with it.” Some are retiring but some are cutting overhead and giving up dreams of big incomes and working for cash. If you don’t have to handle the details of 276 insurance contracts (which I had when I retired in 1994), you don’t need as many employees.

    What if Obama blows up the whole system with this clumsy “reform” and suddenly everybody decides to deal with real dollars and real people. The HMO world will be little affected because they are a closed system although the employee unions at Kaiser may see some pain as they squeeze. But the private practice people may just bail out and start making their own deals.

    Sometimes things get so bad, they have to get better. A real market in health care could conceivably come out of this. Probably not but I’m grasping at straws.

    Mike K (2cf494)

  6. So Medicare is bankrupt isn’t universal healthcare the solution?

    Thomas Jackson (8ffd46)

  7. It would be too much to ask that they get Medicare fixed before making it the basic system for everybody else. Of course, his “proposal” is three pages to Max Baucus. The Republicans can’t really criticize it because nobody knows the details. It is amazing, or will be if it passes, to revamp 15% of the economy with no idea of how it is to be done. This is the story of Obama; no details. That way the Chicago Way can fill in the blanks, like the closing of car dealer franchises.

    Mike K (2cf494)

  8. He’s not going to get this — it’s the political equivalent of “A Bridge Too Far.”

    There are about 60-80 centrist Dems in the House who understand that neither Obama nor Bush are going be on the ticket in 2010. It’s going to be them and their votes.

    I saw some polling in an article somewhere today that talked about how, in overwhelming numbers, voters’ concerns about health care involved costs and availability — NOT extending benefits to those not now covered.

    Any program that makes health care both more expensive and less available, for the purpose of giving greater coverage to those not now insured, is a political loser.

    Congress will feel this at the polls before the WH, and know that they cannot demagogue it away.

    Shipwreckedcrew (e73ed2)

  9. King-Drew is the best argument against government-run health care.

    Michael Ejercito (833607)

  10. ME…you have finally struck gold. K-D was one of those medical mirages where healthy people with minor ailments went to die, most likely from neglect – sometimes by malpractice.

    AD - RtR/OS! (1f03ac)

  11. Through my employer, I currently pay about $3K a year while the employer pays about $17K a year. This medically ensures me and my family and I can say that the plan is good. However, I don’t have much of a clue about what would happen in case of a catastrophic medical occurrence. So, currently I feel ok with my plan but I am fearful of what might happen in case I really need it.

    I’m all for dumping that plan in exchange for a similar amount in taxes (maybe a smaller amount, if everyone is forced into the plan nationally, and it is a not-for-profit entity) if I still can use the same doctors and have the peace of mind of not going bankrupt if something bad happens.

    oderfla (22a589)

  12. King Drew was racial politics translated into health care. I was an expert witness in a couple of cases treated there. The level of care was amazing.

    Mike K (2cf494)

  13. Shipwrecked,

    I think you’re underestimating how strong the desire to do good is in most Americans.

    Health care reform should be an easy sell for a persuasive president like Obama.

    It’s not like the Republicans have stopped him on anything yet.

    poon (093c46)

  14. Poon — it’s not the GOP that is going to stop him. He’s not going to be able to round up the votes he needs in the House. He has Dem. members in seats that they won in 2006 and 2008 that are in historically safe GOP districts. THose House members will lose in 2010 if they vote with Pelosi on Obamacare.

    THey know that.

    Shipwreckedcrew (e73ed2)

  15. Obama isn’t trying to sell health care reform. He’s trying to sell higher higher taxes what are confiscatory and depleting of capitalist energies.

    Barack Obama hates capitalism and he hates America as it is presently constituted and he doesn’t give a damn about your health care concerns. Trust me.

    The health care reform is just the but wait there’s more part of his droning and interminable sick sad dirty socialist infomercial.

    happyfeet (2d133f)

  16. That last paragraph outlines the main obstacle over which the Clintons — and others before them — have stumbled.

    I recall Bill Clinton in early 1993 waving his finger at Congress and saying something along the lines of “if you don’t give me an awesome, super generous health-care bill, the wrath of me and the public will come down on your heads.”

    The Democrats lost control of the House in the off-year election soon thereafter, and I still remember Clinton looking unhappy and chagrined.

    King-Drew is the best argument against government-run health care.

    It would be a fitting and appropriate tribute if the King-Drew Medical Center, assuming it’s ever reopened (or even if it’s not), should be renamed after the guy now in the White House.

    Oh, and King-Drew failed because of a lack of enough money, a lack of enough funding! NOT!

    Mark (411533)

  17. “THey know that.”

    That sounds like a threat, ship.

    I don’t think the new Democrats have anything to fear from former Republican voters.

    Bush’s bad taste will last for years.

    Besides, you’d be surprised how many Republicans have uninsured friends and relatives.

    poon (093c46)

  18. Bush is already the good old days. wow. That was fast.

    happyfeet (2d133f)

  19. This thread is a microcosm of how the sides stack up on ObamaCare: The more ignorant you are about government-run health care, the more you support it.

    Brother Bradley J. Fikes, C.O.R. (0ea407)

  20. Yet amazingly, America has thrown the “smart” side into the dustbin of history, eh, Bradley?

    poon (093c46)

  21. Health care reform should be an easy sell for a persuasive president like Obama.

    It’s not like the Republicans have stopped him on anything yet.

    Comment by poon

    It’s early. The Republicans are a minority. You will get what the Democrats are willing to sign. Then you can live with it. I’m not sure that all the Democrats are wiling to ride this runaway train over the cliff but we will see.

    Yet amazingly, America has thrown the “smart” side into the dustbin of history, eh, Bradley?

    Comment by poon

    This has happened before. Act in haste; repent at leisure. I think that’s a very old saying.

    The people who know the risks are not always able to convince ignoramuses of the consequences of their actions. That’s why we have bankruptcy.

    Mike K (2cf494)

  22. No one has any idea how this story ends I can’t wait to find out if the dirty socialists will triumph and create a just and prosperous society the way they made the trailer you can’t tell but I bet they pull it off cause of Barack Obama says that there are those who say these plans are too ambitious, that we should be trying to do less, not more but Barack Obama doesn’t think the plans are too ambitious and Barack Obama says no actually we should be doing more not less! Hah! So there! And also everyone has a right to health care because health care is a right is what Barack Obama says and I believe him. In my heart is where I believe him.

    happyfeet (2d133f)

  23. Has there ever been a President who said “I” more often than Teh One?

    JD (2ed087)

  24. The level of care was amazing.
    Comment by Mike K — 6/4/2009 @ 7:00 pm

    Would you care to tell us
    (as if we don’t already know, but poon might find it informative – if he could understand)
    which end of the scale “amazing” might fall?

    AD - RtR/OS! (1f03ac)

  25. JD,

    There’s been another president?

    —-

    feets!

    Karl (3bf5f8)

  26. “Bush’s bad taste will last for years.”

    poon – How’d his ass taste?

    daleyrocks (5d22c0)


  27. The level of care was amazing.
    Comment by Mike K — 6/4/2009 @ 7:00 pm

    Would you care to tell us
    (as if we don’t already know, but poon might find it informative – if he could understand)
    which end of the scale “amazing” might fall?

    The care was so amazing it failed a test 99% of hospitals pass and let a woman die writhing on the waiting room floor. Yay government.

    Eric W (11dcd7)

  28. The Obama wants to tax employer paid health care, he says it’s income and should be taxed. However, I haven’t heard the same excuse used to urge taxs on welfare payments, along with all the other taxpayer funded entitlement benefits the Democrats keep in place to buy elections.

    Let’s all come up with ideas for new taxes. What say DRJ? How about a post for ideas to increase the Federal revenue? What’s out there that isn’t presently taxed and could easily raise truck loads of cash for the Dems to fritter away?

    Ropelight (e36d4f)

  29. Saturday morning links…

    Today is Canada’s Tax Freedom Day
    Viking:

    The big one – The Corner: "On Tuesday, President Obama sent a letter to Senators Kennedy and Baucus outlining what kind of bill he wants and will support. And what he wants is a government takeover …

    Maggie's Farm (1db130)

  30. Watch- Obama will rev this up into another “emergency” that will require immediate passage before anyone can render an intelligent discussion or anlysis.

    drjohn (862e69)


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