Patterico's Pontifications

7/7/2009

Obamacare at Recess

Filed under: General — Karl @ 1:04 pm



[Posted by Karl]

How is the government takeover of the US healthcare system going? According to The Politico:

As Congress returns from the Fourth of July recess, negotiators tell us that the die may be cast on health reform over the NEXT TWO WEEKS. If bills are going to be passed off both floors by the end of the month, they’ll need to be in shape by then.

On the other hand, Roll Call reports:

Senate Democratic leaders’ hopes of approving health care reform before adjourning for the August recess appear all but dead, with the prospect of meeting President Barack Obama’s demand for a bill on his desk by Oct. 15 looking increasingly difficult.

Logistical hurdles in the Senate, while significant, are only part of the problem. A major political battle looms over the key components of health care reform — particularly over the role of the federal government — that could stall Democrats even after they gained a filibuster-proof majority with the addition of Sen.-elect Al Franken (D-Minn.).

***

[P]olitical difficulties abound in Obama’s push to overhaul the nation’s $2.3 trillion health care system this year.

Congressional Republicans and other opponents of Obama’s health care agenda are sure to use next month’s recess to sow doubts about the legislation, particularly the cost of reform and the so-called public option for health insurance.

Even Democratic allies such as organized labor might go on the offensive in August, either to push for a more robust government-run insurance option, or to discourage Obama and Congress from taxing health care benefits to help finance reform, a proposal that remains under serious consideration. In fact, both conservative and liberal advocacy groups actively opposed Senate Democrats during the Fourth of July recess.

“The longer something’s laying out there, it’s a target,” said one downtown operative monitoring the health care debate. “It’s a target for all of the vulnerable folks who are going to have to make a tough call on it.”

However, an insurance industry insider speculated that the August recess could allow policy experts to examine the legislation and recommend changes that strengthen the bill in advance of a presumed fall floor debate.

Or it will be just more time for the more than 350 former government staff members and retired members of Congress to spend $1.4 million a day lobbying Congress.

But wait, there’s more! If conservative and liberal advocacy groups and stakeholder lobbyists were not enough, there are the wildly competing demands of constituents at town halls when they go home. Moreover, major questions like payment are subject to regional politics on top of party politics. Will blue staters be subsidizing red staters? Or will covering working-class people in high-cost-of-living states drive up the costs Congress is trying to drive down?

Speaking of cost savings, three hospital associations agreed to contribute $155 billion over 10 years toward the cost of insuring the 47 million Americans without health coverage. Too bad that’s less than the $215 billion previously pledged, and a fraction of the $2.2 trillion Pres. Obama promised. About $100 billion would come through lower-than-expected Medicare and Medicaid payments to hospitals, driving up costs in the private sector. Another $40 billion will get kicked back through a new government-sponsored insurance program, will not pay at Medicare or Medicaid reimbursement rates (until the feds double-cross them later when the money gets tight).

That all presumes there will be a new government-sponsored insurance program. White House Chief of Staff Rahm Emanuel now says that Pres. Obama is open to a “public option” with a “trigger,” despite fears on the Left that a “trigger” will gut their takeover attempt.

Obama’s flexibility can be explained in part by the polls, which continue to show that a public plan — and Obamacare generally — is popular… unless people have to pay for it:

Although 69 percent of voters nationwide say Americans should have the option of government- run health insurance, only 28 percent would choose to be covered by it, according to a Quinnipiac University national poll released today. Voters say 49 – 45 percent they would pay more to reform health care, but a total of 72 percent don’t want to pay more than $500 a year.

As Peter Brown, assistant director of the Quinnipiac University Polling Institute, put it: “[S]even out of ten voters aren’t willing to chip in what amounts to the price of a cheese pizza per week – without extra toppings – in order to finance an overhaul.” In addition, while 55% support limiting tax deductions for those earning more than $250,000 to finance a health-care program, by 46-38 %, they realize the government cannot raise enough to finance healthcare reform that way. Furthermore, when asked, “If a health care overhaul plan lowered your health care costs and insured all Americans, — but limited your choice of doctor, hospital or treatment, would you support or oppose such a plan?”, people oppose it by a 66%-30% landslide.

Given all of the above, you might think the government takeover of healthcare is not going well. But if the Democratic strategy is to move any two bills into a House-Senate conference and strongarm moderate Dems into not filibustering whatever gets drafted in the back room, these are relatively small hurdles to overcome.

–Karl

25 Responses to “Obamacare at Recess”

  1. Poor Dems: Governing turns out to be a lot harder than campaigning, doesn’t it?

    JVW (a8c610)

  2. Dont’ worry – Rham “kill him with a knife!” will use this crisis in order to create another. Don’t like Healthcare Reform? Say hello to Cap ‘n Trade! Don’t like Cap ‘n Trade? How about the door behind Stimulus #2? The sky is falling! Wraaack!

    Dmac (e6d1c2)

  3. I foresee another vote where the Congress votes on a bill that has not been written yet.

    SPQR (72771e)

  4. What is sad is that there is a possibility of real reform with affordable coverage and good quality but this is not the way to get there.

    One sign of mendacity is the taxing of health benefits paid by employers will exempt unions.

    Mike K (2cf494)

  5. http://news.bbc.co.uk/2/hi/science/nature/8138429.stm

    OT , finally… someone …

    HeavenSent (1e97ff)

  6. The Union excemption while DISGUSTING and IMMORAL and UNETHICAL would make for great political hash for Conservatives.

    Obama as a corrupt politician who sold his support for the Unions campaign contributions.

    The RNC could run that commercial for 3 years along with “CORRUPTION IN CONGRESS: Why doe Charlie Rangel have 3 empty apartment in NYC under government subsidized rent control? What is Charlie hiding, who are they and why are we paying for it?”

    Easy to be the dissent so long as young have no concern for maligning and destroying you opponent.

    HeavenSent (1e97ff)

  7. young = you

    HeavenSent (1e97ff)

  8. On my blog, I have a link to an op-ed from Paul O’Neill that is very important. The proposed “reform” has NONE of the components of quality improvement. I have spent the last 15 years talking myself blue in the face with people about the role of reducing error and improving process in healthcare. If Obama gets single payer, that will be lost forever. In the NHS they can’t make Muslim female nurses and doctors scrub their arms. The hospital infection rates are going through the roof.

    Mike K (2cf494)

  9. Just like when a union is organizing a shop and negotiating a collective bargaining agreement, and will trade anything to management for a “closed shop” clause(one that mandates union membership to work at the establishment), so too will the congressional Dems will trade any perk, pork, or earmark they feel necessary to bribe members into voting for Obama-care and Cap-n-tax…

    I mean, that’s how they roll!

    Excellent post, as usual, Karl…

    Bob (99fc1b)

  10. I suspect ABC’s already very public groveling obeisance on health care will be a factor what convinces shaky Dems that Barack Obama’s media will get their backs on an unpopular vote. Sending that signal might have even been the main reason for it in the first place.

    happyfeet (e8d590)

  11. Things are still going good on the basis of my late Uncle Edward’s measurement. When presented with how bad X or Y was (do insert your social catastrophe of the day) he would take a look out the window and say: “It can’t be that bad… still no dead bodies in the street.”

    He had lived through the Spanish Influenza epidemic… the man definitely had the best measuring stick for a ‘crisis’ that I have ever run across.

    ajacksonian (87eccd)

  12. particularly over the role of the federal government

    Oh, you mean like which bureaucrat will decide if you get just pain pills or surgery?

    Patricia (2183bb)

  13. Oh, you mean like which bureaucrat will decide if you get just pain pills or surgery?

    Or, once Obamacare is fully implemented, a placebo.

    JVW (a8c610)

  14. Anyone who has ever seen government provided healthcare should be scared. Inthe US the only government run healthcare services are the VA and Indian Reservations.

    Remember the VA which subjected veterans to medical experimentation without their knowledge? The agency that runs hospitals not fit for Zimbabwe? And our fantastic reservation hospitals?

    Of course Congress has exempted themselves from this bill’s provisions. Any surprised by this?

    Thomas Jackson (8ffd46)

  15. Good to see Andrew Sullivan caring about Sarah Palin’s family’s health. Chutzpah!

    and

    Rahm Emanuel’s other brother (not the foul mouthed agent) is deciding who gets special treatment under Obamacare and who does not. A criteria exists for those who “contribute.” While this is supposedly for organ donors (of course you are dead most of the time you donate organs so perhaps this is for your family) could it also apply to those who “contribute” in other ways? Time will tell.

    What could go wrong?

    Joe (a32cff)

  16. Note how we can get literally hundreds of comments about some slutty stewardess snowbilly, but not even 20 about how Teh One is going to destroy our healthcare system.

    JD (7286cd)

  17. That is a pretty damn sad commentary.

    This health care story is, without question, much more central, the stakes are higher, and the urgency is paramount.

    Of course, Obama doesn’t want us to be thinking about that. He wants us to be thinking about Russia, Palin, and perhaps even unemployment and Israel. We can focus on healthcare after he’s got his law and he needs us to ignore whatever he’s pushing at that point.

    Hoyer is laughing at the idea of reading the bill before voting on it. Much less it being available for me to read 72 hours prior to the vote. This is a crisis that just can’t wait those three days. Like the stimulus, which basically has barely even taken effect yet.

    Why can’t they rush through their health care bill with a sunset provision? Honestly, I wish every mere act of congress had a sunset provision. That would be a pretty cool amendment to the constitution.

    Juan (bd4b30)

  18. Sunset Provisions…
    Sure would put a “knot in the knickers” of base-line budgeting.
    The only way to get such an amendment out of the Congress would be for 36 state legislatures to pass resolutions calling for a Constitutional Convention to take up such a matter, and 2 other state legislatures to have the resolution calendared.
    This tactic has worked in the past (the exact amendment escapes me at the moment) only because the agenda at any Convention would be difficult to control (see: 1787), and the delegates selected by the various State Legislatures might want to reel-in some of the powers that Congress has abrogated to itself.

    AD - RtR/OS! (685f75)

  19. So, basically, the more the public knows about a piece of legislation, the less they will support passing it.

    Does this not tell you something?

    Gregory of Yardale (07425b)

  20. You know, this whole ‘the last time they had a convention they threw the whole mess out and started from scratch’ doesn’t really sound all that bad.

    And I wonder if we’re getting to the point where a bunch of red states could be sufficiently polarized to go ahead and try a significant reform. Term limits for Senators and Congressmen, Balanced Budget, doing something about Raich.

    We’ll see, but it’s clear the status quo is hopeless.

    Juan (bd4b30)

  21. Not just the public, but the Legislators themselves.
    Or, why would Steny Hoyer be so adamant about not posting a complete bill for them to read before the vote.
    When Caligula appointed his horse to the Senate, he set a terrible precedent. Now it seems we have 535 of them sitting in judgement of what the rest of us may do in this life.
    I wonder what kind of bit works best on an Appropriations Chairman?

    AD - RtR/OS! (685f75)

  22. Its my opinion that “health care” is far to broad of a scope of any administration to tackle. Here are some examples which in my humblest opinion should all be handled seprately:

    Medicaid- This whole system has become a complete money sink. People deserve healthcare, what people do not deserve is the huge overhead costs of running this system, the trickle down of money/services to the end user is deplorable. When taxpayers fund this program with 40B and only 10B is actually benefitting the people in need, a reorginization of program is immedialy necessary. This not only goes for Medicaid, but Medicare, Veteran Healthcare and a managarie of other governmental programs which do nothing but it up its budget in operating expenses.

    At one time these programs were good programs, however, it has become apparant that over time it has cost taxpayers more to run these programs administrativly then the benefit to the public.

    On the off topic, I think ALL of Americas “assistance” plans need reformation, we have so many defunct and costly systems (Unemployment, Job Centers, Public Assistance, Education Departments) which are outdated and are costing us ALOT in which we see nothing but worsening of the situation coming out of it.

    Sarah (9f5551)

  23. Universal healthcare will save small businesses money! I promise. It will just cause everyone who is an actual taxpayer a crapload.

    JD (059b59)

  24. Which is roughly 50% of the adult population at present, so gosh, wonder what those who don’t py any taxes will prefer?

    Juan, I’ve been screaming about term limits for all congressional critters and local politicos for years now, with no success at getting the measure on the ballot here. Too much resistance from the entrenched pols and their handmaidens, and the local citizenry still seems comatose most of the time. But they may finally be waking up, and even though I realize that term limits are far from the panacea as some supporters claim, I feel strongly that it’s the only way to get the special interests and gerrymandered congressional folks out of office when they’re way past due. If a politico has proven their past effectiveness in office to their constituency, they can always run for a higher office.

    Dmac (e6d1c2)

  25. I’m for health care reform, and I want to see it done soon. I don’t care what party does it… this issue is not going away considering our nation keeps getting older and our health care system consistenty ranks lower and lower in comparison with other nations.

    Note: The current United States’ rankings on life expectancy, water quality and infant mortality are 24th, 39th and 41st respectively falling behind countries such as Bosnia, Cuba, Panama, Sri Lanka and Vietnam.

    If we really have “the best health care” on the planet, why doesn’t it show itself? Why are we not even in the top fifty when it comes to prenatal care?

    Luke (19bc74)


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