Patterico's Pontifications

7/30/2009

Obamacare: We’ve Only Just Begun

Filed under: General — Karl @ 11:51 am

[Posted by Karl]

Yesterday, Pres. Obama’s proposed takeover of the US healthcare system took hits in polling from from NPR, TIME, Gallup, NBC/WSJ and the New York Times. Today’s Pew poll is about as bad.

The Hill and Politico report on the Congressional Progressive Caucus threatening to bolt over the deal their leaders forged with the Blue Dogs — and that is over the supposed substance, not the delay for a vote by the full House until September, when time is so clearly the Democrats’ enemy.

The emerging proposal from the bipartisan “gang of six” Senate Finance Committee negotiators that would drop a government-run insurance plan caused wailing and gnashing of teeth throughout the Leftosphere. Matt Taibbi, Scott Lemieux and Howard Dean are good examples, though Jane Hamsher attacking Ezra Klein as insufficiently dogmatic may be my favorite. Moreover, it seems that a bipartisan proposal will not emerge before Congress goes on August recess.

Grading Pres. Obama’s efforts to sell healthcare reform, Lefty blogger Nate Sliver gives The One a B+, a D+, a D- and two Fs. President Obama’s AARP town hall showed a man clearly on the defensive. It is thus no surprise that Obama plans to retool his rhetoric — though 8 bullet points, pitched mostly at the insured (who are overwhelmingly happy with their coverage already) are unlikely to change the field much.

All (or most) of the above news can cheer the Right, but the Right cannot lose sight of the larger picture, which remains pretty gloomy. Chuck Grassley, the ranking Republican on the Senate Finance Committee, still thinks the odds of sticking us with some healthcare bill are very good, as does Rep. Mike Ross, chairman of the health-care task force for the Blue Dog Coalition in the House. Killing the public plan would be a mostly symbolic victory — essential, but not enough to prevent government-run health care.

Accordingly, when conservatives and libertarians press their elected representatives during the August recess, they should make clear that dropping the public plan is necessary, but not sufficient. Our representatives need to be told that Fannie Med co-ops are just as unacceptable as a government insurance plan.

The point should be driven home that government-run healthcare schemes with most of the same elements now being discussed have been proven disasters in Tennessee, Maine and most of all Massachusetts, which has been judged a failure by everyone from Reason to the Boston Globe. The pattern is always similar — costs soar out of control, which in turn pushes government to reduce benefits or payments to doctors and hospitals (pushing them to skimp on care). Our representatives need to be told that these schemes inevitably lead not only to government-rationed care, but the death of the medical innovation.

Our representatives need to be told that as much as we do not want a public plan, we do not want a Health Choices Czar imposing costly mandates (like the guaranteed issue mandate that nearly doubled insurance premiums in New Jersey), driving people into government-run health exchanges and interfering with our right to choose our own doctors.

Centrist Democrats are going to be pressured by their progressive colleagues and the punditocracy to cave in, to support — or at least not filibuster — whatever final bill gets cooked up in a backroom House-Senate conference. They are going to get told that the failure of Hillarycare in 1994 led to the GOP electoral tsunami that year. Centrist Democrats need to be reminded that the Democrats could have lost more seats had they passed Hillarycare. They need to be reminded that after Congress passed the Medicare Catastrophic Coverage Act in 1988, a mob of seniors heckled and chased then-powerful Rep. Dan Rostenkowski down a Chicago street and attacked his car. His colleagues faced a public only slightly less angry. Less than two years later, before the bill’s implementation, Congress repealed the law by huge margins.

The Democrats may be struggling today, but their current attempt to take over our healthcare system is far from meeting its Waterloo. Stop thinking ABBA. Start thinking The Carpenters.

–Karl

54 Responses to “Obamacare: We’ve Only Just Begun”

  1. You know what would be nice.

    An email list of the Blue Dog Democrats and RINOs who are pro this lunatic legislation.

    Any help?

    HeavenSent (01a566)

  2. Keep in mind that only a relative few Democrats are susceptible to public pressure, the rest are either from safely blue districts or, in the case of the Senate, don’t face re-election until 2012 or 2014, know their re-election is going to be more about what is going on then than now, and thus aren’t going to be overly concerned about the polls showing the public not liking the Democrats health care plans. So the pressure ought to be focused on the vulnerable Democrats who are the only ones who will worry about coming down on the wrong side of the public on a very big deal.

    And it is just as important to put pressure on the Republicans to not cave and strike a deal in the interests of ‘bi-partisanship’. Remember, every GOP vote the Democrats get allows a vulnerable Democrat a free pass to vote no.

    steve sturm (369bc6)

  3. It’s not just the public plan. There is worse. Consider:

    1. Plan formats would be defined by the government, with certain minimum coverages. Everyone would have to buy something they don’t want or need because some lobby (e.g. chiropractors) got their clause in. Is maternity coverage extra?

    2. Within a plan format, there would be a maximum cost spread. IIRC, the max spread between, say, a 23-year-old runner and a 60-year-old overweight Type-II diabetic alcholic would be a factor of 2. Can you say “generational transfer”?

    3. Someone other than your doctor would be making medical decisions, likely based on mass statistics. Sorry, but 63% of cases are not helped by treatment X, so no one can have it, never mind what your doctor thinks about your individual case.

    And that’s just for starters.

    Kevin Murphy (805c5b)

  4. Charles Grassley is working very hard to get a bill we can all support.

    happyfeet (71f55e)

  5. Karl, I like cooperatives as an option except I agree with the WSJ article that funding them big time is a non-starter. GHPS and HIP plus a Washington area Group Health that a friend of mine worked for for 30 years are all aimed at a certain segment of the population that likes HMOs. I had some property in Puget Sound and about 20 years ago, I called them to see what they were paying general surgeons. I was thinking that it might be a way to relocate and semi-retire. They paid general surgeons about $75,000. I don’t know who they got in those days for that money but it wasn’t me.

    An insurance exchange, which has also been mentioned, might be an option in which mandates are removed and state lines can be crossed. Without that, you are back to the mandate feeding frenzy. California this year mandated a trial of acupuncture for EVERY workers comp case. There is almost no reason to deny it. I was on the CMA Legislative Commission for years and saw how the mandates grew. It is very hard for politicians to resist and Republicans are even worse (at least in California) for sponsoring marginal medical stuff.

    At the moment, it is probably better to fight the whole thing and then try to start with a reasonable approach when Republicans hold one house.

    Mike K (2cf494)

  6. I know a lot of people who think that once the Sens and Reps get an earful from their constituents (while on break), they will not pass any healthcare bill. I am not so hopeful. I think something will get passed – there’s still a strong, slobbering press and a gaggle of powerful lobbyists; as well as enough “I’ll get my payoff now and not worry about getting re-elected” congressmen – to get passage.
    Maybe I’m too cynical, but I think we’re on the brink of economic disaster. Add a shot of swine flu and a smidgeon of rouge Nukes – maybe the Mayans’ 2012 view is not that far off.

    Corwin (ea9428)

  7. The Democrats sure are avoiding making the same mistake the Clintons did. Instead of engaging in a hysterical and preposterous vilification of the pharmaceutical industry, they are now engaging in a hysterical and preposterous vilification of the private insurance industry. And those greedy tonsil-poaching doctors!

    Glen Wishard (02562c)

  8. haha – I meant ‘Rogue’ not rouge. (Made me turn red with embarrassment)

    Corwin (ea9428)

  9. Remember Hawaii as another “public insurance” state. They mandated health insurance for children. The State set up a government health insurance plan for kids–for those families that didn’t already have private insurance for their children. Guess what; parents cancelled their private health insurance on the little kiddies in droves–and bought the cheaper, state provided child’s health insurance plan. They bankrupted the system, and the scheme was called off in 7 months.

    The state children’s health insurance plan administrators were stupefied. “We didn’t expect this result.”

    Well duh.

    Mike Myers (674050)

  10. [...] aren’t many people in Congress who are looking forward to the August recess trip home, but I agree with Karl that the Democrats are just beginning to [...]

    Patterico’s Pontifications » Democrats Point Fingers in Healthcare Fight (e4ab32)

  11. I am not very knowledgeable when it comes to the Blue Dogs, but I found this great video on a news site I always visit, and that was when I started to do a bigger search to see if I could find more information, this site popped up, and I think it is pretty interesting to see what other people are saying. You should check this video out.
    http://www.newsy.com/videos/a_bad_case_of_the_blue_dogs

    Mark (c6f9e9)

  12. Even if Obamacare is stopped what makes any of you think the GOP has the spine to pass asomething that will put a stake through the heart of the dhimmicrat attempts to nationalize healthcare? An amendment is required to stop this sort of nonsense and any federal participation in any quasi private venture. No more Fanny Mae or Freddie Macs.

    Thomas Jackson (8ffd46)

  13. Comment by Glen Wishard — 7/30/2009 @ 12:55 pm

    Yep. Because we all know that insurance company’s drive for profit is not a conflict of interest with people’s health. Well put.

    Seattle Slew (e9f1c0)

  14. “Because we all know that insurance company’s drive for profit is not a conflict of interest with people’s health. Well put.”

    SS – What do insurance company profits have to do directly with health – make the link for me kiddo?

    We do know what impact rationing care has and throwing grandma under the bus has. Do you want to head back down that path of discussion?

    I think you should put your head back in the oat bag where it belongs.

    daleyrocks (718861)

  15. We ration health care now. Did you, as a fresh 19 year old kid (assuming you are older than that now, despite the obvious clues that you are a teenager) get your prostate examined annually? That is rationing. What is the next GOP talking point, so I can go ahead and shoot that one down.

    Seattle Slew (e9f1c0)

  16. What exactly makes you beieve that care will be more timely, at a lesser cost, more accessible, and more efficient when Teh One takes over?

    JD (7bdd7f)

  17. SS – Annual prostate exams are not recommended procedures before a certain age as far as I’m aware. Are pap smears too? Are those really considered rationing or effective medical prectice.

    So are you denying that we will ration care a whole lot more under Obamacare?

    Please answer my question about those hideous insurance company profits.

    I appreciate your concern over my prostate. I have had it check as part of my annual physical since my late 20s. Some people apparently like that part of the process. Why do you ask?

    daleyrocks (718861)

  18. It is a horse’s arse, daley.

    JD (7bdd7f)

  19. 16- Strawman alert! Strawman alert!

    Seattle Slew (e9f1c0)

  20. 17- It is both rationing and effective health care, actually. Weird that the two can so creatively coexist, isn’t it?

    Seattle Slew (e9f1c0)

  21. That is what your side is promising. Or, are those not what people should expect? At least a few of them are honest enough to admit that they just want single-payer, and this is just a little step towards it.

    JD (7bdd7f)

  22. So, you actually believe that a for-profit health insurance company is more likely to provide complete care to a patient than a not-for profit insurance company? I would like to hear your detailed arguments for that, and don’t give me the ‘competition’ meme, it is all used up. Competition required companies to spend less on their product. Their product is human health.

    Seattle Slew (e9f1c0)

  23. Unwilling to answer straight-forward questions, Seattle?

    Hopefully, the government will do a better job of managing and rationing healthcare than they have done managing the cas-for-clunkers program. Or the reinvestment and recovery that is not for actual recovery act.

    JD (7bdd7f)

  24. Which question? Yes, a not-for-profit health care system would be much better for human health.

    Not going to answer my question?

    Seattle Slew (e9f1c0)

  25. “Their product is human health.”

    SS – Wrong. Their product is insurance and you lefties keep mixing up what you are talking about.

    “So, you actually believe that a for-profit health insurance company is more likely to provide complete care to a patient than a not-for profit insurance company.”

    I took no position yet. Please address my question. You keep confusing insurance company profits with health. Please trace for me the source of insurance company profits and show your work.

    daleyrocks (718861)

  26. Seattle – You answered A question, I suppose. It was not any of the questions posed in 16 or 21 direcy to you. It seems like an answer to a question that you wished had been asked.

    As for your question, there is no historical evidence that the government can deliver healthcare at lower costs, better access, better quality, and more efficiently than even the flawed existing system.

    JD (7bdd7f)

  27. “a not-for-profit health care system would be much better for human health”

    SS – We have a great number of not-for-profit hospitals in out health system already. Surely you are aware of this.

    daleyrocks (718861)

  28. “Competition required companies to spend less on their product.”

    SS – Spend less of what? Competition is not the correct word to use if the players do not play by the same set of rules. With the government option contemplated under Obamacare, the game is rigged.

    daleyrocks (718861)

  29. Or a better job than running the healthcare system they ALREADY are in charge of…

    Scott Jacobs (d027b8)

  30. 25. Wrong. Their product is, ultimately, human health. You righties keep getting that wrong. It is sad.

    Seattle Slew (e9f1c0)

  31. Maybe the government should just demonstrate that they can run the VA, Medicare, and Medicaid, where they control costs, provide better access, better quality, and improved efficiency, then they can look at destroying the existing system.

    JD (7bdd7f)

  32. 28. That wasn’t all that insightful. It is easy to sit back and throw a comment like that out without any sort of proof or reasoning. You don’t think that a health care system that allows companies to drop customers once they become sick, or to make up bogus reasons why the ailment was ‘pre-existing’ is rigged?

    Seattle Slew (e9f1c0)

  33. Healthcare and insurance to pay for healthcare are not the same things, Seattle.

    JD (7bdd7f)

  34. But it is not rigged to let the government run at practically unlimited loss, while writing the rules for entry into the market for everyone else? Good Allah.

    JD (7bdd7f)

  35. Maybe the government should just demonstrate that they can run the VA, Medicare, and Medicaid …

    … and the Indian reservations.

    DRJ (6f3f43)

  36. The people what think health insurance companies sell “human health” as opposed to selling the right to participate in a risk pool are a lot more clear on the subject when malpractice insurance is the subject of discussion.

    happyfeet (42470c)

  37. Oh, I see, JD. So you’re saying the bill that is going through congress has nothing to do with the payment of such services, just the actual care? Sounds like you need to read the bill.

    Seattle Slew (e9f1c0)

  38. Sounds like you need to read the bill.

    this one makes it just too easy

    happyfeet (42470c)

  39. I should have known better. Until Seattle and its ilk are able to demonstrate that the government can deliver cheaper, more efficient, better access, and better quality, they should just leave everyone else alone.

    JD (7bdd7f)

  40. How would the government do that without the permission? You are so obtuse. I guess that is your self-defense mechanism when you’re wrong.

    Seattle Slew (e9f1c0)

  41. I think that they should present the bill, be honest about their motives, ie. Barney Frank and single-payer, and the Congresscritters should damn well read the bill. As happyfeet said, this one makes it too easy.

    JD (7bdd7f)

  42. Permission for what?! Good Allah.

    JD (7bdd7f)

  43. Too easy for what? Good allah… your claims of moral and conversational superiority are nauseating.

    Seattle Slew (e9f1c0)

  44. Permission to demonstrate their ability to do what they are promising? They can start with the VA, Indian reservations (thanks DRJ), Medicare, and Medicaid. So far, to date, government has demonstrated the opposite of what they are now promising.

    JD (7bdd7f)

  45. “Wrong. Their product is, ultimately, human health.”

    SS – Pretty funny. What does ultimately mean? If no claims are presented by a policyholder how is the insurance company providing human health dipshit?

    daleyrocks (718861)

  46. That one went sailing right past your head, Seattle.

    I claimed no moral or conversational superiority, whatever that is.

    Are you an heir to the Massengill estate?

    JD (7bdd7f)

  47. Well, I tried. Predictable result …

    Goodnight, all.

    JD (7bdd7f)

  48. Oh yeah? Well the jerk store called, and they are running out of you!

    Is that what this argument has come down to? We are comparing Indian reservations to health care? Can we compare pickles to beets next? Yay! I love esoteric arguments with n’er do wells! Hip Hip…. (you guys finish)

    Seattle Slew (e9f1c0)

  49. “You don’t think that a health care system that allows companies to drop customers once they become sick, or to make up bogus reasons why the ailment was ‘pre-existing’ is rigged?”

    SS – Could you point to some “proof of reasoning” as you call it that this is going on. There are laws against post claim underwriting in spite of urban legends on the left. The National Association of Insurance Commissioners is assembling data on nationwide practices in response to the recent demagoguery in Congress. The preliminary data showed 56 legitimate cases out of more than 200,000 complaints in 2007, but it’s nice of you to throw unsupported memes out there.

    What part of the unlevel playing field between a government plan and a private plan don’t you understand? Will the government plan be required to maintain levels of reserves and surplus to pay future claims the way private plans do or be exempt? Will it be subject to the same detailed form and rate filings private plans have to make with state regulators? Will it be subject to examination by state auditors? Will the adequacy of its reserves be opined upon by independent actuaries? Will it pay higher or lower commissions to agents than private plans?

    Have a go at answering some of the questions sport.

    daleyrocks (718861)

  50. Obama, Pelosi and SS just hate them some insurance companies.

    daleyrocks (718861)

  51. This is Seattle Slew at his best. Failing to understand that health insurance is not the same as health care. Just like having car insurance will not fix a broken car, you have to go to a repair shop.

    SS, the thing about Indian Reservations is that the health care provided by the government is not of the highest quality. Health care on Indian Reservations is run by the government. So, like Medicare, Medicaid, VA hospitals, etc… it is another example of government-run health care. Did saying it twice in different ways help you understand it now? The point is, when they can fix these, maybe some of us will believe they can run a national health care system.

    The thing that went over your head is about reading bills. You suggested someone else should read the bill when our legislators aren’t even reading them, or that the final bill hasn’t even been written yet.

    Go back to AofS, at least there you’ll benefit from a certain fondness they have for regular inept trolls. You’ll still have your butt handed to you, but at least you’re appreciated.

    Stashiu3 (ed6467)

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  54. [...] It has been clear for some time that dropping the public plan is necessary, but not sufficient to defeat a government takeover of the US healthcare. The Obama administration has always been [...]

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