Obamacare faces a backlash from the Center-Left
[Posted by Karl]
Kirsten Powers, David Brooks and Michael Kinsley are not exactly charter members of the VRWC, but they do not have much nice to say about Obamacare — or the way Pres. Obama is trying to sell it to a skeptical public. Here’s Powers:
An analysis of a new poll from the centrist think tank Third Way finds that Obama needs to radically alter how he’s selling his plan to America.
Obama’s central message so far has focused on the promise of lower costs for health coverage and more accessibility. But the poll (conducted by the Benenson Strategy Group) suggests that these aren’t the most potent issues.
In fact, a mere 29 percent of respondents agreed with the promise that their premiums would go down as a consequence of reform. And regarding “accessibility,” only 9 percent said that in the last five years they were without coverage all or most of the time.
Moreover, when asked, “Who do you think will benefit most from reform?” a whopping 60 percent chose “other people, but not [me].”
Third Way labels this the “what’s in it for me?” phenomenon. It argues that Obama must convince the middle class — which largely has health care and is satisfied with that care — that his plan would benefit them.
David Brooks, while floating ideas that would make a government takeover of the US healthcare system even less politically saleable, recognizes the facts on the ground:
As Alec MacGillis reported in a front-page piece in The Washington Post this week, “All signs in Washington suggest that cost considerations will be kept at arm’s length as health-care legislation moves forward.” As my colleague David Leonhardt wrote in his column this week, “The current health care system is hard-wired to be bloated and inefficient,” and health care economists don’t see the current bills doing enough to fix that.
The basic problem is that the American people have gotten used to high-tech, all-everything health care, under the illusion that they don’t have to pay for it and that it’s always better for them. Politicians are unwilling to force voters and donors to give up that sort of system, even the parts that are ineffective.
Michael Kinsley piles on:
[P]eople, even liberals, are starting to get unnerved by the cost of all this. We now talk of trillions the way, even a few months ago, we spoke of billions. In mid-June, the Senate health committee put out its version of reform and was horrified when the Congressional Budget Office figured that it would cost a trillion dollars over 10 years (over current spending) and would still leave millions uninsured. The committee retreated to its lair and re-emerged in early July with a revised plan “scored” by the CBO as costing only $600 billion and leaving only 3 percent of the population uninsured. Six hundred billion doesn’t sound like all that much to achieve, or come close to achieving, an important and long-standing goal such as universal health care. But keep in mind that health-care reform is supposed to save money. Its premise is that the current path is unaffordable. In that sense, a “mere” $600 billion extra is total defeat.
And that’s before you recognize that the $600 billion figure is an accounting shell game – the program’s total outlays remain somewhere between $1 and $1.3 trillion. This dynamic is playing out even in the solidly Democratic House, where at least 40 members of the Blue Dogs were demanding changes to key aspects of the joint House bill and threatened to derail the leadership’s timetable.
Getting a pair of bills to a House-Senate conference and beyond requires that the House pacify enough Blue Dogs and that the Senate persuade enough centrists not to filibuster. It seems as though the recent efforts by Democratic leadership to adopt a more partisan approach has provoked a backlash in Congress and the punditocracy. House Speaker Nancy Pelosi and Senate Maj. Ldr. Harry Reid may have tipped their hands too soon.
—-
Update: Roll Call reports that “House Democrats’ health care bill has been delayed indefinitely as leaders continue negotiations with fiscally conservative Blue Dog Democrats…”
Update x2: But wait, there’s more! From the Politico:
–Forty members of the conservative Blue Dog Coalition – representing just enough votes to kill a party-line vote – articulated their “strong reservations about the process and direction” of an early preview of the bill offered by chairmen of the Energy and Commerce, Education and Labor and Ways and Means committees.
—A pair of junior members of the House garnered 60-plus signatures on a letter siding with prescription-drug makers and President Obama and against the call of Energy and Commerce Chairman Henry Waxman (D-Calif.) to reinstate some price controls.
—A group of 22 wayward New Democrats expressed their hope that government-sponsored health coverage would piggyback on Medicare’s pre-existing network, despite earlier opposition to the idea from caucus leaders.
—And finally, a mix of 20 rural and Western Democrats made their case for why the bill should fix inequities in the reimbursement rates Medicare pays to health care providers in “low-cost, high-quality” states.
Also, deranged Rep. Pete Stark updates us on the cost: “Right under $1 trillion… We’re trying to do it on the back of an envelope, but I don’t have any more than a guess.”
–Karl
The only way I see the U.S. having national health care is to first spend 10 years laying the groundwork. Somebody, or some group, less polarizing than Michael Moore needs to do what he did in Sicko and focus on the “peace of mind” aspect of national health care, where your coverage does not depend on your job or your ability to pay monthly premiums, where there are no surprises, no set yearly or lifetime limits. Where people’s life and career choices can be made unaffected by the need to maintain medical coverage. I think that many, maybe most, people could be convinced through this route.
It will never pass by the Clinton or Obama method where a giant system nobody understands is forced through congress, quick, before anybody gets a chance to block it.
tim maguire (4a98f0) — 7/10/2009 @ 1:49 pmtim maguire,
That’s pretty much what the poll KP cited says, too.
Karl (894fab) — 7/10/2009 @ 1:59 pmMcCain had the start of the transition but he couldn’t explain it and, no surprise, Obama lied about it. Medicare is collapsing as fewer and fewer doctors will accept new patients. The regulation model, where you pay full price but control the price and ban any private arrangement, requires perfect knowledge of 13,000+ medical procedures and interactions by the regulators. It is the same thing that did in the Soviet Union. You simply can’t do it and make sense.
What we could do is start to go back to the indemnity model of insurance where the insurance pays a flat fee for each service and it’s up to the patient to negotiate or pay the difference. That’s what France has but this requires a private free market mechanism and that is anathema to Democrats. Also, that sort of reform doesn’t require 300,000 new government employees.
Anything that is free will be abused. There is resistance to co-pays by many patients but that is the first step to freedom. If people are too poor to pay co-pays then they should go to a community clinic and get free care but that is not the same as private care. You cannot force the one into the other by regulation and enforcement. Right now, doctors cannot charge the patient anything that Medicare does not allow. I once had a patient get so upset at the amount Medicare discounted my fee for a very big operation (a Whipple procedure, for those who know), he insisted I take $500 in cash when he came to the office for a post-op visit. I broke the law by taking it. I hadn’t asked for it but Medicare banned such transactions.
We have to get to a free market model or this will really get bad. There is no USA for an escape valve if we end up like Canada.
Mike K (2cf494) — 7/10/2009 @ 2:35 pmI’d like to see health care reform designed to remove as many middle men as possible from the system, and have feedback for results. To a conservative, this means shifting decisions to patients from 3rd party payers except for catastrophic costs. The reforms needed include reducing arcane billing and denial protocols, and the expense of malpractice costs. I’d also like to see a different model for medicine than what the government uses for childhood education. In education, if a child attends a public school, books, teachers, support staff and facilities are paid by the taxpayers. If a parent opts for a public school, they pay for it AND pay for their share of public education. They can however, pay for adjunct tutoring and supplies/educational opportunities that they pay for just their own children. I’m approaching the age of Medicare and seeing similarities to the above between what Medicare and non-Medicare doctors can prescribe for their patients, even to the extent of other medical care recipients ending up partially subsidizing Medicare since the govt. reimbursements don’t always cover the cost of care. Why, for example, is a virtual colonoscopy not paid for, but the far more invasive procedure is? Instead, why not give patients the the choice of procedures, but let them know that they must pay for any retest needed. Why not allow a floor of care, but allow patients to add on services? That would change model so it’s NOT the Medicare or govt. medicine and govt. education model. Accept what the govt. will pay for or pay for it all yourself, not patient/student friendly or responsive. Another area I’d like to see some actual reform debated about. My husband had a tumor removed some years ago on his pancreas. The bill was about $100K, but the hospital settled for Blue Cross paying 1/4 that. Having that large a spread between the uninsured price and the insured price is insane. Yet another area. I have a daughter with moderate to severe health problems. If the military deems the problems military service connected at over 30%, she will have govt. provided health care beyond VA care (which varies hugely depending on where you live). If she, or the others at her Wounded Transition Unit, were discharged with less than 30%, they are given a one time check and no health coverage except possible VA care. We looked at health premium prices and they were prohibitive. So, how do you provide a safety net for people with chronic (expensive) health issues? None of these areas seem to be topics of real discussion amongst the politicians creating the health plan. I frankly don’t care much about the health costs to those who chose to gamble by not getting any coverage, although, as I said above, when there’s a 4 fold difference in what the uninsured are charged, I have real sympathy for that. Finally, my family is from Canada and I have seen the difference my relatives have in medical care. My uncle had to travel 400 miles for a quadruple bi-pass surgery scheduled for 4 months after diagnosis, it was cancelled after his travel was performed, and then rescheduled. My dad in the US? It took the 3 days needed to clear the Plavix from his system, and the surgery was performed within 5 miles of his home. Lots of areas ripe for reform without dumping everything and going with a govt. medicine approach which shows few innovations, longer waits, and provides less patient friendly options. I am retired military, so I and my dependents have seen 30+ years of that medical care, the exceptional, the benign, and the really appalling.
HChambers (9d6a40) — 7/10/2009 @ 2:48 pmI think that many, maybe most, people could be convinced through this route
Not when they figure out that the plan as currently constituted will eventually require gov’t rationing, which will then lead inevitably to the gov’t deciding who is more worthy than others in receiving life – saving treatments. Go up to Canada and ask anyone what they’d do if they were diagnosed with late – stage cancer; they’ll tell you they’d hightail it immediately to the US and pay cash, lest they die while waiting for the initial chemo/radiation treatments.
Dmac (e6d1c2) — 7/10/2009 @ 2:50 pmHChambers, there’s no way I’m wading through that type of posting – is it so hard to break up your voluminous thoughts into a few coherent and concise paragraphs?
Dmac (e6d1c2) — 7/10/2009 @ 2:51 pmOne of my complaints with President Obama is that he has, in general, failed to use his ‘bully pulpit’ effectively (a strange thing given his unusually strong speechmaking abilities).
aphrael (e0cdc9) — 7/10/2009 @ 2:57 pmAnyone know of a health care plan exclusively for retired white guys who are in good health, straight, don’t smoke, don’t drink to excess, don’t use narcotics, don’t sky dive or drive race cars, get regular check ups, and do what their doctor says?
I’m in the market for a price quote.
Ropelight (bb3af5) — 7/10/2009 @ 3:00 pmaphrael, I guess I’ve never been convinced that Obama’s speechmaking abilities were that strong. He has the ability to make a rhetorical flourish out of vacuous, and often contradictory, sentences, but I don’t think I’ve ever seen him actually engage in persuasive speech.
Seriously, can you think of a speech where he attempted to persuade the audience to any idea deeper than a bumper sticker slogan?
SPQR (72771e) — 7/10/2009 @ 3:03 pmObama is unusually dependent on his teleprompter. That is not a good sign. He seems to be removed emotionally from many issues in every day life. I don’t think he has much to say that the folks who program the teleprompter haven’t thought of and written down for him.
There is a way to reform health care and solve some of these problems of access and transportability. It would be gradual and would involve a way to transfer health insurance from employers to a non-profit fund that would have a board comprised of employees, employers who contribute, providers and is privately run. Once that was working, we could figure out how to get the poor into the same program with some subsidies.
What Obama is trying to do is not health care reform. it is social revolution of a type foreign to this country.
Mike K (2cf494) — 7/10/2009 @ 3:11 pm“One of my complaints with President Obama is that he has, in general, failed to use his ‘bully pulpit’ effectively”
aphrael – I disagree. He doesn’t have a message that resonates with people once he gets past his normal platitudes. If 70% of people are happy with their health care coverage what is he try to sell them with this bill? He keeps describing it differently and screwing it up.
They won’t have to change doctors or plans – no longer operable.
Taxes will not increase – no longer plausible when coupled with all his other lavish spending and social engineering.
What about rationing – Obama and his people raised this bad boy themselves – who is going to tell grandma she can’t get a hip replacement?
He’s blowing it aphrael because the message is not compelling. The 50 million uninsured figure is also bloated to begin with.
daleyrocks (718861) — 7/10/2009 @ 3:40 pmIt’s sort of an odd moment… this georgie soros wet dream thingie passes and conservatives I think will be profoundly alienated from their crappy dirty socialist government but my feel is that the conservatives also think that if this thinger passes they’ll soon be vindicated as our little country sinks into a dirty socialist morass of debt and central planning. But I don’t think that for real you can be alienated and vindicated at the same time. Not necessarily. Vindication sort of implies a continued investment in the system, cause you’re still situating your beliefs in context of your little country’s oppressive politics. Alienated people don’t reliably do that. Just turn their backs is what they do a lot of the time. They stop believing. Me I believe in America. Today.
happyfeet (cbbf70) — 7/10/2009 @ 5:58 pmOne of my complaints with President Obama is that he has, in general, failed to use his ‘bully pulpit’ effectively (a strange thing given his unusually strong speechmaking abilities).
I don’t think he wants to put himself in a position where he can be held responsible for something that goes wrong.
Imelda Marcos (5ff8b1) — 7/10/2009 @ 7:12 pmThat’s why he’s chosen speeches, platitudes, and idea exchanges, rather than actual policy proposals.
That might not have been Imelda Marcos.
OOps (5ff8b1) — 7/10/2009 @ 7:27 pmI agree with Imelda.
MayBee (5ff8b1) — 7/10/2009 @ 7:28 pmIf you disagree with Imelda, watch out for flying Jimmy Choos.
daleyrocks (718861) — 7/10/2009 @ 7:38 pmHe never fails to assert that government will make it all better cause of government loves you very very much. He doesn’t want government held responsible for something that goes wrong I think.
happyfeet (d4866a) — 7/10/2009 @ 8:03 pmHe never fails to assert that government will make it all better cause of government loves you very very much. He doesn’t want government held responsible for something that goes wrong I think.
True.
MayBee (5ff8b1) — 7/10/2009 @ 8:07 pmBut sometimes, Washington really screws with government.
MayBee – I agree with Imelda too. Obama keeps pointing at those motherfarkers for designing the bills as if they weren’t what he wanted. That way he can keep pretending to vote present and avoid blame for the worst provisions unless people hold his feet to the fire. He does not like accountability because he has never been held accountable in the past.
daleyrocks (718861) — 7/10/2009 @ 8:26 pm[P]eople, even liberals, are starting to get unnerved by the cost of all this.
Which is why Obama, in some basic ways, really is an ultra-liberal. But considering his background, with people like Bill Ayers and Jeremiah Wright, should anyone be surprised by any of this?
Mark (411533) — 7/10/2009 @ 10:13 pm#4
Nice post. Clearly the US system towers above one payer, centralized systems. Such centralized systems do not provide healthcare, they ration it. The Left will not admit it.
When Medicare was proposed we were told it would reduce costs and cover more Americamns. What it did do was bankrupt the government and drive healthcare costs up through the roof. Government meddling is more responsible for the vast increase of medical costs compared to inflation, than any other factor. Compound government mandates such as emergency room service and you begin to see what government has wrought.
Americans understand the service and effectiveness of government everytime they call the IRS for information or have to deal with any government agency. I doubt anyone will believe that government control of healthcare will result in better healthcare.
And as always its hard to sell a program that the Congress speciffically exempts itself from.
Thomas Jackson (8ffd46) — 7/10/2009 @ 11:24 pmHe does not like accountability because he has never been held accountable in the past.
Exactly.
MayBee (5ff8b1) — 7/11/2009 @ 7:44 amI think Powers is following the same reinterpretive framework that the Dems have followed for years (the “What’s the Matter with Kansas?” philosophy). What she’s essentially saying is that Obama should lie to get more people to support his healthcare plans.
The fundamental problem with implementing ANY kind of government-run healthcare scheme isn’t that people don’t support it, it’s that they expect everyone else but themselves to pay for it, as Karl has pointed out several times now. Well, if we are “out of money,” as Obama has said, who the hell is going to pay for it?
That’s why the Dems are floating things like this absurd, California-style “surcharge” on high-earner’s taxes to help pay for this nonsense.
Another Chris (a3bb8f) — 7/11/2009 @ 12:20 pmMeanwhile, we hear from the tax and spend wing of the Democrat party as to how they want to pay for all of this. Is there any Democrat in Washington sane enough to recognize the folly of shifting the costs for this all to the top income households? Do they understand that the more the tax burden is placed on a small group of top earners the more widely the revenue from that group will fluctuate based upon economic conditions, and therefore the more unstable our budgeting process will become? Has Washington learned nothing from California’s problems?
JVW (b0704d) — 7/11/2009 @ 12:26 pmAnother Chris (12:20) made my point as I was drafting my comment.
JVW (b0704d) — 7/11/2009 @ 12:37 pm[…] cloud of gloom over Pres. Obama’s efforts to take over the US healthcare system is expanding beyond the Center-Left. Even Ezra Klein is occasionally allowing himself to realize that people do not want to pay higher […]
The Greenroom » Forum Archive » What if Obamacare fails? (e2f069) — 7/15/2009 @ 9:27 am