Monday, March 15, 2010

All The Wrong Reasons To Be Mad About Health Care, Is The Obama Mojo Back?

Be Mad, But Not Because It's Socialism
The current version of health care reform, some variant of the Senate bill plus reconcilation fixes may well pass this weekend. The CBO cost estimate has not yet come back, which puts in serious jeopardy Speaker Nancy Pelosi's promise to allow 5 full days to examine the bill before voting, but I can't fathom her not holding a vote prior to the President's departure for Indonesia in a week if she thinks she has the votes. And word is out of capitol hill that Pelosi may well have some Democrats in her back pocket to put this thing over the finish line, Democrats who would prefer to vote no in a tough election year, but would vote yes if absolutely needed to hit 216. Blue Dogs and Stupak Democrats. In fact, the betting odds on Intrade have soared the past few days for passage of the bill, current standing at a price that puts the odds of passage at 75% versus about 30% at the start of the month. This thing isn't quite over yet, but it's probably going to happen.

Republicans are mad, really mad. Me too. Just for the opposite reasons. Let's discuss the GOP claims.

(1)This Is a Government Takeover of Healhcare / This Is Socialism
Socialism, for you students of economics, is an economic system where the government controls the means of production. For instance, we have largely socialized surface transportation in this country, as the government owns almost all of the roads, bridges and train tracks. We have partially socialized air transportation as the government owns the airports but not the equipment.

The United Kingdom has a socialist health care system. Every Doctor works for the British government and every hospital is owned by the government.

Canada does NOT have a socialist health care system. Hospitals are private and Doctors have private practices. Canada DOES have socialized HEALTH INSURANCE system, whereby the government administers health insurance for everyone.

What is proposed in the bill is neither of the above. Not a single soul presently in private insurance would move to a public plan. There would be more government money, but it would be for the purchase of private insurance.

And that is a shame. It is a shame that Democrats do not have the courage of their convictions to push for socialist health care or at least health insurance, at least for such fundamental things as catastrophic care and immunizations. A shame that they wouldn't stand firm for a public OPTION let alone a public trust, like every other first world economy has, at least in part.

Socialism? Pfft. They coudln't mangae liberalism. Contrast this with Great Britian where former CONSERVATIVE Prime Minister Tony Blair called the socialist health care system there "a national treasure." That's the right wing in the UK.

(2) This Bill Cuts Medicare / The Old Will Face Death Panels
Grandma will be before a death panel to treat her cancer. The old will be dying in the streets. You get the picture. Funny how government run health care is the best thing since sliced bread for those over 65 and an abomination for those under 65, but I digress.

The Sarah Palin death panel stuff is nonesense of course. And that is a shame.

Costs for end of life care are the juice in the runaway inflation numbers behind medical spending. We all will die, and most of us will have thousands of dollars expended on us at the end, often tens or hundreds, on treatment which may extend our lives only matters of hours or days or not at all.

The ONLY way to REALLY contain health care costs is to have a serious conversation about what cares makes sense and what doesn't. Is the brand new drug necessary or is the drug invented in 2000 whose patent expired and is one tenth the cost sufficient? Do I really need another surgery when my prognosis is terminal? These are uncomfortable questions, but they are the real questions that have to be answered if we are ever going to seriously confront the cost issue.

(3) This Is a Huge New Spending Program We Can't Afford
This is the most massive new government program of our lifetimes, they say. We just can't afford it.

This is a tiny bill. Less than a trillion over 10 years. Less than we've spent in Iraq to date. Less than the cost of the Bush perscription drug plan. Less than the Bush tax cuts.

A massive bill? Hardly.

And that is a shame. It's hard to reshape 16% of our economy with spending that amounts to less than 2% of our economy. Feels more like a tweak than a sweeping reform when you look at it that way, huh?

So do I support the bill? Yes, but marginally. It expands access to the uninsured which I hold to be a fundamental moral issue in a country as rich as ours (and recession not withstanding we are FILTHY rich as a nation -- we consider cell phones, internet access and cable TV to be essential expenses). It doesn't go nearly far enough. It does precious little to contain costs. Make no mistake -- we'll be back talking health care reform again in a few years. But it is better than what we have. And I applaud the President for not giving up on it, although I wish we were having a much different conversation.

Where's This Guy Been?
I wrote last week about the ever-so-slight signs that President Obama was turning a corner with his approval. Look at him go now. He's talking with a renewed fire about health care in the kind of unambiguous, moral, trancedent terms that I have been begging for the past year. He looks like he is more likely than not to get a win on his signature issue.

But the Obama Administration is firing on a number of other fronts. Senator Chris Dodd revealed the Democrats financial reform measure and there are even some indications of potential bi-partisan support. Arne Duncan is talking aggressively about educational reform, including aggressive performance management of teachers, pleasing former Education Secretary and all around GOP expert Bill Bennett to the point that he described Duncan as having "upset all the right people and that is a good sign." There is even talk of talking immigration reform and cap and trade. Okay, let's not get carried away about the last two. But something is definitely different in Washingon....the big O looks like he's back. Is this just campaign bluster or will it last? Who knows. But the game is a heck of a lot different today than it was the day after Scott Brown stunned the world. And that was less than two months ago. See how quickly things change in politics?

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