Health Care Summit After-Report
Feb 26th, 2010 | 37 responses
Steven Pearlstein of the Washington Post was quite impressed by the insincerity and lack of concern for Americans’ health care needs demonstrated on the GOP side:
I’m not sure what else was accomplished at Thursday’s Blair House summit, but surely one result is that we learned what Republican “leaders” really think about health care and health insurance.
The most important thing Republicans think is that if there are Americans who can’t afford the insurance policies that private insurers are willing to offer, then that’s their problem — there’s nothing the government or the rest of us should do about it.
“We just can’t afford this,” said Eric Cantor, the fresh-faced House minority whip from Virginia, while John Boehner, the House Republican leader, called it “a new entitlement program that will bankrupt our country.” What they were referring to, of course, was the $125 billion a year that Obama and his Democratic allies propose to spend in subsidies so tens of millions of low-income households can afford to buy health insurance and handle the co-payments. But if paying for those subsidies means raising taxes on high-income households with lots of investment profits, or capping a tax break for people with extravagant health insurance, or charging a modest fee on medical device makers that refuse to moderate future price increases, then Republicans are agin’ it.
That was their clear message Thursday. It was their message during all those years when their party controlled Congress and the White House and they did nothing and said nothing about the plight of the uninsured. And it is clear that they would continue to do nothing if, by some miracle, Democrats were to drop their plan or embark on a more modest approach. For Republicans, the uninsured remain invisible Americans, out of sight and out of mind.
Pearlstein’s WaPo colleague, Dana Milbank, takes a sharply different point of view. He scolds Pres. Obama for scolding Republicans too much and for taking too much of a leadership role:
An equal number of Democratic and Republican lawmakers assembled around a table at Blair House, and each had a chance to speak during the seven-hour televised talkathon. But members of the opposition party may not have fully understood that they were stepping into Prof. Obama’s classroom, and that they were to be treated like his undisciplined pupils.
Obama controlled the microphone and the clock, and he used both skillfully to limit the Republicans’ time, to rebut their arguments and to always have the last word.
Among the first to have his knuckles rapped was Sen. John McCain (Ariz.). The 2008 Republican presidential nominee accused his former rival of “unsavory” dealmaking, of breaking his promise to put health-care negotiations on C-SPAN, of supporting a 2,400-page bill, of giving favors to lobbyists and special interests. He directed Obama to “go back to the beginning” with health-care reform.
“Let me just make this point, John,” the president said when the tirade ended. “We’re not campaigning anymore. The election’s over.” Teacher directed student to drop the “talking points” and “focus on the issues of how we actually get a bill done.”
Noam N. Levey and Janet Hook have an excellent news report about the summit in the Los Angeles Times. Levey and Hook suggest that the significance of today’s meeting is that it frees Democrats to go it alone on health care reform, knowing they’ve done everything reasonably possible to work with Republicans on a bill that achieves the Obama administration’s health reform goals:
Facing unbending Republican opposition to a healthcare overhaul, President Obama confronted a stark reality Thursday as his televised summit ended: If he and his Democratic allies in Congress want to reshape the nation’s healthcare system, they will have to do it by themselves.
[...]
… [W]hat emerged with crystalline clarity were two parties with an unbridgeable disagreement over how to deal with the nation’s healthcare crisis.Republican lawmakers remained staunchly against the Democratic bid to use the federal government to regulate health insurance, subsidize coverage for tens of millions of Americans and force changes in the way medical care is provided.
“There are some fundamental differences that we cannot paper over,” Senate Assistant Minority Leader Jon Kyl (R-Ariz.) told the president at the summit.
Obama acknowledged as much as he wrapped up the 7 1/2 -hour gathering. “I don’t know, frankly, if we can close that gap,” he said. “We cannot have another yearlong debate.”
By underscoring the ideological chasm separating the two parties, Obama’s summit set the stage for Democrats to pursue a go-it-alone endgame without any pretense of bipartisanship.
Karen Tumulty makes the same point even more bluntly:
What was also made evident was that if the Democrats want to pass a health care bill this year, they are going to have to go it alone. And that they are preparing to do just that. Again and again, they brushed aside the Republicans who insisted that they should scrap the legislation that they have been working on for over a year and start all over again. Americans, said House Speaker Nancy Pelosi, “don’t have time for us to start from scratch. Many of them are at the end of the line.”
Paul Krugman notes that even on elements of health care reform that Republicans claim to support — such as being denied insurance coverage because of preexisting conditions (real, or made up) — they had remarkably little of substance to say:
What really struck me about the meeting, however, was the inability of Republicans to explain how they propose dealing with the issue that, rightly, is at the emotional center of much health care debate: the plight of Americans who suffer from pre-existing medical conditions. In other advanced countries, everyone gets essential care whatever their medical history. But in America, a bout of cancer, an inherited genetic disorder, or even, in some states, having been a victim of domestic violence can make you uninsurable, and thus make adequate health care unaffordable.
One of the great virtues of the Democratic plan is that it would finally put an end to this unacceptable case of American exceptionalism. But what’s the Republican answer? Mr. Alexander was strangely inarticulate on the matter, saying only that “House Republicans have some ideas about how my friend in Tullahoma can continue to afford insurance for his wife who has had breast cancer.” He offered no clue about what those ideas might be.
In reality, House Republicans don’t have anything to offer to Americans with troubled medical histories. On the contrary, their big idea — allowing unrestricted competition across state lines — would lead to a race to the bottom. The states with the weakest regulations — for example, those that allow insurance companies to deny coverage to victims of domestic violence — would set the standards for the nation as a whole. The result would be to afflict the afflicted, to make the lives of Americans with pre-existing conditions even harder.
That’s all for now, folks.
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37 Responses to “Health Care Summit After-Report”
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Slate seems to have a different view (and just for the record they are pretty liberal on issues)
http://www.slate.com/id/2246025/?from=rss
Some might feel it's worthwhile reviewing the details.
http://www.kff.org/healthreform/sidebyside.cfm
In reality, House Republicans don’t have anything to offer to Americans with troubled medical histories. On the contrary, their big idea — allowing unrestricted competition across state lines — would lead to a race to the bottom.
This “race to the bottom” phrase has become the mantra of the Democrats whenever discussing competition across state lines. What we are really talking about is allowing competition by making available insurance plans with varying degrees of coverage. If someone wants to buy insurance that will not cover homeopathy, massage therapy or chiropractic care, they should be able to do that. Due to pressure from special interests many states require everyone to buy a Cadillac plan instead of a Chevy plan.
The whole “race to the bottom” issue could be avoided of course by the federal government setting minimum standards for plans sold across state lines.
Race to the bottom is a stupid and confused concept.
As near as I can tell, and the reason it's confused is there are actually 2 competing concepts in it.
1. Insurers will run in and offer stripped down plans (the President's Acme insurance analogy from yesterday). People will be forced to buy these plans because they don't have enough money to afford a better plan. But, if you're a Democrat, in the context of your own bill without the minimum standards, this isn't a problem because you've provided subsidies to allow those who need it to purchase “standard” plans. If a consumer wants to but a stripped down plan, spend less of his or her own money and all of the government subsidy, I'm not sure what the issue is. And, lets be clear about what a stripped down plan is. It simply covers less or requires higher copays. There's nothing wrong with such a plan per se. You get what you pay for.
2. Race to the bottom is actually a form of cherry picking. What will happen is mean insurance companies will go in, target the healthy only and offer them very low rates and not market to other people. This will strand the unhealthy in plans where they will have to pay more. The reason this even relates to interstate competition is a bit unclear since a one state insurer could conceptually do it today. Oddly enough, this seems like pricing the cost you face. If healthy people require insurers to pay out less, they should get lower costs, shouldn't they? Otherwise, they are just subsidizing the unhealthy.
Both of these lines of argument rest on a two premises. First, the unhealthy or those with preexisting conditions shouldn't have to pay a lot more than the healthy. Second, there is a minimum standard, not of what healthcare should be available, but of what insurance should be required to pay for. I think both of these premises are false.
For those of you who are for HCR, what would be wrong with expanding and paying for increased Medicaid eligibility (as both bills do) and covering those with uncoverable preexisting conditions via a Federal payor or putting them in Medicare (under the same logic that SSDI exists within social security). Why are those not sufficient “reforms” to accomplish your goals?
Allow me now to answer my own question. They probably are sufficient but they would be a lot more expensive (as scored by the CBO) than the current plan. The reason why is the current plan levies taxes without levying taxes.
If you're uninsured and you want to be, you can't be anymore. This produces surplus to help cover those with preexisting conditions. If you're healthy, you're going to pay more due to guaranteed issue and no maximums. These things all sound good but are basically a cost shifting argument. It's a clever plan really. Rather than actually have the government pay for the things it provides, let's make the citizens pay in a way that doesn't look like a tax.
And, lets be clear about what a stripped down plan is. It simply covers less or requires higher copays. There's nothing wrong with such a plan per se. You get what you pay for.
Not only is there nothing wrong with this, but it's actually much better on a systemic level if more people have a greater degree of cost sharing. Even the CBO acknowledges that overall medical spending will go up under most of the plans because of people using medical services more when they can get more of it without out of pocket expense. Since overutilization of medical services is part of our systemic problem, encouraging policies which don't have consumers' 'skin in the game' is a step in the wrong direction.
On the lower income end, we certainly should be careful that people can get policies with low deductible/copay (or do something to subsidize those portions as well) because you don't want people being unable to afford routine preventative care. But for the middle class, copays and deductibles should be significant enough to encourage more rational decisions about doctor visits and screening tests. I say “should be”, meaning that we should still at least allow people to choose plans that do this, not that we should mandate everyone's plan being set up that way.
The reason this even relates to interstate competition is a bit unclear since a one state insurer could conceptually do it today.
My sense is that states which have robust minimal requirements today (NY, NJ, CA and others) wouldn't want this because it would drain healthy people from their pools which currently help subsidize the plans in their states. Of course, they're not subsidizing it very well as it is now, because these are the states where insurance rates hav skyrocketed the most.
A different view from what, Patrick? I agree that Slate is pretty liberal on issues, and this piece you linked to seems like a pretty liberal piece.
I don't see that much to disagree with in it.
What are you seeing that I don't?
Kathy, you agree with this:
President Obama won. So did congressional Republicans.
or this:
Republicans came out ahead for the same reason: They did not look like hell-bent obstructionists.
or this:
The complexity demonstrated today helps Republicans because they're arguing that Congress should address the issue incrementally. There are policy arguments against this approach, which Sen. Ron Wyden says actually “does less and costs more.” Yet that case wasn't convincingly made today. Obama and Democrats have been making the case for comprehensive coverage for months, and they haven't convinced anyone. In fact, people like the legislation less. Nothing today changed that dynamic.
The Slate author had a much different reaction to the summit than what you've expressed, so it's hard to believe you didn't “find much to disagree with” there.
Well, Christine, I agree that Dickerson was a bit wimpy with the “Oh, Republicans did great and Obama did great, too” bit, but he also made some very cogent points about Republican intransigence, none of which you included in your sample quotes.
Example: All of the rest of the paragraph that begins with the line you quote, as follows: Republicans came out ahead for the same reason. They did not look like hell-bent obstructionists.” While I disagree that Republicans did not look like obstructionists (hell-bent or not), and I don't quite see where he's getting that impression from, Dickerson continues in the same paragraph, as follows:
The rest of the piece was similar — a bit schizophrenic, but basically something I could agree with overall.
I read him as saying that he still thinks that the GOP is being intractable but that the public overall is not going to view this as a negative. That appears to be the main thesis, in fact, as his title indicates.
So while I get that he also said things you agree with, the main thrust of the piece is something you disagree with and that's why I was questioning you saying that you didn't see much to disagree with. Basically you're right that the author is a liberal and so he hasn't changed his opinion about the GOP position, but he appears to have written the piece mainly to say that any change in the public's opinion (not just liberals, but overall) would be in favor of Obama personally and the GOP, and against the Dems in Congress.
Basically you're right that the author is a liberal and so he hasn't changed his opinion about the GOP position, but he appears to have written the piece mainly to say that any change in the public's opinion (not just liberals, but overall) would be in favor of Obama personally and the GOP, and against the Dems in Congress.
I don't really understand the distinction he's making between Obama and the Democrats in Congress. I mean, I realize that Obama's personal popularity and Congress's popularity among the public are separate, but in the context of yesterday's summit, I don't get what he's pulling from the summit that makes him think the “Democrats” came off badly but “Obama” came off well. I don't see how that connects to the purpose of the summit. I mean, the whole point of the summit was for Obama to challenge the Republicans to “put their money where their mouths were,” regarding bipartisanship — to put up or shut up. So that when (not if) they refused to do that, Democrats in Congress could truly see that it was truly pointless to keep begging for bipartisanship because it wasn't going to happen, and they could feel free to pass health care reform on their own w/o Republican participation, knowing they had given it their all. It was showdown at the OK corral.
The Democrats didn't even have much of a role to play at the summit — they were the intended audience. Obama came off well because he took a leadership role and did it superbly, and that was what he intended and planned to do all along. So, whatever Americans watching the summit concluded about “the Democrats,” I don't see the relevance. Therefore, John Dickerson's conclusions about how the Democrats came off relative to Obama isn't relevant either. And whether or not I agree with Dickerson about how the Democrats came off relative to Obama isn't relevant.
The reason I found nothing much to disagree with in Dickerson's piece was because his position on the issue of health care reform itself is similar to mine — he supports it. The other stuff he talked about is window dressing, cosmetic stuff — and if I don't agree with it, it's not a substantive disagreement so it doesn't affect my overall feeling about what he has to say.
I don't really understand the distinction he's making between Obama and the Democrats in Congress.
The distinction is that Obama is trying to save his presidency and allow the Dems in Congress to take the hit for passing an unpopular piece of legislation via an unpopular process.
I'm sure you won't agree with that statement but I think that people who are less entrenched in the liberal viewpoint can see it. Obama came across as the mediator who tried to save the marriage of two parties who are heading for a nasty divorce, but then he'll ultimately say that there are irreconcilable differences (that's pretty much the note that he ended on yesterday.)
Perhaps, and perhaps also, people who are less entrenched in the conservative viewpoint can see that:
1. No one really knows whether it's the legislation that's unpopular or the fact that it's not been signed into law after a year of fruitless debate and obstruction, but what we DO know is that by large majorities Americans do want health care reform that will provide competition to the private insurance cartel, and that will give *them* a real alternative to the private insurance industry — such as the public option.
2. There is nothing “unpopular” about “the process” because “the process” is the same “process” that Republicans have used in 16 out of 22 instances of that “process” being used in the past 20 years. The public doesn't care about “process” to begin with. The public cares about results. What is unpopular with the public is that after a year of working on one bill, *there are no results.*
3. That Obama cares deeply about health care reform, which he campaigned on for two years before becoming president, and that to the extent that he IS concerned about “saving his presidency,” he realizes that the only way to save it is to pass a strong health care reform bill, because if he does what the Republicans want and scrap it, the Democrats will be slaughtered in November and in 2012.
4. That the Republicans *know this,* and that's why they want Obama to scrap the bill — because they know that passing it will *help* Obama's presidency, not destroy it. If they thought that passing health care reform would destroy Obama's presidency, they would be falling over each other to make sure it did pass, not trying to prevent it from passing.
5. That saying that Obama is “allowing the Dems in Congress to take the hit…” is the precise opposite of the truth. That Obama was allowing the Dems in Congress to take the hit *before* now, when he stayed aloof from the entire process and let Congress flounder without guidance or leadership. That what he's doing now, far from “allowing the Dems in Congress to take the hit…,” is letting the Democrats know he has their back, and that HE is going to take the leadership position on health care reform now, that health care reform belongs to HIM now, and that they will NOT have to take any hit.
6. That the Republicans in Congress are grasping at straws and coming up with lie after lie that get more transparently desperate by the day (“reconciliation has never been done before,” “No one has ever passed a major piece of legislation like this bill via reconciliation before,” “reconciliation is the nuclear option,” and on and on and on) in order to stop health care reform.
I'm sure you won't agree with any of the above, but I think that people who are less entrenched in the conservative viewpoint can see it.
When I was in the army, the third most valuable tool was the entrenching tool. (Your rifle and helmet were 1&2).
For politicians, it is getting an idea entrenched so it soon becomes an article of faith.
Do you not notice that every time you describe what 'most people want' or what most people 'know', it is exactly what you personally believe?
I'm not claiming that everyone sees things the way I do…I'm just saying that I believe there's close to half the country that is expressing negative viewpoints of this legislation and the process that's been involved. You can choose to believe otherwise, or believe that as long as it's slightly less than 50%, or whatever, that it doesn't matter…but only time will tell if I am correct and you are wrong in your assumptions and reading of the overall public sentiment.
Forgot to hit the reply button. The comment I posted just previous to this one was meant as a reponse to you.
Do you not notice that every time you describe what 'most people want' or what most people 'know', it is exactly what you personally believe?
There are several possible responses to this. One is that I actually said that “no one really knows” why large percentages of Americans are dissatisfied with the way health care reform is going. Lots of people — like you, and like many others — are assuming it's because they don't like the bill, think it's too expensive, think it's too big, think it's a government takeover, don't approve of the process, etc. But really, we don't know that.
I do stand by my statement about the public option, though. That has consistently polled very high among Americans.
Another response that comes to mind is that, although no one knows exactly why Americans are getting impatient with the health care reform legislative battle, common sense can sometimes help lead one to rational guesses about, for example, matters like the public being “upset with the process,” wanting Democrats and Republicans to “work together” and “be bipartisan,” “demanding more transparency in the process and an end to back-door deals,” etc. Now, perhaps you are someone who does care very deeply if there was no transparency, or lots of bickering, in the process that led to the passage of a really good bill that turned out to help lots of Americans. I don't. And I really do strongly suspect that most Americans don't. There are lots of laws and programs now that have helped an awful lot of Americans that are extremely popular. We might take Medicare as an example, or Social Security. What was the process that led to the passage of those bills? Was one party making back-door deals? Was the other party slow-walking the process? Were the senators and representatives screaming and cursing at each other? I really don't know, to be truthful. Do you know? Do you care? I sure don't. You probably care about the substantive consequences of the legislation, but I'm not believin' that you're worried about how Congress conducted itself while debating the bills that are now law. Really, if you think about it, this is not condescension, it's simple common sense based on human nature. If the government does something that makes your life better, then barring evidence of criminal behavior (and maybe not even then), people simply are *not* going to fuss and fret about “the process.” Most people want results, and if they get them, they don't look a gift horse in the mouth.
The third — and, of course, most obvious, response I have to your remarks is that your pointing out to me that every time I describe what most people want, it's exactly what I personally believe, whereas you, by contrast, are not claiming that everyone sees things the way you do, is bullpucky. In your comment previous to the one above, you wrote, “I'm sure you won't agree with any of the above, but I think that people who are less entrenched in the liberal viewpoint can see it.” Who are these people who “less entrenched in the liberal viewpoint”? Conservatives like you?
I'm sure you will agree that it makes just as much sense (or as little) for you to say that people who are less entrenched in the liberal viewpoint can see things the way you do as it does for me to say that people who are less entrenched in the conservative viewpoint can see things the way I do.
Looking back at my initial comment regarding Obama trying to save his presidency, I'll concede that I wrote that in a way that is open to the same criticism I'm directing toward you. That statement was my opinion, and I think it meshes with the opinion that the Slate author was expressing about the political calculus of yesterday's meeting (at least in that Obama's political interests are not one in the same with Congressional Dems'.) I did write it though as though I was expressing what I believed as fact, not opinion though, and that's not what I intended to do.
Maybe its the passion with which you express your opinions, though, but I always get the impression that you believe your opinions are by definition the correct ones and anyone who doesn't agree is either ignorant or dishonest. Again, maybe you don't intend that (maybe my inferrence, not your implication, based on the passionate language.)
I guess I know my own mind, so I know that I'm not deluding myself into thinking that I always read the political tea leaves correctly or that I know how to interpret the 'will of the people'. I certainly see reasons to interpret things differently than you do with regard to HCR (especially, for instance, the MA senate election- if it was so important to the majority to have the Dems pass their version of HCR, how in the world would they let anything else trump that when they had the chance to fill another seat with a reliable Dem vote?) But I'm not claiming that I am right, just expressing my take on it and saying, we'll see, won't we?
Re: the process, and whether or not people care. I think they do at this particular point in time. I think that people have been awakened after years of ignoring the political games, because everyone knows where that has gotten us. And I think that you're presenting it as though good legislation really does come about in spite of backroom deals, and I don't believe that is so.
As for the reconciliation part…the people who oppose this bill (and the polls show that is a very significant number though of course it varies depending on how the questions are asked) do care about whether that process is used because it basically means that the Dems might pass this with the narrowest of margins. Since this is a very sweeping piece of legislation, if passed without support of 49 + %,. the people who make up that percentage feel that the Dem party has ignored their serious concerns (and much about the way the 'debate' has been handled has already led people to feel that way.)
Thanks Patrick, I didn't see the actual summit being at work, but was looking for a well reasoned analysis and not just partisan postings. You link, although it doesn't cover everything seems a bit more moderate than the other items I've seen on this thus far.
What we all know is that the majority of people are tired of pure partisanship from both sides and that the majority wanted to scrap this legislation and start anew.
What needs to be done is to follow the mold of Harry Reids jobs bill and break up healthcare reform into its components and be able to say yay or nay on each without the others cluttering the discussion. In other words, keep those items that are popular and can be passed and ditch the excess baggage that has been obstructing the more popular parts.
As for the reconciliation part…the people who oppose this bill (and the polls show that is a very significant number though of course it varies depending on how the questions are asked) do care about whether that process is used because it basically means that the Dems might pass this with the narrowest of margins. Since this is a very sweeping piece of legislation, if passed without support of 49 + %,. the people who make up that percentage feel that the Dem party has ignored their serious concerns (and much about the way the 'debate' has been handled has already led people to feel that way.)
Keep one thing in mind, though, Christine. There is no “sweeping piece of legislation” that will be passed through reconciliation. The sweeping piece of legislation has already passed, both houses of Congress. What Democrats are planning to put through reconciliation are only the minor fixes that have been agreed upon between House and Senate Democrats, and the plan now, from what I've read, is for the House to pass the Senate bill first, and then as soon as possible after, the adjustments will be passed through reconciliation. The bill itself has already passed.
This is absolutely the way reconciliation has been used dozens of times in the past, Christine — and if Americans in general think it's anything out of the ordinary, it's only because Republicans have been lying about it so many times that it's become the accepted wisdom. But it's simply not true.
“This 'race to the bottom' phrase has become the mantra of the Democrats”
and liberals whenever the states, or constitutional federalism, are mentioned, or given any kind of respect (and sometimes mere notice or regard), in place of mindlessly fixating upon Washington.
“break up healthcare reform into its components and be able to say yay or nay on each”
Yep. Long overdue. Rack 'em and stack 'em — not only get rid of everything but the essential real reform elements, but rank them. The compare the lists and rankings, Rs and Ds, form a bill with theo ones on which there's agreement or should be (regulations about pre-existing conditions and recission, high risk poll reform and relief, some kind of “shall insure” with participation and payment requirements to enlarge the pools, and so on), wrangle over some others, and get on with it, already.
(There's really no valid place for federal intrusion into state high risk pools, but some would want at least a basic, uniform, somewhat consistent setup in all states, which is understandable.)
This never was hard. Some of us listed reform elements, to which the bill and the effort should have always been ** LIMITED **, all year. Sadly, it's still not going to be that easy. The Dems still want more.
It's true that the bills passed in each chamber, Kathy, but again, that was by a whisker and people did take note of the way in which it was accomplished (the deals that were made to get Blue Dog support.) Also noteworthy is that the calculus has already changed, in part because of the voters sending one additional GOP Senator to DC.
It may be a moot point anyway, of course, since numerous pundits are saying that Pelosi doesn't have the votes.
Maybe its the passion with which you express your opinions, though, but I always get the impression that you believe your opinions are by definition the correct ones and anyone who doesn't agree is either ignorant or dishonest. Again, maybe you don't intend that (maybe my inferrence, not your implication, based on the passionate language.)
Well, I have strong, clear opinions and am very passionate about them. I know that can come across to some people as communicating that my opinions are the only correct ones. All I can say about that is that I have been able to have spirited, even heated, debates with a number of TMV regulars, which are yet ultimately felt to be respectful and worthwhile on both sides (and I am referring to debates in which the other person has told me this in one way or another, so I'm not projecting my wishful thinking here). With others, not so much. You actually happen to be one of the regulars here about whom I feel that way, most of the times that we cross swords, so to speak. You infuriate me sometimes, and I'm sure I do you, as well, but I almost always feel those debates are worthwhile.
Then there are others with whom, for me, it feels very frustrating and pointless to debate, because for whatever reason the exchanges are filled with partisan talking points and factually sloppy assertions, and sometimes ad hominems. And that's on both sides. I just don't feel we're talking to each other; it feels like we're talking past each other, or at cross purposes. I think the reasons for the differences, though, have more to do with argumentation style or personality or both than they have to do with me believing my views are the only correct ones.
My debating style is passionate and opinionated, but also intellectual (not the same as intelligent; I know you know that, I just want to say it). I don't know if you would agree, but I think you rise to the level of an intellectual argument whether you are an intellectual by nature or not. Those others here who I most enjoy debating with also argue on that level.
So, take all that for what you think it's worth. It's honest and sincere, I can tell you that much.
Also, as a final note, I do want to thank you for conceding that one point. I appreciate it.
“but again, that was by a whisker”? Christine, are you serious? If a supermajority and a simple majority are both unacceptable to you, what's left?
Have you though of a auto insurance that insures only people with “no accident” (I am one of them) and people with any kind of accident, even a scratch would have to go to a higher pool. I would love that but my premiums keep raising every 6 months, you are guessing right: I AM FINANCING BAD DRIVERS! That's what “insurance” is about. And yet a driver “have the choice” to have a clean record, most sick people have illnesses “out of their control”.
I didn't say that majority in the House and supermajority in the Senate were unacceptable. What I meant by 'by a whisker' is that it took a year of wrangling and dealmaking to get their own party to vote for it, even though they held a large majority of seats in the House and a supermajority in the Senate. Regardless of the attempt to blame the GOP for forcing them to get the votes from within their own party, they did in fact control enough seats but barely got it done.
The very fact that if the votes were held again today, they would not have the votes, suggests how slim their hold on it was. They barely cleared the hurdle that they had to get over in each chamber.
Regardless of the attempt to blame the GOP for forcing them to get the votes from within their own party, they did in fact control enough seats but barely got it done.
You are absolutely correct about that, Christine. If Democrats had the party loyalty that Republicans have, health care would be passed by now.
Actually, no.
Some accidents or damage to our cars is within our control if we're good drivers, other times it's not. Just as some illness is within our control to avoid through lifestyle choices, while in other cases it's not. So, I really don't see the distinction you're trying to make.
If you want to argue that healthcare is something that shouldn't be dealt with on the insurance model, there are ethical/moral defenses of that position (or even pragmatic ones, based on the effects of poor health of individuals on society as a whole.) But I don't think the argument you are making, that poor health is less avoidable than car damage is, is effective at all.
And of course such insurance exists. Watch a progressive commercial. Good driver discount…homeowner discount…what do you think that is but price discrimination based on behavioral markers or past experience. What you have described is almost exactly what auto insurers do. So I don't have to think about it because it's real.
This is exactly my point. Auto insurers can mostly price any way they want based on what they perceive to be the risk of the particular driver in question. When we limit through community rating or limits on preexisting conditions, health insurers ability to do the same, we raise the price for all of the healthier people.
HCR as constructed is entirely about transferring cost from the less healthy (whether insured or uninsured) to the more healthy (insured) and from the more healthy uninsured to everyone else. That's the cost we never hear about because the CBO doesn't need to score it.
Sorry, it should say “and from everyone else to the more healthy uninsured (individual mandate)”
A bit of humor from The Onion: