Obama’s Moderate Health Care Plan

Jonathan Chait at TNR argues that the health care reform legislation turned out moderate in substance (a point that I tried to make in yesterday’s post here):

Obama’s plan closely mirrors three proposals that have attracted the support of Republicans who reside within their party’s mainstream: The first is the 1993 Senate Republican health plan, which is compared with Obama’s plan here, with the similarity endorsed by former Republican Senator Dave Durenberger here. The second is the Bipartisan Policy Center plan, endorsed by Bob Dole, Howard baker, George Mitchell and Tom Daschle, which is compared to Obama’s plan here. And the third, of course, is Mitt Romney’s Massachusetts plan, which was crafted by the same economist who helped create Obama’s plan, and which is rhetorically indistinguishable from Obama’s.

Again, the key is to look at the resulting policy, and not just the politics of health care reform.

         

Author: ELYAS BAKHTIARI

Share This Post On

17 Comments

  1. If a “moderate” health care plan means taking the bad ideas offered by the Democrats and combining them with bad ideas offered by the GoP, then I guess “moderate” policy isn't much good either.

  2. Andy,

    I agree wholeheartedly.

    Sorry, Elyas, but any plan which incorporates the Fascist/Corporatist approach can hardly be termed “moderate”. This plan is much too overreaching and provides about as much opportunity for disaster as did the status quo.

    Jeff Dreibus

  3. So getting rid of pre-existing conditions and the laundry list of good reforms are all nuked because of a single component? That sounds a bit extreme. Do you find none of the things in the bill, I mean it is huge, to be good or are you so angry you have moved to black and white world?

    It also begs the question how do we ensure that you and I that have health care are not paying for Jimmy that refuses to get it? Will not the result of me and you paying more for Jimmy still be the same “fascist” result in the opposite direction? Should we just force companies to write it off all together as a lose, which of course would be gov dictating the action which is also problematic?

    Sorry I have heard for around ten years that the prime reason for growing costs were those that had no coverage, from GOPers, and now you are saying that can't be resolved regardless if we end up paying more for them in the first place(which we are currently doing)? Actually the specific three reasons listed to me have been; dead beats that do not have insurance, tort reform and increased competition and this health care bill only misses tort reform, you would think that Goper's would be skipping through the streets linking arms with their new found lefty buddies.

    From my view its a good bill, I am not fond of the fascist care elements but I also hated them when Romney set them up in MA. Over time I have come to accept that my fellow citizens will not see that we have only two options to contain costs, nuke the entire systems reg/laws and all(this means all of the AMA's goodies) or single payer. Over time I have come to accept that we will have a “free market” system that will cost us around three times the amount the rest of the world pays but I live in the US and I am used to subsidizing private industry to calm the fears of my conservative brethren who demand free market competition even if we have to weave it out of nothingness and often getting a worse result.

  4. I forgot to ad that moderate is between classic GOP and Dem packages and ideas from the past to today not necessarily a “moderate” approach. A moderate approach in a nation as far to the right as we are(one I would describe as almost totally corporatist/fascist) maybe but that's about it.

  5. Of course nothing the democrats do can ever be considered moderate. That's a rule now you know.

  6. There is nothing moderate about a program that will convert the health insurance industry into the health care costs transfer industry. Insurance rates will have to go up significantly to make up for everyone who will game the system and to fund all of the federal mandates.

    In addition, the law and currently written will eliminate health care as a good career for the middle class. First generation immigrants and the desperate poor will be the only ones left to take the low paying jobs in health care. Image the number of medical mistakes that will occur because most of the workers are functionally illiterate.

  7. Cheer up, libs and Dems. It sounds better than “watered-down.” (Need I suggest visualizing that funnel?)

  8. TMSF,

    We are not only talking Fascism here but collectivistic Fascism at that so, yes, I say we scrap the plan and start over. Nothing good will come from this approach; it is antithetical to the concept of free choice upon which our until-recently successful society was built.

    And I pitched just as big a fit when I learned of Mitt Romneycare as I did when I first heard of Senator Max Baucus's vision of Obamacare which has now been realized. I don't care whether the Fascist is a pachyderm or a donkey, I resent the taking of my freedom by either.

    And, for the record, my wife is one of those “deadbeats” who has been denied health insurance hence is not “paying her fair share”. Our state (North Carolina) has an insurance “pool” which ostensibly provides those fortunate souls with “pre-existing conditions” and affordable option. Would you like to know just how “affordable” that option is? Try $500.00/month with a $5K deductible. Such a deal! So, yes, she surely is a deadbeat.

    If health insurance had simply been made affordable and available to everyone, enough people would purchase it to keep the system solvent and the problem would be solved without forcible collectivism.

    Jeff Dreibus

  9. “I am not fond of the fascist care elements”

    As I wrote on another thread, though, the fascist “managed cartel” (Big Government and Big Business Big Partnership) is the model for this country, and the same thing was done earlier with HMO “alliance”-based HillaryCare in the 1990s. The insurers are in it as long as they can remain; the feds are happy to exploit the insurers and use the existing insurance model as they progress toward Medicare or VA for everyone.

    * * *

    “Our state (North Carolina) has an insurance “pool” which ostensibly provides those fortunate souls with “pre-existing conditions” and affordable option. Would you like to know just how “affordable” that option is? Try $500.00/month with a $5K deductible. Such a deal!”

    Jeff, I've had experience myself with pre-existing conditions and the insurance nightmare. I have not had (up to now) to rely on state high-risk pools, but have had to rely on the individual market most of the time.

    I just got my letter from my current state's Blue Cross rejecting me due to my pre-existing condition, and fortunately it admits me to the high-risk pool. (As I posted elsewhere, what about states where you are rejected for individual insurance or a family plan but you don't get admitted to the high-risk pool? I don't believe the ObamaCo people are the kind who thought about important things like this.)

    I'm currently maintaining my out-of-state Blue Cross individual (shall-issue) plan at $400/month while I consider switching to the high risk pool at $400/month but I don't know all the exclusions and limitations.

    Mid-four figures is actually cheap, Jeff. I have a buddy here at work on an individual plan, in California, could be Anthem (who was in the news recently), paying $900 or more a month with policy limitations.

    An ordinary family plan is easily four figures (over $1000 a month) in a state such as New York where I used to live. (I was on a Maryland individual plan for $350 at the time.)

    I believe many state high-risk pools (AIDS and cancer patients, say) have individual plans at over $1000.

  10. Incidentally, there never was an excuse for the federal government to be involved in this. But if it did, why did it not start basic reform by going to “community rating,” which has everyone (the largest pool possible, of all possible insured people) paying similar or equal, low rates? And if not that, why didn't we hear of at least an effort to take over the state high-risk pools, maybe create “regional” or a single nation-wide assigned risk pool (there's a quick salient toward federal health care for all)? We heard nothing about this.

  11. Corporations by definition are collectivist and therefore any system using them would be collectivist by nature, of course our Rand fans forget the collectivism they enjoy meaning the financial kind.

    If we want to nuke fascism in our system we need to nuke a whole bunch of our system, basically everything we have done for nearly a century. This may sound extreme but its true and if we are playing with the idea of nuking an entire bill because of a single component I dont see it as any more over reach than we are already discussing and it would actually begin fixing problems instead of tinkering around the edges making the Dem and GOP pols howl with glee while we fill their campaign coffers.

    If you want affordable health care or health care that is available to everyone(which would mean options they can afford and actually do something not 500 per month with a 5k deductible) the only option is single payer and do not even think about the public option because it will likely be to expensive without subsidization. This was once hidden when we made a good deal of money in this nation and the costs slowly rose but now without or without HCR your bill is going up and by astronomical amounts, the reason…you are already paying for the care of others and you have no choice in the matter.

    What ideas have you because I see that you have needs and do not want mandates but demand lower costs which leaves me wondering how you think this gets paid for, higher taxes? That of course would still be money spent, do you have any ideas on this short of it falling from the sky? Dont get me wrong I am not fond of the mandate and have hated on it since Romney care as well but I also see that we as a nation are trying to get blood from a stone without any willingness to admit someone eventually will need to find a way to pay for things or none of us will have anything but those at the top which is increasingly the reality of the situation. Without mandates how do we get there, and what is there? Can we tell hospitals they will only get X amount and fix the prices so that the 500 a month can go further? How is that acceptable?

  12. This link…
    http://www.politicalcentrist.com/Political%20Ce

    Makes a good case for how the finance committee (you know that one where Bacus got Olympia Snowe to vote yes?) started toward a bipartisan bill, but the attempts by Reid to force the public option poisoned the well, even though they failed to get the public option through.

  13. Well, the link didn't paste, but look for the article entitled “Another Day Another Bipartisan Opportunity Lost” at http://www.politicalcentrist.com

  14. That would have been the public option or expanded medicaid, of course they did not offer it alone but if they would have it would have been labeled as “government takeover”/communism since a gov entity would have been “competing” for customers. Of course me and you know they are not competing for anything, those people wouldnt have a choice but try to convince insurance companies that paying astronomical prices is not a choice…for them it is only not a choice once they will not cover you at any price. Also GOP members would have pointed out is is a slippery slope ending in a single payer system.

  15. TMSF,

    What I had in mind was a modest subsidy for those relative few (some fraction of 47 million) who can not afford to pay for overpriced health insurance. As long as Obama & Co. are printing trillions in funny money for the banks, automakers, etc., why not give the people a tiny fraction of that aid as well? That, along with indexing the rate of maximum per-year increase to that of inflation and, yes, doing away with the pre-existing condition exclusion, would have gone a long way toward solving the problem.

    No, I don't think that money will fall from the sky; somebody's going to pay. But whom would you rather “punish” primarily for this mess? The American people who are innocent in the creation of it? Or the health insurance jackals who have a leading role in this disaster because they have been (and will now to an even greater extent be) basically allowed to operate outside the laws of supply and demand and the anti-trust and anti-discrimination laws which apply to (almost) every other enterprise in America?

    Impractical, you say? Not nearly so impractical as the plan which was just approved. And yes, there is far more to dislike about it than the “mandate” aspect. The heavy tax increases, for example, would be far lower if the more modest approach I outlined above had been attempted.

    Jeff Dreibus

  16. But the insurance companies are corporations that by federal law have to find the most profit they can every quarter for their investors, this is according to the Supreme Court not some odd reading of corporate law. They are not designed as charity machines. So, much like has happened with colleges, if we subsidize this it will make costs go up though at a slightly slower rate then they are currently, probably a little faster then they will under this legislation.

    As costs go up and wages remain stagnate, or as they have been doing for the last few years and actually falling, the subsidie's will of course need to go up on a continual basis meaning that it will in the end cost us more but those that are investing in Insurance company stocks will do VERY WELL for themselves which of course they have been all along. In the end all tax payers will be paying for the subsidee's which means we all carry the burden of those that do not want coverage, the only difference from HCR I see in your plan is that people will not have to buy it(which means we will be paying for their costs in higher taxes and premiums regardless so costs will continue to rise as they are now) but those that do want it will still be subsidized like they are in HCR though likely at higher rates since the mandate will not be allowed to lower costs. The one cost lowering device you do offer is price controls which is honestly one that I would not offer since it just further distorts markets, when you use price controls in a single payer system it works because you are seeing the cause and the effect and therefore can make needed changes but in a “free market” system like what is mandated here by the GOP you are asking private companies to fix their prices that they negotiate with dr's and hospitals without lowering their services which again is waiting for money from the sky.

    Do you have the tax increase numbers for your idea?

    What are the estimates of the real world consequences of fixing prices at the insurance level but not the manufacturer or service level? Keep in mind the results of Nixon's price controls is one of the many reasons the economy was horrid throughout the 1970's.

    Once we get into the realm of higher taxes and premiums would it not be easier to go to single payer where #1 it is many multiples cheaper and #2 you do not have to worry about which bill(likely both) will be going up every year? I know we like to think that other nations pay a lot for their health care but nothing compared to us.

  17. TMSF,

    King's X already.

    To me, declaring that “A little bit of Fascism isn't so bad if the rest of the untried plan sounds good” is not unlike saying that one is “a little bit pregnant” or has “a touch of AIDS”. But the issue is academic: it is what it is, it is here-and-now and we will all have to live (or suffer) under it together with the exception of those who made it law.

    You have what you want — now please go enjoy it.

    Jeff Dreibus

Submit a Comment