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Posted by on Mar 22, 2010 in Politics | 36 comments

The “Dirty Little Secret” of Health Care Reform

And now the deed is done, as Macbeth said upon emerging from the chamber with blood covering his hands. The Democrats’ majority in Congress has finished their series of back room deals and procedural maneuvers and gotten some version of their health care “reform” package voted past the bipartisan opposition to it and on its way to the President’s desk. And now that it no longer matters, somebody really should come along and let you in on the Dirty Little Secret underlying the battle so recently concluded. This is exactly how the Republicans wanted it to end. And at least for some of the Democrats in Congress, they are waking up to a world where one is reminded to be careful what one wishes for.

For all the theater and ginned up drama in the endless media cycle this weekend there was never any doubt how this was going to end from the moment the Sunday vote was announced. Say what you will about Nancy Pelosi, but when it comes to the political arena, she didn’t fall off the turnip truck last night. The question wasn’t whether there would be enough votes to pass the bill, but rather which Democrats would have to walk the plank for it and who would be the last ones standing out over the shark infested waters with the Speaker’s saber poking them in the spine. And now that it’s done, a six month, eleven day clock has begun running down and the Republicans are setting up a Chinese water torture plan which the media will have no choice but to assist. Drip, drip, drip.

Make no mistake… there are some benefits which will come to at least some Americans from this legislation, but they’re still a long ways off. And in the meantime, people will open up their newspapers, turn on their televisions, click on their web browsers, and begin to see one story after another in the months to come.

As the oh-so-conservative MSNBC said this morning, the final tally will show people that this package represents the largest cumulative tax increase in the history of the United States. All of the new or increased taxes and fees will be added up. And when the “doc fix” comes through later this year (and rest assured… it will) the deficit numbers will once again shoot up rather than down.

Drip, drip, drip.

10,000 IRS Agents are going to be assigned to make sure your medical insurance is up to snuff or you will be hounded by the government?

Drip, drip, drip.

Every doctor who decides to close up shop after looking over the new economic landscape under this legislation (and polling shows that there are more than a few) will be rolled out for endless interviews on all the talk shows. Every pharmacy that joins in with Walgreens and says they can’t take any more Medicaid customers to fill prescriptions will get their own headline.

Drip, drip, drip.

This President – the one who was going to be the answer to all the dreams of the pro-choice movement – signed an Executive Order banning the use of federal funds for almost all abortions which would have given George W. Bush pause?

Drip, drip, drip.

Local news will continue to report how costs will increasingly be shunted from Washington down onto the already cratering budgets of the various states. (Such as New York, where the government is already talking of delaying sending out income tax refund checks because they are broke.) And now they have to cover more medical costs?

Drip, drip, drip.

All of this takes place during the run-up to what promises to be the most heated midterm election cycle we’ve seen in more than a decade. And the truly amazing thing for you fans of irony (remembering that we’re discussing the politics, not the policy, here) is that it could have just as easily gone the exact opposite way. Had the bill failed, there would have been no endless discussions coming over the details. While a majority of Americans seem to agree that they don’t like this bill, an even larger margin agree that there are problems with the health care system and something should be done about it. If the Republicans had stopped this effort, the Democrats would have had a free run from now until November to keep saying, “The Republicans took away your only chance for health care reform.” They wouldn’t have had to worry about how to pay for it, the effects on the budget, costs to employers, premiums or availability. They could have just painted the GOP as the bad guys and very likely held their current majority in Congress if not expanded it, rather than facing the electoral mudslide which seems to be heading their way.

Politics is funny, eh? Well, not “funny ha-ha” in this case, but you get the idea.

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  • Schadenfreude_lives

    Yes, be prepared for the ‘shock’ as it comes out that this bill will actually raise the deficit, cost way more than projected, increase taxes even more than is being admitted, increases insurance premium costs, and forces reduction in actual medical care provided.

    • CStanley

      Oh, come on, Schade. Obviously if those things come to pass, it’s only because the Dems had to compromise so much, since the GOP obstructed and prevented them from passing the more liberal versions which included the public option.

      • Schadenfreude_lives

        CS – Well, I thought THAT was so obvious it didn’t need stating, or the related corollary that it can be fixed by even higher taxes, greater direct government control, nationalizing of all hospitals, and new, also IRS-enforced, food consumption and body-fat indexing based tax rates.

        Add in all other ‘healthy living’ provisions (anti-smoking, anti-drinking, anti-red meat, etc.) rules and regulations you can think of. But rest assured. Our Government, thinking only of Our Health, will think of SO many more things that need to be controlled in the name of HCR than we can possibly imagine right now.

        • vey9

          “Our Government, thinking only of Our Health”

          Why, yes you have a point! Why stop there? We need a lot less food and drug regulation. Shut down the FDA and USDA meat inspections! That way the US processors can compete on a level playing ground against the Chinese in killing off those yappy dogs and bawling children.

          • Schadenfreude_lives

            Oy vey9 –

            Spoken almost like a true believer. Change the subject, and set up a strawman to attack. You are debating like a 6th-grader.

            Who said anything about making sure the food chain is not contaminated? So, would you have no problem with the government telling you how much red meat per week you may be allowed to consume without a penalty, or mandated amounts of fruit and vegetable consumptions?
            Telling you what your BMI must be, or pay a tax penalty?
            What about engaging in high-risk pregnancies?
            How about extreme sports, with higher-than-normal levels of risks for severe injuries?
            Health taxes on drinking alcohol?

            These all sound out there now, but new laws and sweeping new mandates have unintended, and intended but hidden, consequences.

            Another obvious (to me) side-effect is going to be the prescription drug and specific treatment black markets that will expand and/or develop.

  • shannonlee

    You sound like someone that does PR for a Rep candidate. I guess the right needs someone on here to counter balance Kathy 😉

  • Leonidas

    The Pelosi Plantation is opening for business. Taxpayers picking the cotton swabs.

  • Axel Edgren

    So explain how the republicans are going to pick up enough seats to repeal the bill over Obama’s veto when there aren’t even enough democrats running.

    See, some of you seem to believe that having a bunch of nervous, simpering and generally feckless democrats stay comfy in congress some more years is more important to the left than getting a new reform that continues the tradition of medicare and medicaid. Yeah, well, naw.

    If the democrats in congress had tried to actually sell and improve this bill more, then they would have deserved to both vote for this bill and get an actual boost for the midterms (which, as we all know, usually go splendid for the incumbent party). As it is, the base managed to force them to lie in the bed they had made, which is good – people get what they deserve.

    Big majorities do not last in America. Now, the democrats managed to get something good and long-term beneficial out of a fleeting alignment of the stars. Mumbling smugly about November over and over and over and over (and over) again is not going to change that.

  • elrod

    Of course, I think Jazz is 100% wrong here about the politics. A defeat would have utterly demoralized the Democratic base and led to a 1994 rout for sure. Much of the other concerns are either alarmist or not likely to be noticed by the general public (we’re talking politics here, right?)

    But we have several months to see, don’t we?

  • galtin86

    How melodramatic! Expect to see a lot more of this type of doomsday fear-mongering.

  • Elyas

    Or a different scenario: Time will pass and people will see that there are no death panels for the elderly, that the new “socialist” healthcare system is still based on private insurance, and that most of the dire warnings about the consequences of the reform legislation won’t come to pass.

    Republicans have been crying wolf for a solid year and won’t look great when in walks a puppy.

  • elemming

    The NYT has an actual fair and balanced editorial section and they have a conservative misleading editorial. Deficit reduction isn’t front loaded, there is much, much more in the second decade than the first.

    This is not the result the GOP wanted. They wanted to have no health care reform bill so they could frighten people with what they could make up and say was in it plus run on Democrats not being able to get anything done plus the Democratic base staying home out of disgust like what happened in Massachusetts and in Clintoncare.

    This was a huge Republican defeat. They will try a scorched earth Rove-Atwater policy of how the communists have taken over but the Democrat base is energized that they got something done, even if it needs to be improved later, instead of going down to defeat yet again. This is going to be a bloody vicious November election but both sides now recognize they are in a fight instead of the Democratic base staying home because they feel those feckless pussy Democrats in Congress can’t accomplish anything.

  • Jazz,
    Complain all you want about tax increases, the fact is that this bill will save money over the next decade. Democrats could have gone the Republican route and just paid for this all with deficit spending, but Democrats are actually responsible.

    Remember that when Republicans when in control, they passed Medicare Part D. That “entitlement” will cost a trillion in just a decade and promises no savings over the long run.

    • CStanley

      Chris, even if you believe that the CBO score wasn’t gamed by the Dems to get the score they needed, it still makes no sense to claim that the bill ‘saves’ money. At best if the proponents’ claims are accurate, the bill includes revenue increases through taxation and fines to pay for the new programs.

      What you’re trying to claim would be like saying that I’m planning to save money by buying a larger home and then taking a second job to pay the mortgage. That may arguably be a responsible way of getting something that I want or need, but it isn’t ‘saving money’ no matter how you slice it.

    • Schadenfreude_lives

      the fact is that this bill will save money over the next decade

      No, the fact is it will not:

      BTW – good to see you back after a long absence.

  • DLS

    Well, while the fools keep babbling “historic” [snicker], the honest libs and Dems (who won’t admit it) are relieved that the Dems have extracted themselves out of the mess that they created entirely themselves.

    I’m wondering what the Dems will do next. Will delusional people “blame” the GOP and want to see the GOP “punished” by having the Dems go crazy and rush even more to pass even worse legislation than in the previous year? Will these power-hungry people be encouraged by a perceived collapse of the opposition (power vacuum, weakness inviting aggression)? It’s possible.

    Will the Dems rush to accomodate infantile-entitlement-demanding immigrants before November? (Yes, probably.)

    Finally, here’s a dirty little secret that should be no surprise, given manipulation of the media and public opinion, trying to suppress disapproved “fishy” dissent…

  • DLS

    “A defeat would have utterly demoralized the Democratic base and led to a 1994 rout for sure.”

    This is not 1994. Yesterday’s Republicans should have laid that to rest, if there actually were still any questions.

    The farther left is dissatisfied with the way things are going and may outdo the Right this November.

    As to the results yesterday, the Dems weren’t thrown back (see historical diagram below). The rest of the year, as of now, doesn’t appear to be one of retrenchment and earned humiliation, having to go back all the way to the start of 2009 again. (Again, see diagram.) What we now wonder is, now that the Dems are proceeding past Moscow, do they plan to stop at the Urals, or go on into Siberia, or do they have crazy Vladivostok Pacific Coast visions on their mind, for totally crazy overreach once more.

  • DLS,
    Ya bro. The Democrats passing stuff they’ve promised to do for years is “crazy overreach.”

  • Leonidas

    Republicans have been crying wolf for a solid year and won’t look great when in walks a puppy.

    Progressives have been crying for decades but still waiting for them to invest their money in the Progressive Insurance Company that provides the services they want. They are pretty spineless when it comes to only using their own money.

    The far right has its moral bankrupcy on torture the far left has its on healthcare. The far righties celebs refuse to undergo waterboarding themselves and the far left refuses to put its money where its mouth is.

  • CStanley,
    It reduces the dreaded debt that I keep hearing so much about. Does that count for nothing in your book? Surprise me and say you appreciate Democratic attempts at fiscal restraint.

    • CStanley

      I find it incredible that anyone believes that it will reduce the debt, so I can’t express appreciation for what is IMO obvious chicanery.

      It’s hard for me to say which is worse, the GOP creation of an entitlement without even making an attempt to say where the funding will come from, or the Dem creation of another entitlement with manipulation of CBO scoring to claim that there will be enough money coming in to pay for the new liabilities and the existing ones enough to reduce our overall debt. The former is bad enough, but at least you can have a straight up debate about whether we should do it or not while with the latter, present case, people can’t debate honestly what they don’t understand.

    • Schadenfreude_lives

      It reduces the dreaded debt that I keep hearing so much about

      Nope, wrong again. Actually will end up increasing it by over $500B, in just the first 10 years.

      Of course, for a President and Congress that are racking up over $1T a year, I guess that is small potatoes, and we should be thankful for that, huh?

  • Leonidas,
    You comparing support for torture to expanding health insurance?

  • CStanley,
    Democrats changed their legislation so it would be less generous in terms of subsidies, and have more taxes. As a result the CBO said their bill *should* reduce the deficit even more than previous bills under consideration. I would think you would applaud that kind of “manipulation” of legislation to be more fiscally responsible.

    • CStanley

      They also manipulated the timing of benefits and taxation (and in the case of the taxes, this makes it unlikely that the revenues will ever materialize because they’re depending on future Congresses to leave in place the future taxation that they were too politically vulnerable to put into place today, so why would we believe that future Congresses will do so?)

      They also lumped in unrelated savings from the federalization of student loans and (I think this made the final cut?) reducing postal services. That’s fine as it goes (I object to the student loan takeover for other reasons, but that’s another discussion…) but the problem here is opportunity costs. Those savings should be directly applied to debt reduction, not thrown into the hopper to support the costs of new entitlements which will purportedly also reduce debt, eventually. Same is true of all the extra taxation- that additional tax revenue is needed for debt reduction, and when (not if) the entitlement spending here proves higher than projected, the extra revenue that is supposed to pay down debt will never actually materialize.

      Edit: Oh, I forgot to mention one other manipulation. They’ve counted the revenue that will result from certain changes, but not counted the liabilities that go along with those changes. This is the case when they count the additional SS revenue that should result from people getting increases in wages instead of health insurance, but they don’t count the additional liabilities that result from the payouts of higher SS benefits to the people who pay in more, and then with the newly created insurance products for long term care, they count the premiums on one side of the ledger but then no liabilities for payouts on the other side.

  • DLS

    The Dems’ past year’s notorious record and the problem they created for themselves, that they just got out of, Chris, is obvious — or should be, at least.

    I fear the Dems may not have learned, and may resume this excess, or even go on a true rampage now.

    “It reduces the dreaded debt that I keep hearing so much about.”

    This is doubly disturbing. First of all, who believe it will reduce the debt? Second, are you actually ridiculing concern about the debt? (Do you expect the printing presses to run overtime someday?)

  • “First of all, who believe it will reduce the debt?”
    People outside of Rush Limbaugh’s audience at least give this bill a fighting chance at reducing the deficit. That’s 100,000,000x’s the fiscal responsibility we’ve ever seen from the other side of the aisle.

    “Second, are you actually ridiculing concern about the debt?”
    I’m ridiculing people who have suddenly become debt scolds after having sat on their hands through the Reagan and Bush II administrations while the deficit ballooned year after year. To these folks concern over the debt is only a political weapon to be brought out during Democrat administrations.

  • DLS

    I’m wondering how the Obama traveling campaign circus will do this time. It seems our Prez is going to take his show on the road again. (It’s 2008, all the time!) There’s a little problem that needs solving, if late — now that the Democrats, who hated this legislation, were convinced it is “historic” and voted for it:

    “Opinion polls show the public, by a margin of 49 percent to 40 percent, opposed the legislation”

  • Well, if you’re all right, when your Republican heroes regain control of Washington they can try to actually put a dent in the deficit. I wouldn’t hold my breath waiting for that to happen though.

    In the mean time, enjoy your government mandated health insurance.

    • Schadenfreude_lives

      Well, they can start by repealing HCR! 🙂

  • DLS

    Chris, the Dems this past year have shown themselves to be worse than the GOP ever, fiscally. Fact.

    The Dems are now making everyone more familiar than ever with subjects like “debt trap” and “inflation.”

    I give the Dems some “credit” for desperation in how they scrambled to cobble legislation and pass it, but that does leave me worried now not only about any new stimulus measures but about how the Dems now may threaten to pass all kinds of additional bad legislation — resuming from last year, lesson not learned.

    It doesn’t matter if the far Left starts screaming for all kinds of extremist legislation, “or else” in November.

    As for the GOP, they’ve become even more irrelevent and weak now. Filibuster now, repeal later?

    • shannonlee

      “Chris, the Dems this past year have shown themselves to be worse than the GOP ever, fiscally. Fact.”

      Last thing I read said the total cost of the Iraq war will be over a trillion dollars, it might reach two….when you calculate in all future costs. Then add in all of the other wonderful things Bush did in his eight years and how they helped cause the financial colapse…yes Reagan, GHWB, and Clinton helped…I would have to disagree with you that fact.

  • DLS

    “we should be thankful for that, huh”

    We should be thankful we don’t have a Dem energy policy yet, “correcting” the following US “error.”

    Gasoline prices (powering evil cars, trucks and sordid SUVs):

    Belgium, $7.33 France, $7.00 Germany, $7.41

    Italy, $7.05 Netherlands, $7.79 UK, $6.57

    Evil Hegemonistic-Jingoistic Hierarchical-Patriarchical Bush-Cheney-Reagan Legacy US: $3.02

    Maybe later this year, eh? Along with cap ‘n’ trade…

    (Don’t be so quick to write that off as humor. A fuel tax is a vast future revenue-raiser for entitlements.)

    • shannonlee

      Fear mongering with gas taxes? 🙂

      You’re right though, we will need to tax gas…for numerous reasons…just not yet and not that much.

      • DLS

        “Fear mongering with gas taxes?”

        Merely thinking ahead.

        I suspect an energy tax or a transportation fuel tax is coming.  I hope it’s not too much of a political weapon used on everyone here and that there’s at least some thought put into it before it is enacted.

        It wouldn’t surprise me to see a general federal consumption tax in addition to income and wealth taxes after 2020.

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