Archive for the ‘Health’ Category
So the thing I don’t get about David Frum getting canned is that there’s an unequivocal sense in which the health care strategy of the GOP failed. And matter what flavor of the hour predictions Chris Matthews was making it always looked they’d pass something through. Even after Scott Brown, they had a bill through the Senate and a huge majority to work with in the House.
The viability of pretty any political strategy depends on an assessment of if you’ll or lose. Since they had 60 votes, or 59 and a passed bill it’s just clear why the GOP thought they would defeat the bill. There were never any unconditional no votes on the Senate side, just conditional yes votes. Maybe they didn’t they could win, but thought their opposition would lead the broader public drop their support for Obama. It hasn’t happened.
You get a similar calculus on financial reform, climate change or immigration. If it’s going to become law then maybe you don’t want to be on the losing side or you’ll take a tough vote to break the tie, but the same politicians being asked to be the 52nd vote for something that’s going down might not be so interested. Just thinking for myself I’d lose my seat for climate legislation, but not to make environmentalists feel better because they lost by a smaller amount.
So you can’t do strategy without having the discussion Frum wants to have, but apparently it’s beyond the pale for the modern GOP to even try to talk openly.
I would have thought that if a poll resulted in contradictory results, like the NBC-Wall Street poll on health care which says that voting for or against the health care reform will both make voters less likely to vote for their Congress person you might question the validity of poll results. But not if you’re Chuck Todd to whom such a finding indicates “polarization” of the issue.
So why do you need a decoder ring (and where can I get one) to read the Washington Post’s analysis of Obama’s legislative strategy on health care reform:
Increasingly, the White House appears to favor having the House pass a version of the measure that cleared the Senate with 60 votes in December. The Senate would then pass changes to the bill to satisfy some demands of House Democrats. That Senate vote would take place under a parliamentary procedure known as reconciliation, which requires 51 votes rather than 60.
It remains unclear whether Democrats have enough votes within their ranks for this strategy to work. At the same time, it is only “one option” the president is considering, a senior White House official said Sunday
Do they appear in favor of the House, then Senate Rec strategy or is it the only option they’re pushing? It’s like one paragraph was written with an on the record quote and the other on background for two different stories and then put together.
Mike Stark interviewing retiring GOP Rep. John Shadegg
SHADDEG: Well, you could better defend a public option than you could defend compelling me to buy a product from the people that have created the problem. America’s health insurance industry has wanted this bill and the individual mandate from the get go. That’s their idea. Their idea is “look, our product is so lousy, that lots of people don’t buy it. So we need the government to force people to buy our product. And stunningly, that’s what the Congress appears to be going along with. Why would they do that?
P.S. There really is no “this bill” for health insurance companies to have always wanted and it’s misleading to say so. Some versions of the bill help them much more then others. Even now that the Senate has passed a version of health care reform the final product could change in ways that really change how happy the health insurance industry is with the bill.
Let’s state some facts:
The US is the only industrialized country that doesn’t provide universal health care.
According to the WHO World Health Report for 2000 the US health care system is ranked 37th which is the lowest of all the western countries (except for New Zealand)
In the US, we spend twice as much on health care per person in comparison with other OECD countries.
From these facts, we can see that there is a correlation between providing universal health care and overall health care system performance. One could even argue that it’s the reason why other industrialized countries have a better health care system because of the ability of the government to compete with private insurers and because of the lowered administrative costs. But let’s not get into too much of the details here, let’s just talk about some common sense.
Does anyone think being ranked 37th is a good thing? Probably not.
Does anyone think paying twice as much for health care is a good thing? Probably not.
Ok good, so we’ve come this far. Now how do opponents of universal health care propose that we improve our system? Instead of crying out “socialism” as your criticism of single payer, why don’t you give an example of a country that has the system that you desire? Where does the World Health Organization rank that country?
My suggestion is to look at what country has the best health care system (France), analyze why their system is so good and adopt similar policies. In other words, we should learn from the best. Who disagrees with learning from the best? Of course you can present your own criteria to show that some other system is better, but then my question would be, “What data would you be using?” I’m using the data from the World Health Organization and you?
So for those of you who oppose the idea of learning from France, give some other model that we should follow and then explain why it’s better, instead of crying out “socialism” which is just empty rhetoric.
I was recently listening to the October 18th This American Life on health insurance and it hit on quite a few poorly thought out, but nonetheless widely held ideas.
In one section they go over the conflict between insurance companies trying to keep prices down vs. drug companies trying to promote their most profitable drugs. The basic dynamics were presented accurately: drug companies want expensive drugs covered that aren’t always necessary while health insurance companies fight against unnecessarily costly drugs they also do so in a manner that sometimes causes people to not get the drugs they need. And then we’re told it’s “the system” and they’re just following incentives.
All well and good until you think about that fact both political parties have been tweaking “the system” fairly regularly and doing so with significant input from insurance and drug companies. Neither industry is overly interested in proposing any sort of compromise on this particular issue, so people get hurt.
We’re treated to lots of talk about how health insurance are driven by systematic factors though out the whole show. Insurance companies are made up of good people, systematically forced to do bad things. The whole train of thought holds up only as long as you ignore their own input to their own situation. Health insurance lobbyists have torpedoed reform efforts for years and done so in a ethically horrendous and dishonest manner. If the good people of the health insurance companies wanted to avoid rescission or denying coverage based on preexisting conditions you’d have no way of knowing it because they’ve spent decades pushing against the reforms that would make them unnecessary.
You hear the system excuse for denying coverage, drugs and procedures all the time. And once they find a new loophole to exploit you’ll hear it again to defend that practice. We need more discussion of the manipulation of the system instead of more excuses about how we’re all pawns.
The health care reform debate is clearly getting a little heated. The kill the bill crowd and the swallow the pill and pass the bill crowd just aren’t coming to resolution on what the Democrats should do. Here is Matthew Ygelsias getting annoyed at personal attacks on his pro-bill position:
The cute meme of the day seems to be that the health care reform debate is breaking down along the same lines as the Iraq debate. Which is to say that since, for example, Matt Yglesias was wrong about Iraq he’s also wrong about health care and we should listen to Howard Dean.
It’s true that views about the Iraq War line up with views about health care only if you exclude (a) all politicians, (b) all conservatives, and (c) the most prominent liberal pundit in the country. But that’s a mighty arbitrary way of looking at the universe.
Nonetheless, there are substantial similarities between the Iraq War and Health Care votes despite their unrelated subjects. Democrats are being to told to support the bill because it’s important to the party, rather then strictly on the merits of the bill. Both bills were presented as the only path forward, at times misleadingly. And strongest the corollary is that opposing the compromise bill is attacked as simplistic, while supporting the bill makes you a sell out.
The merits of the related arguments are substantially different in each case, but the debate is pretty similar. The case that voting down health care will hurt the Democratic party is much stronger then it was with the Iraq war. Democrats look terribly disorganized and ineffective and failing to pass a bill at this point would be harmful to their electorally chances. But that point runs both ways, passing the bill without a public option is also a serious problem for electoral success.
And there are alternative paths. They can start over and if they failed they would start over and they’d probably use budget reconciliation and need only 50 votes in the Senate. There are lots of problems with that path, but it’s a real option just like sanctions and containment were real options for Iraq.
Carrots and Sticks has come in contact with people on both sides of the push for this bill. They’re both smart and knowledge. Both sides need each other and at the same time need to challenge their respective legitimacy. The question is how do you keep the process constructive? It’s not easy, watch Al Franken on the Senate floor sometime, but that needs to be the goal.