Two good pieces on health care reform and the Democrats
In Forbes, Shikha Dalmia offers a good summary of the present state of health care reform. It’s worth reading the whole thing, but here’s a short excerpt:
…[B]oth the Democratic Party and President Obama have mutually reinforcing blind spots that have rendered them incapable of seeing what’s crystal clear to every other sentient being in the country: This was the wrong bill at the wrong time…
And here’s another good article, this one distinguished by having been authorized by Pat Cadell and Douglas Schoen and appearing in the WaPo. They both have been Democratic pollsters and still self-identify as Democrats, although Cadell has morphed quite a bit to the right in recent years. An excerpt:
…[T]he battle for public opinion has been lost. Comprehensive health care has been lost. If it fails, as appears possible, Democrats will face the brunt of the electorate’s reaction. If it passes, however, Democrats will face a far greater calamitous reaction at the polls. Wishing, praying or pretending will not change these outcomes…
Health care is no longer a debate about the merits of specific initiatives. Since the spectacle of Christmas dealmaking to ensure passage of the Senate bill, the issue, in voters’ minds, has become less about health care than about the government and a political majority that will neither hear nor heed the will of the people.
And while I’m busy doing the link thing, here’s an excellent piece on a different topic, the so-called Al Qaeda Seven.
The Cadell-Schoen article is relevant to many of the issues previously discussed here. It does a good job of pointing out how this will ultimately be a no-win situation for the Dems. Unfortunately, they are also taking this country on a ride to a place most of its citizens simply dont want to go. I have faith in the resilience of the U.S. and its people, but this is a needless detour.
I appreciate the line by Cadell and Schoen that:
I think that “mainstream” Democratic Party appears to be lost for the time being. I deeply regret this. Even though my views are more to the right of the political spectrum, and I am a registered Republican, I regret the loss of a functional, rational Democratic Party capable of contributing workable ideas into the political process. This is the nadir of all the bad trends that have gripped that party since the McGovernism of 1972.
On the issue of how this is ultimately a no-win situation for the Dems, in addition to the Cadeall-Schoen article cited by Neo, let me also cite with approval Geoffrey Britain’s comment on a previous post, which essentially notes the same thing.
I am waiting for some psychology professional to produce an explanation of the Democratic Party’s behavior with regard trying to hang itself using Obamacare as a rope. I read some explanations of their behavior but this level of blatant irrationality requires a detailed and extensive analysis. It’s like a lynch mob trying to hang itself.
Ref your final sentence, ‘here’s an excellent piece on a different topic, the so-called Al Qaeda Seven.’
I don’t know why you believe it is excellent, because it seemed a very confused piece to me. Throughout, the author refers to the “al-Qaeda terrorists” held as detainees, but if they haven’t been convicted then they can’t be terrorists, only terrorist suspects.
The author goes on to assert,”They are not accused criminals. They are enemy combatants held in a war authorized by Congress.”
If it is indeed a “war,” that would make them prisoners-of-war, though the author seems to dismiss this possibility.
The author then claims they are “al-Qaeda terrorists who violate the laws of war.”
Violators of the laws of war can be charged with war crimes, and in such circumstances would need legal representation from a lawyer. Why is the author of this piece so confused?
As a footnote, both the author and Cheney seem to be outraged at the prospect of the criminal justice system being used for terrorism suspects, but didn’t the Bush/Cheney administration use the criminal justice system in the cases of Richard Reid (the shoe-bomb case) and Jose Padilla?
I also recommend a recent excellent article by Mark Styen (sorry, but haven’t found the citation yet. Help anyone?)
In it Steyn points out that the Dems simply do not care if they temporarily lose elections. The passage of health care will make a very large part of this economy and our very lives subject to liberal socialist programs that will be virtually impossible to reverse.
He points, as an example, to Great Britain and notes that there, even when conservatives are elected, they do little more than mind the government store of pre-existing liberal programs.
I first noticed Cadell in 1975. He has always been the voice of reason.
I have always been puzzled and amazed that anyone–in this case the Democrat Left–would try, yet again, to make and sell any policy based on the notion that government involvement in any endeavor has the capacity, or even (truth to tell) the aim, of controlling costs. I do not know of a single instance where costs have been cut or controlled as a result of any government program or involvement. Does anyone else? I’d be interested to hear of it. Massively increasing costs is almost a sine qua non of government programs. It’s part of the definition of the things.
I cannot support this contention with statistics, but my somewhat educated guess is that the greatest driver of increasing costs is third-party payment. I am not alone in this. The condition results from several factors, the greatest of which is the misapprehension of what insurance actually is. Health insurance was instituted broadly as a form of untaxed compensation, designed to circumvent WWII-era wage controls. Nice for the guys coming home from overseas. but pernicious in long-term effect. For one thing, not everyone received it. Well, the history of the thing has been dissected by many worthies, including Milton Friedman. But when I was growing up in the 1950s and had rheumatic fever, my parents paid for doctor’s office visits and many tests (and they were not unaffordable at that point), but insurance was reserved for what was called “major medical”–the kinds of things that might really attack family finances, like hospital stays and surgery–the kinds of things that, today, are intelligently addressed by high-deductible insurance policies supported by health savings accounts. I’ve long thought that, if we could do one thing and one thing only to address the problem, we would sever the connection between health insurance and employment. I’ve never thought, however, that the smart way to do it would be to replace employment with government as the insurance provider.
Well, it gets tiresome. It’s complicated, but at bottom it’s really pretty simple. You help the people at the bottom who can’t manage insurance on their own (this would include the pre-existing condition conundrum), and everyone else is sent to the market-place. I think many people would be astonished at how quickly some manner of sanity would begin to take over and prevail. You want costs to come down? Stop subsidies, and minimize third-party payments to truly catastrophic situations. You want some reasonable control of over-testing and general over-use? Have people be responsible for their own bills, and stop the malpractice mess.
But in addition, remember that there’s a pretty good argument to be made that costs should be rising. It’s a rational response to exponentially increasing quality of care. If we want the quality-of-care improvements that are manifestly the results of developing technology, we are going to have to make up our minds that they must be paid for, because none of it is cheap. That’s another bottom line. If we want quality to continue to increase, we must realize that it will bear a price tag. And we aren’t entitled to anything.
betsy b. said, “I’ve long thought that, if we could do one thing and one thing only to address the problem, we would sever the connection between health insurance and employment.”
There have been a couple of pretty good books written on just this subject that pretty well demonstrate the truth of your statement. (Unfortunately, I can’t find them or would cite the titles and the authors.)
McCain’s HCR plan was to give individual purchasers of health insurance the same tax break that employees with employer paid healthcare get. (It’s a tax free benefit for them.) Or to count healthcare insurance premiums paid by employers as taxable wages for the employees. That way, people would not think of their healthcare as relatively cost free and/or it would level the playing filed for those buying their own policies. A good idea, IMO.
Four easy steps that could receive bipartisan support and would bend the cost curve down.
1. Tort reform.
2. An aggressive anti-fraud and waste program for Medicare and Medicaid.
3. Set up five standard levels of insurance coverage with standards the same nationwide. Then allow all insurance companies to sell in all 50 states. (Competition!)
4. Set up a national (most insurance companies participating) risk pool (to spread the risk and losses around) to take all people with pre-existing conditions at affordable rates.
After 2018, anyone without healthcare insurance that develops a chronic disease will have to rely on charitable organizations for care. No more going to the ERs. (An incentive for all to buy insurance of some kind.)
Buying healthcare the same way we buy any service would make people more mindful of the costs and force some competition. When I was a kid, (in the 30s)the doctor’s office had prices posted for various procedures. Most people paid cash (or on time) as there was little insurance in those days. (Some paid with barter – Chickens, eggs, yard work, painting, etc.)
I noticed the cost of major medical procedures really began going up after the law was passed requiring all ERs to treat anyone that came to their door. I had surgery in a hospital in a city that had a lot of violent crime. My surgery cost about three times what it should have because (and the hospital billing office told me this) they had so many gun shot and knife wounds to treat gratis that they had to make the cost up elsewhere.
There are many better ideas for reform than the mish mash of government bureaus and agencies that will be, in effect, sitting between the doctor and the patient in most treatments. That type arrangement cannot help but drive the costs up.
Martyn of England: While Americans were saving your limey butts for the second time in the twentieth century, a group of Nazi terrorists landed from a submarine on the east coast. FDR directed that they be given a fair military trial and then shot. That is what should be done with today’s terrorists. Of course, as England, or the UK as you folks call it, is well its way to being an Islamic Republic and has a ruling class composed of face cards, I doubt you will understand this matter.
Bob from Virginia is looking for a rational explanation for the Democrats’ apparent political suicide on the health care bill. I think I have part of the answer. In the service we used to say that a stiff d**k has no conscience. That’s part of what’s going on here. The lefty Dems are in heat over the possibility of national government health care after almost 100 years of waiting. If they get their foot in the door, there is no turning back. We can thank all those voters who wanted hope and change and the media that looked the other way.