Sen. Tom Cotton on health care reform and the GOP
Tom Cotton is interviewed the Hugh Hewitt show:
I think the CBO report provides useful information, but at the same time, the CBO director is not Moses. He’s not walking down from the mountaintop with stone tablets. And we should evaluate that useful information with a critical eye. You know, we should examine the evidence and the conclusions they reach, and see if those are justified. We should also examine their history with health care estimates, which pretty consistently overestimated, for instance, the coverage that Obamacare would provide. They seem to just have some challenges getting right the influence of a healthy individual insurance market. All that said, I think the Congressional Budget Office is directionally correct. They’re right that coverage levels will go down in the coming years under the House bill. They’re also right, I’m afraid, that insurance premiums will continue to go up in the near term, for three to four years, before they start perhaps falling in the long term. However, I suspect that the political consequences of those near term changes means that the long term will never actually arrive. That’s why I believe it’s so important that the House take a pause and try to fix some of these fixable problems in their committees, which is the easiest place in Congress to fix them, whereas the Senate floor is the hardest place to fix them…
I think the Rules Committee might be the place where some of these changes happen. What kind of changes do we need?…
He goes on to try to answer that question.
As usual with the topic of health care reform, the answers are complex. I’m not sure how his proposals would work out, but I very much respect Cotton and think he deserves attention on this.
My confidence in the impartiality of the Congressional Budget Office has over time deteriorated. I’m not saying its been corrupted but I’m not saying it hasn’t either. It’s a federal bureaucracy answerable to Congress. Given the corruption of the IRS, EPA and just about every other federal agency, what confidence can we actually have that it is the last holdout of non-partisanship?
Newt Gingrich evidently has no doubts;
Re the answers being complex, I think this comment by Althouse is spot on:
I read the transcript of his interview and hope Cotton’s view prevails, that it is more important to get this legislation right, even if it means delaying tax reform legislation.
He was saying the Senate needs to push the elements that are included in this bill, rather than conceding they can’t be done by reconciliation.
I’m sure you heard or read Ted Cruz’s idea that the Senate dispense with the parliamentarian and use VP Pence to determine what can be included in the bill. I guess this is a nuclear option of another sort.
The CBO analysis says the current bill would save $383 billion over 10 years, but I wish there were more talk of the expected costs of doing nothing (what that costs). We know that deficits didn’t matter when the Democrats were in control of the purse, but I’m not hearing enough from Republicans on a realistic path to budget sanity. What is tax reform going to cost short term vs. long term. I have read the budget deficit is going to going the wrong direction towards the $1 trillion/yr number if we do nothing.
I really don’t understand why congress can’t tackle tax reform at the same time. It shouldn’t be the same committees doing the work. Are they that intellectually challenged? Or would it interfere with their 3 day work week.
What about the report in Politico that says “a White House analysis of the GOP plan to repeal and replace Obamacare shows even steeper coverage losses than the projections by the CBO”? I don’t believe the White House would not be politically biased against itself.
There might be flaws in the CBO report but there are also flaws with this replacement plan – as their is flaws with the ACA. But it’s not all relative. A better plan does exist somewhere. Would be nice to see Democrats and Republicans set their differences aside and work together on health care.
Montage- This from an Avik Roy article at Forbes:
UPDATE 1: … the OMB report was an attempt to predict how the CBO would score the bill. “This is not an analysis of the bill in any way whatsoever,” said a White House spokesman. “This is OMB trying to project what CBO’s score will be using CBO’s methodology.” My sources confirm that this is the case–and it’s not surprising. Designers of the AHCA needed instant feedback on how changes to their bill might affect the CBO score, and they deployed the OMB’s career staff to help them do that. The Obama White House did the same thing with Obamacare.”
This is a must read article along with this interview to get a handle around what is the potential of the AHCA bill.
https://www.forbes.com/sites/theapothecary/2017/03/14/believe-it-or-not-cbos-score-of-house-gop-obamacare-replacement-is-better-than-expected/#25afe1b15951
Roy builds on Cotton’s comments that the CBO doesn’t have a good track record of projecting enrollment.
Montage,
That you believe that Congressional Democrats would sincerely try to work in a bipartisan manner on any legislation with Republicans is an indication of just how clueless you are… you’re living in the past.
The only ‘compromise’ that they will accept is that which moves the country toward single payer, socialized medicine.
“the erasure of the American republic is the core agenda of the Democrat Party” David Horowitz
As I understand the CBO faces a garbage in garbage out dilemma. It has to make assumptions based on the garbage coming in, guess about what may be the unintended consequences, and then try to figure out how to make a prediction. Not an easy or thankful job. That Ryan is the point of the spear on this makes me doubtful that the CBO, even if not staffed with many bho poison pill appointees, could come up with a semi-accurate assessment. Ryan in the past has put forth very questionable, rosy projections on not just healthcare policy, but also on deficit reduction.
Too much political CYA and the big wallet donors to please to make this complex issue simple.
BTW, glad to learn your power is still on at 3:51 EDT.
parker:
Yes, so far so good.
I’m about to step outside—very briefly—to experience the storm. It’s quite impressive; lots and lots of wind and swirling snow. I have a full-length down coat that I treasure for such occasions.
Glad to hear that neo-neocon. We had a measley 4 inches on Sunday-Monday, but its been cold and windy since the storm came through. We are used to harsh weather as you NE residents must be when it comes to winter. Stepping out into a blizzard even for a few minutes makes one stronger. Its more difficult to deal with 100+ degrees and 115 heat index for 10 straight days in August.
On a basic level, its a good thing to carry on no matter what the weather.
Montage,
Oh please. The likes of Scoop Jackson and Patrick Moynihan could never be leading lights in the democrat party of today. There are a few exceptions but I can count them on the digits of my 2 hands. Perhaps you are too young to know what I am talking about. Try wikipedia if you care, but it is doubtful that you do.
BTW, only the McCains of the gop think there is any possibility of “working across the aisle”. Enjoy your tenure as a member of th party of the emeny of the republic. You are joined by not a few wearing the gop label.
“Would be nice to see Democrats and Republicans set their differences aside and work together on health care.”
No. It would be nice to see the Republicans drive a spike through the heart of ObamaCare and its left-fascist social insurance lay-off predicate once and for all.
As one might say to the face of an ObamaCare supporter: My freedom is more important than your “health care”.
Neo…
The problem is fundamental and simple: Costs.
Nothing in the ACA addressed cost control.
America needs to graduate more doctors — not import 70% of the MD talent.
America needs to graduate more nurses, too.
Importing such massive doses of medical talent from the 3rd World prevents those nations from making normal progress.
This Brain Drain is the PRIMARY reason the 3rd World stays in poverty.
It’s notable that Red China did not permit mass departures among its medical professionals. This policy was one of the policy planks that hugely contributed to Red China’s rise out of extreme poverty. It’s still a pretty poor nation, BTW.
America needs to use the Sherman anti-trust act to bust up the cartels that dominate this sector of the economy.
Under the ABC, the airlines were cartelized until the Carter administration. When their Federal protection evaporated, prices collapsed — 20% then 30% then 50% then 70%. This reversal of trend took years to play out. Today, no-one much complains about the price of an airline ticket. And we never ran out of pilots, either.
Busting the medical-pharma-administration complex would trigger the same chronic price declines.
Virtually everyone is discussing the deck chairs on this economic Titanic.
If the actual cost of medical care collapsed 70% — the economy would grow by leaps and bounds.
The same cartel-economics is ruining education, too. ( K-12 & college) We end up with “rubber rooms” and a collapse in quality… and explosion in ‘administrators.’
“Importing such massive doses of medical talent from the 3rd World prevents those nations from making normal progress.
This Brain Drain is the PRIMARY reason the 3rd World stays in poverty.”
It is certainly a negative but it is far from “the PRIMARY reason the 3rd World stays in poverty.”
Poverty is the result of cultural negatives.
Any society that operates according to the consent of the governed and the rule of law, while also strongly encouraging education, a strong work ethic, the acceptance of personal responsibility and accountability, acceptance of familial obligations and preaches the value of delayed gratification will experience socio-economic success with low levels of poverty.
Walter Williams roadmap out of poverty; “Complete high school; get a job, any kind of job, get married before having children,; and be a law abiding citizen. Among both black and white Americans so described, the poverty rate is in single digits.”
blert: “Today, no-one much complains about the price of an airline ticket.” And we never ran out of pilots, either.”
The price is not the issue. Quality is. That’s what happens when the competitors all go for the lowest common denominator.
“And we never ran out of pilots, either.”
We are now. See:
http://aviationweek.com/commercial-aviation/coming-us-pilot-shortage-real
The U.S. airlines piggy backed off the military for their trained pilots. Now those days are gone. Airline pilot salaries are going to go up or the airlines are going to shrink.
There is no solution to health care prices (which are what are driving health insurance prices.) that can work overnight. Obamacare must go. The transition period will be one in which some of the 22 million who have insurance under Obamacare will either not buy insurance (fools!) or will not be able to afford insurance. It might be as high as 11 billion. The CBO says 14 billion. Providing care for the next few years could become a charitable program spearheaded by donations from billionaires. major foundations, and citizens who want to help their fellow citizens. Billions are donated each year to non-profits that do not measurably affect people’s well being. Providing money for charitable healthcare could be done on a state by state wide basis. Or even a county by county basis – although some money would have to be moved from high income counties to low income counties. The closer to the people the programs are the better. That’s what is wrong with Obamacare. Too far from the users.
The eventual goals that would reduce both healthcare and health insurance costs – insurance sales across state lines, tort reform, attacking cost shifting by hospitals, providing low cost basic healthcare in big box stores, promoting specialty clinics that provide high efficiency surgical procedures at fixed and transparent prices, and other such things – should be accomplished through regulation changes and legislation in the near future.
Not going to happen though. IMO, Obamacare will not be repealed. It will collapse and a all 22 million people will be left high and dry. One of those people is my daughter who has paid through the nose for less choice, and higher deductibles/copays. 🙁
J.J.
I’ve lost track of how many “pilot shortage” articles I’ve read over the years.
LOL.
G.B.
The Brain Drain is tapping the TOP of the talent & ethics distribution in those blighted lands.
The cultural impact of their absence leads to all the ills you’ve posted of.
India, in particular, is way short of top tier talent — which has flown off to California. This trend has reached absurd levels — to be witnessed every time I shop.
A scheme ( H1-b) that benefits them and their employer (Intel) is a disaster for their countrymen.
http://www.lagriffedulion.f2s.com/sft2.htm
LaGriffe spells out the connection between a nation’s IQ distribution and economic ( and cultural ) out comes. It’s astonishingly strong.
Sen. Cotton, whom I admire, is a bit opaque about coverage levels going down and premiums going up under the House bill.
Obamacare raised coverage levels by insuring people in Medicaid (85% of the previously uninsured), so these people of the “raised coverage” were not paying insurance company premiums.
As to premiums going up with greater freedom of choice than under Obamacare, that is not normally how things work, economically speaking.
I wish Cotton had elaborated with some data.
I meant 11 million and 14 million not billion for the numbers who may become uninsured. Quite a difference. 🙁
Pilot shortage coming? Yep. The airlines are going to have to start their own training academies or salaries for the regionals will have to go up.
W!T!F!. So neo I am trying to type in w t f at beginning of all this but can’t. I am a long time lurker here, but appreciate your commentary and all you do. G_d Bless!
given mostly monomania of healthcare..
TRUMP PAID HIGHER TAX RATE [25%]
THAN MSNBC COMCAST [24%]…
MUCH HIGHER THAN OBAMA [19%]…
AND BERNIE [13%]!
SteveOReno:
Let me try it: WTF.
I’m not sure why the spam filter is so very sensitive and touchy, but welcome!