The Right Cannot Defeat Obama's Health Care Plan If All They Offer Is 'Obamacare Lite'

Submitted by Michael D. Tanner on Thu, 05/21/2009 - 12:38

It will be a few weeks yet before we see the final details, but the broad outlines of the democratic proposals to take over the American health care system are becoming apparent. And from what we can see so far, it looks like bad news for American taxpayers, health-care providers, and, most important, patients. The plan would not initially create a government-run, single-payer system such as those in Canada and Britain. Private insurance would still exist, at least for a time. But it would be reduced to little more than a public utility, operating much like the electric company, with the government regulating every aspect of its operation.

At a time of rising unemployment, the government would raise the cost of hiring workers by requiring employers to provide health insurance to their workers or pay a fee (tax) to subsidize government coverage.
Every American would be required to buy an insurance policy that meets certain government requirements. Even individuals who are currently insured — and happy with their insurance — will have to switch to insurance that meets the government's definition of "acceptable insurance."
A government-run plan similar to Medicare would be set up in competition with private insurance, with people able to choose either private insurance or the taxpayer-subsidized public plan. Subsidies and cost-shifting would encourage Americans to shift to the government plan.
The government would undertake comparative-effectiveness research and cost-effectiveness research, and use the results of that research to impose practice guidelines on providers.
Private insurance would face a host of new regulations, including a requirement to insure all applicants and a prohibition on pricing premiums on the basis of risk.
Subsidies would be available to help middle-income people purchase insurance, while government programs such as Medicare and Medicaid would be expanded.
Finally, the government would subsidize and manage the development of a national system of electronic medical records.

Taken individually, each of these proposals would be a bad idea. Taken collectively, they would dramatically transform the American health care system in a way that would harm taxpayers, health care providers, and — most importantly — the quality and range of care given to patients.

In the face of this assault on one sixth of the US economy and some of the most important, personal, and private areas of our lives, one would think that the Republican response would be a resounding “No!” One would be wrong.

Instead, the Republican response has been a plan of their own to increase regulation, mandates, and government control over the health care system.

Sens. Tom Coburn (R-OK) and Richard Burr (R-NC) and Reps. Paul Ryan (R-WI) and Devin Nunez (R-CA) have proposed a plan based on the failed Romneycare experiment in Massachusetts.

It is not all bad.

In fact, it contains some very good proposals, such as changing the tax treatment of health insurance and expanding HSAs. However, it would also preempt many state insurance regulations, establishing new federal insurance rules, including a requirement that insurers accept all applicants regardless of their health or age. There would also be a federal “risk adjustment” board that would tax some insurers and subsidize others based on whether the people they insure are healthy or sick. These policies will mean higher insurance premiums for the young and healthy.

The plan falls just short of an individual mandate, setting up automatic enrollment in exchange plans at “places of employment, emergency rooms, the DMV, etc.” — essentially, trying to achieve universal coverage by nagging Americans to death.

Notably, Coburn-Burr-Ryan-Nunez abandons one of the best recent Republican ideas for health reform, Rep. John Shadegg’s proposal to allow Americans to buy insurance across state lines, in favor of a requirement that states establish Massachusetts-style connectors. But the Massachusetts Connector has been one of the worst aspects of that state’s reform, acting as a super-regulatory body, adding new mandated benefits, restricting consumer’s choice of plans, and adding both regulatory and administrative costs to insurance. (In fact, the Connector adds its own administrative costs, estimated at 4 percent of premium costs, for plans that are sold through it.) What the Connector has not done is live up to its promise of breaking the link between employment and insurance, giving workers personal, portable insurance that they could take with them from job to job, and which they would not lose when they lost their jobs. Unfortunately, the Connector has not lived up to its promise in the latter regard. In fact, as of May 2008, only 18,122 people had purchased insurance through the Connector. That’s very little gain for so much pain.

Since there is virtually no chance that the Coburn-Burr-Ryan-Nunez will actually be enacted, perhaps one shouldn’t get too excised about its failings. It is clearly far superior to Obamacare. But one can’t escape the feeling that the best way to show the American voters that Republicans have regained their commitment to limited government—and to defeat Obamacare—is not with Obamacare Lite.

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Comments

So do nothing then?

Submitted by thirdeblue on Thu, 05/21/2009 - 12:54.

Obama's plan = bad.

Obama-lite plan = less bad.

Do nothing = best?

40 million Americans without health care insurance = fuck you.

I'm not sure these are the "solutions" that Americans are looking for. If Americans were interested as business as usual they would've voted McCain for president.

That's probably not entirely fair...

"In fact, it contains some very good proposals, such as changing the tax treatment of health insurance and expanding HSAs. However, it would also preempt many state insurance regulations, establishing new federal insurance rules, including a requirement that insurers accept all applicants regardless of their health or age" (emphasis added)

So instead of just do nothing you would be in favor of maybe throwing some money out the door to help people who don't need healthcare to get it so the insurance companies can make some SERIOUS cash and then tell everyone else to go fuck themselves. Or is allowing private insurance companies only take healthy people with no pre-existing conditions the only way we can guarantee that HMOs can make their money? Because actually, you know, providing health care to people should be the last thing on our minds.

The net effect of your ideal would be WORSE than doing nothing.

Is profit worth more than life?

Submitted by Maleficent on Thu, 05/21/2009 - 13:01.

many many court decisions, and more laws on the books, say otherwise.

It is not allowable for a company to continue to operate it's factory, as it sickens and kills the surrounding populace.

Why should it be elsewise for Health Care? Particularly when it wastes 6% of our GDP to Not Cover Everyone???

you are so blasted out of touch

Submitted by Maleficent on Thu, 05/21/2009 - 13:03.

that you don't understand that the gov't plan would actually reduce costs to give small business employees health care.

seriously.

small business owners are GOP constituents... or at least they used to be, before the gop went whiggy.

it doesnt matter

Submitted by xc1148 on Thu, 05/21/2009 - 15:48.

republicans had control from 2000-2006 and they thought gay marriage was more important. health care is too important an issue now, and the dems have the power to do what they want. the best you can hope for would be for some republicans to give concessions on other parts of obama's agenda (gitmo, DADT, SS) in order to insert some pro-market ideas into the new legislation.

phony baloney talking point

Submitted by Freedoms Truth on Thu, 05/21/2009 - 17:23.

republicans had control from 2000-2006 and they thought gay marriage was more important.

What an absurd phony baloney distortion. What planet do the people who believe these lies live on? Planet dKOS?!?

The Congress in those 6 years spend almost no time on the matter of protection of traditional marriage from redefinition and in the end did absolutely nothing.

Meantime, the biggest change in Medicare in over a decade was passed, with Medicare part D drug benefit, pushed and passed by Bush. Oh, and a massive tripling of SCHIP was debated, passed and vetoed by Bush, etc.

Leftie trolls constantly want to insert irrelevent gay marriage into every thread. Their homosexual obsessions and distortions belong elsewhere.

health care is too important an issue now

health care is too important to have our system destroyed by the dangerous and wrong socialistic ideas of the Democrats and Obama.

"phony baloney" lol

Submitted by xc1148 on Fri, 05/22/2009 - 08:29.

how many times did you see republicans on television talking about how america was "under attack" from gay marriage? how many times did bush mention gay marriage in 03 and 04? you can't sit there and argue that the republicans didnt bring these issues up for a vote, and discuss them extensively in their campaigns. So you dont like gay marriage, pick any other topic.

Medicare part D is an expansion of government health care is it not? Like you said, SCHIP was vetoed by Bush.

Name a republican senator that would be absolutely distruaght if the current medical system isnt improved (by dems or repubs)...there just isnt anyone like Ted Kennedy or Hillary on the right to balance them. That's really my point. no one on the right "owns" the issue. Grow up.

Dr Coburn, Dr Frist and Dr Ron Paul

Submitted by Freedoms Truth on Sat, 05/23/2009 - 09:58.

how many times did you see republicans on television talking about how america was "under attack" from gay marriage? how many times did bush mention gay marriage in 03 and 04?

Not much. Not compared with the many other issues, items and topics, from Iraq , gwot etc. that were the topic of the 2004 campaign.

you can't sit there and argue that the republicans didnt bring these issues up for a vote, and discuss them extensively in their campaigns. So you dont like gay marriage, pick any other topic.

My other topic is -- healthcare. My point is that ALL the issues are discussed in campaigns and its a phoney baloney talking point to pretend that gay marriage trumped other topics. what little time was devoted to defending traditional marriage in various campaigns and votes, it did NOT crowd out attention to healthcare. If anything, the topic #1 in 2004 was foreign policy, ie Iraq and GWOT. you could credibly blame Iraq for crowding out other issues, but not the marriage issue.

Name a republican senator that would be absolutely distruaght if the current medical system isnt improved (by dems or repubs) )...there just isnt anyone like Ted Kennedy or Hillary on the right to balance them.

Dr Coburn, a baby doctor, is one for sure. Between Dr Coburn, Dr Frist and Dr Ron Paul, you have more knowledge about healthcare than the whole Democrat caucus of lawyers and pandering socialists combined.

http://coburn.senate.gov/public/index.cfm?FuseAction=LatestNews.PressRel...

“President Bush deserves credit for delivering a speech filled with specific, realistic and substantive proposals. Congress now has to decide whether to work with President Bush in a spirit of bipartisan compromise or continue its ‘do-nothing’ habits voters rejected in November,” Dr. Coburn said. “As Federal Reserve Chairman Ben Bernanke warned last week, the right time for Congress to get serious about fixing challenges like health care was ten years ago. If Congress continues to ignore this problem, the next generation of Americans will be the first to inherit a lower standard of living. President Bush has outlined a series of proposals that will reverse our slide toward socialized medicine and put consumers back in charge of their health care dollars and decisions. By empowering individuals and promoting competition, the President’s common sense proposals will make health care more affordable and accessible for all Americans,” Dr. Coburn said. During the last session of Congress, Dr. Coburn cosponsored with U.S. Senator Mel Martinez (R-FL) “The Tax Equity and Affordability Act,” S. 3754, which contained many of the reforms President Bush outlined tonight. Senators Martinez and Coburn plan to reintroduce an updated version of S. 3754 tomorrow.

Insurance

Submitted by Shawn Parker on Thu, 05/21/2009 - 16:10.

It's good policy for all drivers to have auto insurance.. so we mandate (in most states) that people have coverage because everyone sharing the burden is better than having uninsured drivers get into accidents.

In Massachusetts MittCare mandated that everyone, in the same way get health insurance. Cry as everyone will, it's actually worked out pretty well. It's not as expensive as the failed TenneseeCare - and you can get basic coverage for under $300 a month. Plus it's all private health care, not Government care.

do you live in MA?

Submitted by xc1148 on Fri, 05/22/2009 - 08:33.

that is interesting...most of the feedback on Mitt's plan (obviously biased during the primaries) was negative. The WSJ especially hated it. But I thought it was a step in the right direction, and you need trial and error....plans can always be updated later.

wsj is not to be trusted.

Submitted by Maleficent on Fri, 05/22/2009 - 09:03.

controlled by corporatists.

not that most of the Mainstream Media Isn't, but most of it hides it better.

Yes

Submitted by Shawn Parker on Fri, 05/22/2009 - 09:48.

Yes I do live in Massachusetts and I am actually on one of those new Mitt private plans becuase I work for myself. So as a small business owner, I can now afford my own insurance, I had a choice between Harvard Pilgrim, Tufts, and Blue Cross Blue Shied - not bad pickings... let's see, here is my latest premium I need to pay... look at that: $236

I actually think $236 bucks for a solid plan that will protect me is great. I am a Republican who hates taxes, and even I have to admit this is a great deal. This works.

It's not like for $236 bucks I get bad care, my doctor also teaches at Harvard Medical School. Think about it this way, my Comcast cable bill was $160 bucks.

even-better answer on healthcare wanted

Submitted by Freedoms Truth on Thu, 05/21/2009 - 17:16.

Is Michael D Tanner with Cato Institute? His name is familiar. If so, maybe he can point us to the Cato policy-wonk solution in this area.

Is Mr Tanner saying the strategy of offering alernatives is wrong and we should JUST SAY "NO WE CANT" as a policy response? Most of us think that is a trap - it allows the Dems to peg the GOP with the 'status quo' and beat up the GOP as stuck in past. IMHO these congressional Republicans deserve kudos for putting together policies that try to address the issue.

I would humbly suggest that - just as the Republicans have taken to heart the advice "you cannot beat something with nothing" ... that Mr Tanner rather than beat up the GOP for offering mostly pretty-darned-good and certainly-better-than-Democrat proposals on healthcare to offer his even-better-alternative.

The key selling point that needs to be maintained is HEALTHCARE CHOICE. ObamaCare will never claim to take away choice since the polling is clear - voters oppose his plans 2-to-1 if their own health insurance is impacted, but this is the key point: To reach their goals of universal coverage, all these plans deny people choice. They do even worse - the denied choice means less competition, which means higher costs, less accountability, less quality and less innovation.

On specific points like ...

Notably, Coburn-Burr-Ryan-Nunez abandons one of the best recent Republican ideas for health reform, Rep. John Shadegg’s proposal to allow Americans to buy insurance across state lines

100% agreement - the Shadegg proposal would be a huge step in the right direction. Health insurance is so expensive because it is over-mandated, and is loaded to create a system where its forced into an 'all-you-can-eat' style insurance. Actually, its not insurance at all.

If Mr Tanner has an alternative that is BETTER than the GOP alternative *and* the very very bad Democrat plan (no disagreement there), let's hear it. We need alternatives to Obama-care not just "NO". It seems to me that the GOP alternative took it as a premise to try to acheive 'Universal Coverage' and that if you are going to do better, you have to end that linkage/mandate. Is that the case.

On all these issues, the following website is of some help:

http://cprights.org/

denying people mass bankruptcy seemed like Such a Great Idea

Submitted by Maleficent on Fri, 05/22/2009 - 09:06.

half the folks who declare bankruptcy each year do it because of medical costs.

three quarters of them have insurance.

Most people don't know exactly how crappy their insurance is, until it's too late.

Do you think I knew that they'd deny my husband medicine that the doctor said was essential to keeping him out of the hospital? It isn't like they put that in the documentation -- the documentation said get a doctor's note, and you're good.

Tanner is half-right; but a broken clock is right 2x/day too

Submitted by Michigan-Matt on Thu, 05/21/2009 - 17:50.

Tanner gets it right in describing the Obama health care initiatives as currently laid out. He should have stuck to those points and he wouldn't need corrections on the 2nd half of his commentary.

What he gets fundamentally wrong is this the notion of what "the GOP" intends with this line: "But one can’t escape the feeling that the best way to show the American voters that Republicans have regained their commitment to limited government—and to defeat Obamacare—is not with Obamacare Lite."

Sorry, Tanner, that would maybe be the BEST way to show America what LibbieLoon-atics want; not what the GOP wants or intends. The effort to limit govt comes in the budgeting process and calling for a 15% reduction in the federal govt personnel. It doesn't show anyone, let alone America, what the GOP intends or wants.

The House GOP is one of many, many segments of the Party. As a minority party in the chamber, they can't do much but propose amendments intended to adjust the Plan downward before it exits the House... but that's only if they can muster a day-by-day majority on the particular issue at hand. Of course, if the Libertarians hadn't sold out the Country in order to protest McCain's GOP nomination, maybe we wouldn't have Obama now holding the scalpel to our collective throats?

What you should have written about after bashing Obama's Plan is to write: "here is what the Libertarians" want to do with health care.

Plan A: If you get sick and have money, you have an opportunity at restored health.

Plan B: If you get sick and don't, you die. Sorry, the marketplace is a cruel world. You should have gotten a better job or married for wealth. PS> Ain't life a heartless, cruel bitch?

Plan C: put lots of money into cloning, long-term storage of viable brain cells, and genetics so we can control the gene that creates little Libertarians and reincarnate all living Libertarians and grow the Party that way... 'cause we ain't getting anywhere with ideas.

It isn't Obama-Lite. I wish you could stick to what your pals in the Libertarian annex of the GOP might like to do IF THEY HAD ANY POWER instead of tossing brickbats at the GOP yet another time, in another thread, as another predictable Libertarian voice.

Lying about the public plan.

Submitted by omarka on Fri, 05/22/2009 - 00:24.

Cato's talking points aside, Schumer has gone out of his way to say that the public plan specifically will not recieve taxpayer subsidies. If private insurers are not able to compete, it's because the single payer model is superior to ours - as empirical evidence indicates.

This is the sort of thing that represents why the GOP is fucked for the forseeable future. Instead of standing for the public interest and the courage of your convictions, you stand with health insurance companies. Good luck with that, brother.

It's also adorable how you mention things like a standardized medical record system or studies into the efficacy of medical treatment as if they're not only unjustified, but obviously unjustified.

we don't have evidence for a standardized medical

Submitted by Maleficent on Fri, 05/22/2009 - 09:08.

record system saving money, though it will undoubtedly save lives -- which means less insurance costs for the docs.

We do have a compelling argument for the medical record system.

Schumer lies like a rug

Submitted by Freedoms Truth on Fri, 05/22/2009 - 12:51.

Schumer has gone out of his way to say that the public plan specifically will not recieve taxpayer subsidies.

If they dont need subsidies, then what is that smoking hole of $1 TRILLION to PAY for the implementation of socialized medicine?

Or check the GAO numbers on the ObamaCare bill ... It's a HUGE COST.

BTW, when they estimated Medicare back in 1965, they were off (undercouted) by a factor of 9 or so over 20 years.

Where is the evidence of lying wrt the public option?

Submitted by omarka on Wed, 05/27/2009 - 03:08.

You may want to argue against some magical fantasy land that Cato has concocted where John Conyers and Bernie Sanders rule the universe, but that is not the world we're living. I repeat, the characterization that a public plan would rely on tax revenue is a lie. The public plan that is being discussed in the real world (Baucus-Kennedy) is funded by premiums, and has no funding advantage over private plans.

The $ trillion over ten years is related to a COMPLETELY DIFFERENT set of sinks. For a prominent example, there are the tens of millions of uninsured Americans who would have their insurance subsidized (along with other low income Americans). Other examples are in the very opening post that we're discussing.

Here's the point: the right's discussion of health care - and this thread is a fine example - is totally non-serious. If you want to be taken seriously (and incidentally, have a realistic shot at winning an election), raise the level of your debate.

As for Medicare costs...

Submitted by omarka on Wed, 05/27/2009 - 03:16.

... look at the private market. You see inflation in costs for precisely the same reasons. In fact, inflation has been worse in private health than medicare, which uses its size to control closts. That's one reason why we'd want a more regulated, universal system. If we can't control medical inflation, bluntly, we're screwed.

projected costs and subsidies

Submitted by chemjeff on Fri, 05/22/2009 - 13:04.

Schumer has gone out of his way to say that the public plan specifically will not recieve taxpayer subsidies.

Even if Schumer is not being intentionally dishonest (which is not a given), I still don't believe it will end up that way. All this talk about "efficiencies will pay for it all" is just nonsense - we taxpayers will soon be on the hook for a gigantic social welfare boondoggle. Perhaps you could point to ONE, just ONE, example of some social welfare program whose costs came even reasonably close to its forecasted costs at the time of enactment.

You are confusing what the arugment is about.

Submitted by omarka on Wed, 05/27/2009 - 03:12.

What specifically do you think is a "boondoggle?" Do you understand what we mean by the public plan?

A good GOP health care propsal

Submitted by davidfarrar on Fri, 05/22/2009 - 06:34.

A good health care proposal the GOP can offer is a provision that directs each member of Congress to immediately upon passage of Obama's health care plan, to stop their special Congressional health care plan and join the one they just created for all of the little people back home. Let's have no playing favorites here.

ex animo

davidfarrar

I agree wholeheartedly

Submitted by thirdeblue on Fri, 05/22/2009 - 06:46.

Direct incentive to craft the best plan possible.

Me too!

Submitted by acinphx on Fri, 05/22/2009 - 12:52.

David, I think you'd get broad support for this from citizens across the political spectrum. Talk about a winner for the GOP in terms of a policy position! I'm not being snarky; I would be seriously impressed by the pol who has the integrity to say the average American deserves health coverage commensure with that of members of Congress -- fully recognizing this means Congress members will pay more out of pocket if they want to continue the gold standard care taxpayers are currently funding for them, including many Americans without insurance.

Phoney political writing

Submitted by lgm on Fri, 05/22/2009 - 07:02.

but the broad outlines of the democratic proposals to take over the American health care system are becoming apparent.

DIsengenuous. Propaganda pretending to be a simple factual statement. The new proposals, as the writer acknowledges later, have much less impact on our health care system than earlier proposals (Hillarycare, all other advanced economies). The new proposals will increase regulations, but not "take over".

Private insurance would still exist, at least for a time.

Dark suggestions that Democrats have a long term goal impose Soviet Communism with health insurance mandates (like car insurance mandates) an insideous first step. Note that there is absolutely no evidence for these phoney fears.

But it would be reduced to little more than a public utility, operating much like the electric company, with the government regulating every aspect of its operation.

Great analogy. Americans would be glad to get health care as cheaply and reliably as they get electricity. Even the bad old days regulated Ma Bell health care would be better than what we have now.

Creeping Socialism

Submitted by Freedoms Truth on Sat, 05/23/2009 - 11:15.

Sometimes / often the slippery slope argument is an invalid one.

However, when we see that historically the trend of regulation in an area is in a particular direction. More Government spending, dictation, control and involvement. It's creeping socialism.

ObamaCare represents another major step in the direction of socialized medicine, with a government insurance program and employer mandates that combined represent the kind of 'single-payer system' in UK or Canda and which we refer to as socialized (govt-run) healthcare. The cost is $1 trillion over the next decade - minimum - and that represents a huge taxpayer burden to further subsidize the socialized medicine approach. It will kill off alternatives, so the slope is slippery indeed.

Americans would be glad to get health care as cheaply and reliably as they get electricity.

... or food. Or natural gas. Or ink jet printers. Or over-the-counter cold medicines. Or pretty much most of the things you can buy in a store, and that hasnt been totally mucked around by Government over-regulation. It' a great myth indeed that the path to 'cheap and reliable' health care is through the Govt-central-planning economic principles tried in the USSR.

okay. so you tell me how to deal with a corporation

Submitted by Maleficent on Tue, 05/26/2009 - 12:13.

who has decided that the best way to make a profit is to commit "murder by spreadsheet"??

Miscarriages in an emergency room != elective abortions. This is one among many reasons corporate health care has denied coverage to insured workers.

Living with a disease or

Submitted by Allison on Sat, 05/30/2009 - 03:51.

Living with a disease or disorder isn't easy, and one that doesn't get a lot of press is Klippel Trenaunay Syndrome, or KTS. Klippel Trenaunay Syndrome is a disorder that affects the body through a variety of ways, including a large port wine colored patch of skin, varicose veins, and growths in various places in the body, especially limbs and extremities. It does take a few no fax payday loans to cope with. Some famous people so afflicted are Casey Martin, pro golfer, and Carla Sosenko, journalist and columnist. It is covered on the Americans with Disabilities Act, and a cash call to aid research on Klippel Trenaunay Syndrome would be well placed.

tiffany jewellery is the best

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Benefits will be reduced under the Democrat’s plan

Submitted by lisabrown on Thu, 09/24/2009 - 12:28.

Millions of seniors and disabled individuals could lose many of the important benefits and services that make Medicare Advantage health plans so valuable,” according to the letter, which also urged customers to contact their representative in Congress.Obama has indeed proposed a $500 billion slash in Medicare benefits over the next few years in order to pay for his plan, which he says will shift health spending from senior adults to those not currently covered. Additionally, the non-partisan and independent Congressional Budget Office has determined that the administration’s proposed Medicare cuts will significantly reduce seniors’ benefits.Yet the president and Democratic leaders want to keep citizens in the dark, bullying a government agency that’s supposed to protect the health of all Americans to instead threaten the free flow of valuable information that could compromise that mission. The agency’s stern notice orders insurance companies to “immediately discontinue” mailings or web site postings mentioning the Medicare cuts.

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