Saturday, March 6, 2010

GOP Encourages Communication With Dems; Churns Phony Opposition to Healthcare

It seems lately that with every fiber of its being the Republican Party stays on one message: No.

Whatever President Obama wants, don't give him. No matter what. No matter how much he agrees with us.

And now they've wed their "Go with No" mantra with a nice slice of "divide and conquer" by targeting Indiana Democrats in conservative districts.

Via blast email from the Indiana GOP, entitled "Alert: Help Stop Democrats Healthcare Reform!" -

Last summer, you helped us generate thousands of phone calls and e-mails into the offices of Reps. Brad Ellsworth, Baron Hill and Joe Donnelly regarding the health care legislation that Democrats in Washington are trying to force on the American public. Once again, we need your help in this effort.

Since last summer, Reps. Ellsworth, Hill and Donnelly voted for the House version of the bill after months of pretending to have the same concerns as Hoosiers: How much will it cost? Will you get to keep your doctor? Will premiums go up? Will quality of care go down? Months later, we still don't have definitive answers to those questions and the Senate passed an even more egregious bill.

Now, House Speaker Nancy Pelosi is talking about passing that same Senate bill through the House. We must encourage Reps. Ellsworth, Hill and Donnelly to stand with Hoosiers and oppose a government takeover of health care. They already ignored our concerns once, but with a renewed effort and a worse piece of legislation, we might convince them to oppose their own party's bad idea!

Please contact these Congressmen today and tell them that Hoosiers won't stand to have this legislation thrust upon us.

If you want healthcare reform, Democrats, you better get to work offsetting this Republican-orchestrated astroturf opposition. Contact Baron, Brad, and Joe.

While it's masterful political strategy to call this a "government takeover" of healthcare given how people hate the word "government," it's intellectually dishonest.

Under no Democratic plan will the government own hospitals, pharmaceutical companies, or medical device manufacturers or employ a single medical provider. What the government will do is cut checks and negotiate rates, just like with Medicare.

How many elected Republicans have called Medicare a "government takeover" or asked that it be dismantled? Not one. In fact, when Paul Ryan (R-Wisconsin) proposed a budget that talked about even cutting Medicare benefits, House Minority Leader John Boehner and his colleagues ran away from it, though when pressed Boehner couldn't name a single substantive disagreement he had with that budget.

There are robust discussions to be had on healthcare. Most Americans do favor market-based solutions. The problem is that "the market" has almost never delivered solutions Americans want in healthcare.

Has the market done away with prohibitions on pre-existing conditions? No.

Has the market kept premiums down? No.

Has the market kept healthcare costs down? No.

Did the market create portability in coverage? No.

Did the market ensure that medical decisions were made by doctors and not HMOs? No. (This is why "the government" tried to pass the Bi-Partisan Patient Protection Act).

Some may contend that the problem has been "the market" is artificially restricted because you can't sale insurance across state lines. That's an excellent point. But each state has a Department of Insurance that heavily regulates insurance products sold within its boundaries. If companies sell across state lines, who ensures that companies in Ohio haven't denied claims arbitrarily for customers in New York? Who ensures that all plans sold comply with minimum terms that even Republicans would claim they want? Who ensures comparable pricing structures so people can make informed comparisons? It will have to be some entity with federal authority, won't it?

Another Republican Party disconnect is on the notion of forcing people to buy insurance. Oh, the horror! But isn't that precisely what forty-seven states, including Indiana, require before you can operate an automobile? If you drive without insurance, you get a suspended license; drive with a suspended license, go to jail. Why aren't Republicans talking about dismantling these laws in 47 states?

Because many Republicans right now aren't serious about dismantling anything except the Obama administration.

Here's the truth about insurance. The more people in a pool who don't file claims or really even need the insurance, the cheaper it is for everybody. In other words, there has always been and always will be a subsidy from good case to bad case.

A healthy person might want to play the "healthcare lotto." I know because did. I was self-employed, young, single, and healthy, and I could get coverage for $258 a month. Instead, I opted out and spent my money having nice dinners with friends. Fortunately for me, the gamble paid off. But I was precisely the person Wellpoint points to as the cause of its 39% premium increase in California. When you let healthy people (or good drivers) walk away, there are fewer payors to subsidize the remaining people in the pool, and the irony is, the more the premiums go up, the more people will walk away, if they can.

This is how you know the GOP is not serious about eliminating pre-existing conditions. As soon as insurance companies can't "cherry pick" (i.e., offering coverage only to the healthiest people least likely to ever file a claim), premiums will go up unless you ensure that people can't leave the "national" pool. You might let them go from one company to another, but they can't walk away completely, or the premium cost containtment breaks down.

And this setup is precisely what Medicare is, except you have to think of senior citizens as the ones with the "pre-existing" condition of old age. They pay less in "premiums" than they'll use in claims, which is why the system has to be subsidized by healthy people. And guess what? Medicare pays less for services than private insurance. Why? Because it's "government" at the switch negotiating rates, not thousands of smaller insurance companies with less bargaining power.

Republicans also claim they want to empower consumers by advertising prices for services just like at Jiffy Lube. This is a talking point with common sense appeal. But has "the market" made anybody list prices? No. As it stands, there is no website or pricing sheet I can get at a hospital to show me what a tonsillectomy runs. So who is going to compel price listings if not "government?"

Of course, I need to be able to compare apples to apples, or competition doesn't work. But how do I compare the value of an appendectomy? Republicans say they want performance measures for healthcare providers advertised. But to compare appendectomies to appendectomies, we'd need uniform criteria and data collection methods. Has the market developed that to date? No.

What if hospitals fudged their numbers? Would the market impose a penalty on them? Of course not. "The market" wouldn't even know. Detecting wrongdoing by insurance companies, doctgors, and hospitals and penalizing it is what "government" does. (Lawsuits can serve this purpose as well, but Republicans do everything they can to limit those and the resulting damages).

But at the end of the day, all you need to remember is that sixteen years have passed since the Republicans killed the last effort to reform healthcare, and the House Republicans plan will increase coverage by only three million people. Has "the market" gotten thirty-six million Americans coverage they don't have now? No.

In short, when more Republicans get real on what America needs to get healthy, I'm in the market to listen.



Dave said...

The comparison between the requirement to carry auto insurance if you CHOOSE to drive and the requirement to carry health insurance if you CHOOSE to live is spurious, at best. This type of mandate is unprecedented, and liberal talking heads who want to make such a comparison with the legal requirements of a privilege (driving) have unwittingly acknowledged that it's unprecedented. Many citizens are rightly wary of a new government mandate to finance a new government entitlement when "government" is indeed a dirty word to those Americans who love liberty.

Anonymous said...

I find it ironic that you wish to discuss the issue of mandating coverage. The real problem here is the lack of coverage. almost everyone wants coverage or affordable coverage. Trying to make an issue of the mandated coverage simply serves to obscure the issue. In addition, for those who CHOOSE not to have insurance and then become seriously ill or are involved in an accident simply burdens on the taxpayers because the hospitals are required to treat them. They want their cake and to eat it also.

Koz said...

Nice analysis, though I don't think this is quite right:

"Under no Democratic plan will the government own hospitals"

I would put the word 'additional' since since there are plenty of state run facilities now (Wishard) and there already is an entire state-run medical system: the VA system.

iPOPA said...


You are absolutely correct. There is a true government-run medical system at the VA, which has me asking this question all the time:

Pick one Republican party. You either think government-run healthcare is crap, in which case you DON'T really care about veterans when they come home, or you think it's a good system, in which case you're being hypocritical when you're saying such a system is terrible. They certainly can't have it both ways, though they'll try, just like they do when they say Medicare is great but "socialized medicine" is terrible.