A New Angle On Health Care Reform
Now that the public option is effectively dead, Ross Douthat provides an interesting take on where the health care reform fault lines may next become visible:
If the Democratic Party’s attempt at health care reform perishes, senior citizens will have done it in, not talk-radio listeners and Glenn Beck acolytes. It’s the skepticism of over-65 Americans that’s dragging support for reform southward. And it’s their opposition to cost-cutting that makes finding the money to pay for it so difficult.
Christopher Buckley's "Boomsday" was a pretty good satirical take on the same type of retiree-entitlement funding problem.
The armchair political strategist in me says that Obama gave away his biggest bargaining chip too soon, allowing Republicans to next go after anything else in the plan they don't like. But maybe it will allow him to regain control of the message and rebuild his momentum. I think the biggest hurdle he faces is that usually the most motivated part of his base are precisely the 18-29 year-olds who are not particularly interested in being mandated to carry health insurance.
posted by QueensGuy @ 12:48 PM
9 Comments:
Is it really dead? The White House has said a lot of contradictory things. Perhaps they were putting up a trial balloon, but I don't see the far left willing to settle for anything without a public option. Perhaps they've got some tricky maneuver where the bill gets out of the Senate with no public option which is later put back in.
The trouble with health care reform is most people who are happy with their own plan, which is over half the population, don't want the boat rocked. The biggest consumers are old people, and they definitely are worried that things might change too much.
Ah, thanks for the catch. I meant to put "effectively dead" in quotes, because I too think it may again rear its head. Not too long a stretch from "non-profit co-ops" to "government-administered non-profit co-ops." I most appreciated this op-ed for enlightening me how "death panels" so easily went from a Republican-sponsored idea for end-of-life advanced-directive counseling to Logan's Run.
Who is this "far left"? Howard Dean? The left/right thing is ridiculous without saddling them with stupendously meaningless adjectives
I think "far left" is a useful term. In the Congress, there are a lot of Demcorats, and, looking at what they support, it's not that hard to define which ones are far left and which ones are moderate. The terms are relative and fuzzy at the edges, but they're not meaningless--if they were, why would liberals and conservatives both regularly give scores to politicians?
I don't know if many pundits have pointed this out, but the drive for universal health care is difficult because most people who really want health care already have it. Seniors, who (on the average) need it the most, already have medicare. The demographic least likely to have health care -- twenty-somethings and thirty-somethings -- are perhaps making a rational decision. (I think a better choice for a healthy 25-year-old is very cheap catastrophic health insurance.)
So basically, the president has to convince the vast majority of Americans (who already have health care) to forcibly enroll those who don't want it.
Of course, there are some lower class people who don't have health care but who need it. But the Democratic Party abandoned these folks when it decided to be "the party of the middle class" a few years ago. Kucinich and Edwards talked about the poor, but Obama didn't -- and amazingly, he still doesn't. If Obama were to pose with a very poor inner-city black family that doesn't have health insurance, he might sway the heart-strings of middle-class America. But he doesn't do things like that.
The argument Obama uses, along with a lot of others, is that 47 million Americans don't have health insurance. Of course, the number is meaningless, since around 10 million are illegal immigrants, around 10 million are actually covered by some program or another and either don't know or don't care, about 17 million make over $50,000 (half of these making over $75,000) and don't buy it, and millions of the rest are in-between jobs and will soon be covered again.
So actually, the number who'll be directly helped is pretty small, and thus we don't need a massive overhaul.
Anon, citations please. Throwing around numbers without them is a waste of electrons.
Here's a whole bunch of numbers from 2005.
http://aspe.hhs.gov/health/reports/05/uninsured-cps/index.htm
I think the most telling number is the last one - only 51% of the uninsured are uninsured for more than a year. 20% are uninsured for less than 3 months (ie gap between jobs or changing policies or accidental lapses).
I think the current health insurance reform effort is completely misguided. For far less than a Trillion dollars + over 10 years, the gov't could replicate a VA type system to care for the relatively few people who can't afford insurance or to pay for the care they need. Keep in mind, many of the uninsured are healthy young people (62% under 35 years of age), and the large majority of them don't end up needing health care.
It's true that "millions of the rest are in-between jobs and will soon be covered again".
But in addition to that, there are a lot of people who would quit their job and look for a better one, but who don't because they would lose their insurance, which might be disastrous (and if they have an existing condition it's even more of a problem).
This makes the work-force less fluid, which hurts business and workers alike.
I don't have a solution, and I don't know that there is a solution that the government could implement. But I think it is a serious problem.
After all, the law that your employer must give you health insurance is itself a serious infringement on the free market: why not require your employer to buy you a car, instead? At least that could be freely taken to your next job if you were to quit.
Any law that makes it hard to quit your job is a serious step towards feudalism.
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