Thursday, April 1, 2010

Is Health Care Reform a "Big F*#king Deal"? PART 5

I'm a little burned-out on the health care issue at this point (as I'm sure you are as well), so this will be the last in what has become a 5-part series.

I wanted to end with a little politics. No one can deny the incredible passion that this issue stirs in most Americans. Politicians on both sides of the aisle are professionals when it comes to playing on these passions.

So let's finally get to the question posed in the title of the series...Is this Health Care Reform a "Big F*#king Deal? Well, sure it is. There are some new and sweeping regulations on the health insurance industry. That's pretty damn big! Creating tax disincentives to essentially require companies to offer health insurance to their employees and require all Americans to be covered is a big change.

But is it really the embodiment of Stalin and Hitler...communism and fascism. Of course not. It is all about the degree to which our health care system is socialistic. Arguments could be made that any government subsidization of health insurance (e.g., Medicare) is socialistic. But we've had Medicare since the 60s and you didn't see the Tea Partiers up-in-arms during the Bush or Reagan administrations to repeal Medicare? No, you didn't...especially since a lot of Tea Partiers are currently getting Medicare and are quite satisfied with it (they are not exactly the bastions of intellectual consistency...remember this?)

Another great example of why the hysteria is so unwarranted is because a lot of what is in the bill is very consistent with ideas that Republicans have put forward many times before in the past. Take, for instance, what Mitt Romney (former GOP Presidential candidate) actively fought for and implemented in Massachusetts. David Frum did a great job of pointing out the similarities between "Romneycare" and "Obamacare". As Frum puts it:

Romney sharply distinguishes his healthcare preferences from Barack Obama’s. For him, the red line is the public option. He adamantly opposes it. Yet in many other respects, there is common ground. Like Obama, Romney worries about the malign incentives of fee-for-service medicine. Like Obama, Romney regards the status quo as unsustainable. Like Obama, Romney is a big fan of the healthcare journalism of Atul Gawande.
And of course, the public option has now vanished from the Obama plan. Which means that the federal plan bears a closer family resemblance than ever to Romney’s idea: regulated health insurance exchanges, mandates to buy insurance for those who can afford it, subsidies for those who cannot. Romney’s preference would be to omit the mandate for those who “can demonstrate their ability to pay their own health-care bills.” (176) That would be precious few of us. And he wants to allow states ample leeway to innovate without hindrance by the federal government.
Romney frames the distinction between his preferences and President Obama’s as “free enterprise and consumer-driven markets or government management and regulation.” (193)
It’s hard to avoid the suspicion that these two technocrats have more in common with each other on this issue than either does with his party’s more fervent supporters. With this one difference: shout outs to CEOs in Ch 7 – 3, including one to the CEO of drugmaker Novartis.
It's true that this legislation has a lot of flaws in it (as I've tried to point out). But those flaws are not because it is too "liberal" or too "socialistic" (there is no public option for God's sake!). In the grand scheme of American politics, it is actually very centrist and parts are even somewhat conservative.

So why is the right acting so unhinged and rabid about this whole plan? Well, I've tried to be kind and sympathetic in my mind as I've tried to figure out where all of this hatred comes from...but in the end, I am actually pretty cynical about this (maybe not quite as cynical as this, though). It really just seems that, in the eyes of the Republicans, the debate versus the Democrats has turned into a completely irrational game between two competing professional sports teams (or, better yet, two WWF wrestlers). If the other side likes something...well, then our side doesn't like that (even if we might have liked it before). It really is obstructionism at its finest.

The GOP could have acted like grown-ups during this whole health care reform debate and realized that the Democrats, after a major political victory in 2008, were seriously going to pass something. They could have put forth rational arguments about why the Obama way of tackling the health care crisis was the wrong way to do things. But they didn't...all they did was provide raw meat to the massive angry populace (and rightly so, this economic depression is devastating for a lot of people) with their cries of Fascism and "Baby killers". This is the main critique that David Frum wrote a week ago (before subsequently getting fired by the right-wing think tank who couldn't handle the criticism):

A huge part of the blame for today’s disaster attaches to conservatives and Republicans ourselves.
At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994.
Only, the hardliners overlooked a few key facts: Obama was elected with 53% of the vote, not Clinton’s 42%. The liberal block within the Democratic congressional caucus is bigger and stronger than it was in 1993-94. And of course the Democrats also remember their history, and also remember the consequences of their 1994 failure.
This time, when we went for all the marbles, we ended with none.
Could a deal have been reached? Who knows? But we do know that the gap between this plan and traditional Republican ideas is not very big. The Obama plan has a broad family resemblance to Mitt Romney’s Massachusetts plan. It builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994.
Barack Obama badly wanted Republican votes for his plan. Could we have leveraged his desire to align the plan more closely with conservative views? To finance it without redistributive taxes on productive enterprise – without weighing so heavily on small business – without expanding Medicaid? Too late now. They are all the law.
I completely agree and think that some conservative ideas could have really helped this bill. But we didn't get that.

All in all, it's bad enough in this country that we only have two parties running the show. But when one completely excuses itself as it throws spitballs from the corner of the room, then we're all worse off.

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