On Health Care, Republicans Care About Politics, Not Policy

|

Do Republicans care about health policy at all? Not really, at least judging by the party's twenty-plus year history of erratic and contradictory interest in health care legislation. That's basically the point that both Jonathan Chait and Josh Barro make in separate pieces today, and also part of the point I tried to make a few weeks ago when I argued that GOP support for the individual mandate was never terribly strong.

Republican legislators weren't actually interested in health policy, but they were interested in saying they had a health policy. That's why a number of them nodded along when the Heritage foundation proposed the individual mandate. For the most part, Republican interest in health policy coincided neatly with political convenience. Republicans opposed Clinton's health care plan because they thought it was politically advantageous. They whipped votes in favor of an unpaid-for expansion of Medicare drug coverage in large part because they didn't want Democrats to get credit for having passed something similar (it helped that their version was approved by the pharmaceutical industry). And during the years when they controlled the White House and both houses in Congress, they didn't pursue structural reforms to the existing Medicare entitlement or the larger health insurance market because they didn't see a political advantage in doing so. When Mitt Romney passed a health policy overhaul in Massachusetts, a number of Republican legislators voiced their support—not because they cared about the details of the plan, but because they thought it would check off the health policy box, and because they thought there was a political advantage in wielding the plan against Democrats.

However, there have always been pockets of GOP support for doing something about health care, or at least for being seen to do something. Which is why I think Chait is at least misleading when he writes that "Republicans have never appropriated any money to cover the uninsured." Rather than look at appropriations, it's better to look at whether Republican legislators have ever voted for plans that expanded health insurance coverage. And at both the federal and the state level, some Republicans have. Republicans have voted to create state-managed high risk insurance pools. And in the late 1990s, GOP Sen. Orrin Hatch helped create the State Children's Health Insurance Program (SCHIP). Many of his fellow Republicans voted for the bill that created it. In 2007, Republicans reauthorized the program by voice vote, and in 2009, 40 House Republicans and nine Senate Republicans joined Democrats to support extending and expanding the program—an expansion that President Bush had opposed but that President Obama signed into law.For at least the last two decades, health policy has not been a core part of the Republican party's identity. Taking advantage of health policy debates to score short-term political points has. Which is why, despite early promises to have an ObamaCare alternative ready by the summer, Republicans on Capitol Hill gave up working on a legislative alternative. Overall, the party's elected official care more about the political advantage of opposing ObamaCare than they do about sinking effort and political capital into crafting workable legislative alternatives. 

But even the SCHIP votes show how weak GOP support has historically for any particular health policy idea: A majority of Republicans voted in favor of the legislation that created the program when they thought there was a political advantage to doing so, and a little over a decade later, a majority of Republicans voted against it.

I would like to think that the last few years, during which it has been impossible for GOP legislators to avoid thinking about health policy, have changed things somewhat. Clearly there are a handful of GOP elected officials with wonkier backgrounds—people like Rep. Paul Ryan and Louisiana Gov. Bobby Jindal—who do care about the details of health policy. But there's no larger party effort to either craft plans or do the long-term work of building the coalitions to support them. The party's House and Senate leadership are sticking with a strictly political message of opposing the current president's policies and the party's presidential candidate seems content to run on non-specific Obama opposition fake policy plans. Which is why I remain skeptical. If the bulk of the GOP cared about health care policy, as opposed to health care politics, they would have shown it by now.  

NEXT: Watch Fox's The Five Tonite for a Discussion of ReasonTV's Hunger-Striking Postal Workers Vid

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  1. Repubs had six years under Bush to do something as simple as lift the ban on interstate sales of health insurance. They could not even do that…probably got in the way of creating new entitlements where we could pay for grandma’s drugs and so airport fast food employees could get jobs with badges.

    1. “lift the ban on interstate sales of health insurance”

      Like tort reform, this is another non-idea that libertarian wonks are paid to push onto people like you.

      If you allow this, some governor that wants to get re-elected tells an insurance provider: “Move your HQ, your jobs and economic activity here and I’ll let you write your own legislation, no matter how much of an upper hand you get against customers.”

      Then, all insurance providers move to that state. Americans get worse care for higher premiums, and get sicker more often. Since the legislation is written by legislators captured by special interests, competition and innovation is stifled.

      If voters try to undo what the governor did, insurance providers pay people like Suderman to screamingly defend the status quo. See: credit card industry.

      1. tl; dr – libertarians need better ideas.

        1. tl;dr to the tl;dr – Someone doesn’t understand markets.

          1. Again: See the credit card industry.

            Do you think all industries are the same, i.e. if a health insurance provider doesn’t offer the most benefits at the lowest costs or at least finds a niche segment, it will immediately go under due to market magic? It all depends on circumstances – in some regions insurance providers are the biggest employers around, meaning they can easily purchase legislators and vociferous support from outlets like the Reason magazine and blog.

            Inefficiency and legislator-special interest collusion will be a direct result of removing state boundaries in health insurance commerce. Fuck your bad ideas, come up with better ones.

            1. I see the same exact behavior in the auto insurance market, big auto purchasing legislators and colluding to drain my wallet. Fuck off retard.

            2. Fuck his ideas? How is Obamacare anything other than more of the same government ineptitude in the health care market we’ve seen over the last 50 years? Fuck your proven-by-experience bad ideas.

              1. “How is Obamacare anything other than more of the same government ineptitude in the health care market we’ve seen over the last 50 years?”

                And yet you want to support an idea that would lead to even more government involvement in the health care industry (allowing interstate commerce in insurance plans).

                1. And yet you want to support an idea that would lead to even more government involvement in the health care industry (allowing interstate commerce in insurance plans).

                  The level of retardedness expressed here is breath taking.

                  “Plants like Brawndo” is less retarded.

            3. libtoidz believe the “market” is infallable has perfect judgement.

            4. Fuck your bad ideas, come up with better ones.

              you offer no ideas of your own, just ad hominems on those of others. How tedious.

              1. Listen, moron, I just explained in my post why interstate commerce is stupid. You are only good for paying taxes.

                1. you did not explain anything. You trotted out a half-assed hypothesis that is supported by nothing. Damn near every product/service available in this country falls under interstate commerce and, amazingly, few companies have been able to legislate away their competition. Of course, your answer indicates that you already know that but you figure that calling me names puts me in my place. Obama’s dick is calling; open your mouth.

                  1. “few companies have been able to legislate away their competition”

                    See: the credit card industry.

                    Insurance providers are big sources of employment and economic activity, and could make or break the career of a governor, meaning that as soon as a state starts doing poorly the governor will court corporations with corporatism.

                    1. What are we supposed to see with the credit card industry?

                      It is entirely within the power of every state legislature to totally fuck over the credit card industry if they wanted to. Irrespective of where the issuer is incorporated.

        2. Yes – that will fix everything.

        3. Apparntly?

          Your boot-licking is a dead give away.

          1. Oh no I have been called a statist by a libertarian I feel horrible oh I feel very bad about myself because they never call anyone a statist so I must really be a terrible individual.

      2. Or the government could continue trying, and failing, to control health consumer preferences and health care costs will continue to spiral out of control at much faster rates than inflation.
        See: Government

      3. Move your HQ, your jobs and economic activity here and I’ll let you write your own legislation, no matter how much of an upper hand you get against customers

        And if this resulted in such a detrimental balance in favor of the insurer over the insured, then certainly there would be no structure that can provide incentives for new entrants into that market in order capture that tidal wave of discontent with their insurance.

        Do you think that every health insurance plan purchased in every state is only meeting the bare bones requirements laid down by their insurance commissioner?

        1. “then certainly there would be no structure that can provide incentives for new entrants into that market in order capture that tidal wave of discontent with their insurance.”

          Not if legislation is written to support the oligopoly and to stifle free competition. Corporations don’t like free competition if they would lose profits from it. they don’t want consumers to be able to vote with their wallets. Allowing for interstate commerce in health insurance would allow them to write their own legislation and fuck over new competitors. Doye.

          1. Umm, the point of interstate insurance sales is that new market entrants can come in and undercut uncompetitive insurers, no matter where they are. The states couldn’t write legislation preventing that — *that’s the whole point* of passing a federal statute permitting interstate sales!!! What, are you too dense to understand that?

          2. I think you have a fundamental misunderstanding of why the interstate sales is an issue. The states insurance commissioners mandate minimum coverage requirements. Certain states have onerous minimum coverage requirements that drive up the cost of health insurance within their state. For example, I a California resident, pay an inflated premium because my state has deemed mental health coverage a must have in an insurance plan. I don’t feel I need that. I could get a plan from Arizona cheaper without that particular element of coverage if I were allowed to purchase insurance out of state.

            Having said that, there are people in AZ who have health insurance plans that cover mental health and pay the additional premium because, to them, the extra money is worth that particular coverage. The AZ insurance commissioner is not allowed to set maximum coverage guidelines, only minimum. If you wish to purchase a more lavish plan than mandated by the state, go for it. Ergo, in this example, the person in AZ has more choice than I do in California. Fucking competition, how does it work yo?

            1. If you allow interstate commerce, suddenly all insurance providers would be operating from some small state, working together with an uncommonly tiny legislature that answers to an uncommonly conservative electorate. In short, the people that brought us Arpaio and fire-bombs against abortion clinics would leave their retarded imprint on all available insurance.

              It would make insurance more expensive for the sick and cheaper for the healthy, and lead to more healthy people with insurance and fewer sick people with insurance.

              1. It would make insurance more expensive for the sick and cheaper for the healthy, and lead to more healthy people with insurance and fewer sick people with insurance.

                Platitudes and unsubstantiated assertions are fun!

                But please, do explain through exactly what mechanism your forecast of healthinsurmageddon will emerge. See, I actually explained in my example above how interstate competition permits customers to purchase HI at lower costs (thereby increasing access). Meanwhile, you threw out a string of red herrings about abortion clinic bombings and Arpaio as some sort of evidence that insurance would get more expensive for the sick and cheaper for the healthy. Please, do elaborate on exactly how that happens.

                As far as I can tell, limiting the mandated minimum coverage lowers premium costs for everyone. The only theoretical arena where it wouldn’t lower costs is if you got insurance that didn’t cover whatever service you end up needing. But if you have a family history of say schizophrenia, then you as a consumer would likely be shrewd enough to get the slightly more expensive plan that includes such.

          3. uh I got news for you.

            They already did that, it is offically called the Patient Protection and Affordable Care Act.

          4. Allowing for interstate commerce in health insurance would allow them to write their own legislation and fuck over new competitors. Doye.

            This dumb fuck does have a legitimate point, which of course he is too stupid to actually point out.

            That point is that state mandates exist because most people have no idea of what their future healthcare needs will be. So demanding that health insurance cover event X is somewhat analogous to prevent auto insurance form excluding accidents that happen of saturday and sunday or some such factor.

            What the idiot, and most commenters here, miss is that this problem is a predictable result of ‘health insurancers’ actually being prepaid healthcare providers.

            Return health insurance to an actual insurance paradigm, wherein costs over X are reimbursed, by the insurance company to the insured, and the problem disappears entirely.

      4. your opposition to this idea pretty much says you like the current system, and my isn’t that working out well for everyone. Car insurance rates are manageable; competition has something to do with that, as it does with every other commodity on which it is tried.

        You come to an intellectually dishonest conclusion based on a series of premises that do nothing but fit your hypothesis, which is pretty weak in the first place.

      5. This has a built in assumption that corporations (who purchase the overwhelming majority of health insurance) would put up with that.

        Sure they want the cheapest health insurance they can find but by the 3rd time a senior employee leaves because the health care sucks they’ll be looking for a company that meets their needs better.

      6. If you allow this, some governor that wants to get re-elected tells an insurance provider: “Move your HQ, your jobs and economic activity here and I’ll let you write your own legislation, no matter how much of an upper hand you get against customers.”

        If only those customers weren’t forced to buy their products, via Obamacare.

  2. Damn Ron Paul and his GOP cronies for not caring about health care

  3. The Republicans should have got Andy Griffith, this time in his “Larry Rhodes” persona, to do their ads.

  4. I have noticed that republican voters, for the most part, only tolerate republican politicians. What the official line of the party is rarely agrees more than a small majority with what any given individual R voter believes. Most R voters seem to hold a majority of libertarian ideals but dont realize it.

    D voters are a whole different kind of animal. Most of them seem to lean toward belonging to various cults of personality, and believe in their D leaders without question.

    *SIGH*

    1. Those seem like pretty close to the same animal to me.

  5. The teams are not about plans. Even Obamacare is not a plan. It’s just another Medicare Part D.

    1. Indeed. They haven’t even found a way to make Obamacare sustainable yet, they just punted that down the road since they have to appear to do something. And that’s the fatal defect of democracy: people want a government of action even when no action is needed or the government will only fuck things up more.

      1. “And that’s the fatal defect of democracy: people want a government of action”

        Only if they are suffering and they can’t see a laissez-fare, anarcho-capitalist society alleviating that suffering.

        Humans don’t like to suffer. If the health-care system in the US was better, democrats would not have been able to pass the PPACA. Conversely, democratic overreach following their 1964 victory led to Reagan’s ascension, the Wisconsin deficit allowed Scott Walker to write legislation almost on commission from his corporate donors and still survive, and if climate change causes enough damage you can kiss carbon-dependent economic activity and economic development bye-bye.

        People want to solve problems and avoid suffering. You want them to turn America into Galt’s Gulch? What’s in it for them?

        1. Concerned troll is concerned.

          1. Concerned voters are concerned. It’s not my fault you lost in the marketplace of ideas regarding the trajectory of the health care system in the US.

            1. Last poll I saw over 60% of those “concerned voters” want to repeal Obamacare… and your trajectory takes us right over a fiscal cliff you idiot.

              1. “Last poll I saw over 60% of those “concerned voters” want to repeal Obamacare…”

                They want to raise taxes on your beloved job creators and they also want the government to force insurance providers to not raise premiums for pre-existing conditions.

                “and your trajectory takes us right over a fiscal cliff you idiot.”

                And ending all welfare programs will take us over a societal cliff. Oh no wait private charity will take care of that olololol.

                1. because undertaxation is the nation’s problem? Please. We’re not running a monster debt because folks don’t pay enough in taxes; we have it because politicians are unable to control spending.

                  And there is a clear and unmistakable reason for why the US pays so much more in health care than do other countries: those other countries, and their socialized systems, often say “no” to certain treatments. We don’t do that; we say yes to grandpa’s $500 pill so he can hang on for three more weeks or we pay for his five-digit chemo regimen that may work if it doesn’t kill him first. The countries you want to emulate do not do that; they have the functional equivalent of those dastardly death panels you deride.

                  1. because undertaxation is the nation’s problem

                    The irony is that the socialists don’t actually believe that, despite their contrary posturing.

        2. Bullshit
          The PPACA passed because authoritarians like to dictate and Sandra Fluke likes the idea of “free” contraception.

          1. “The PPACA passed because authoritarians like to dictate”

            Obama ran on reform to the left of what he signed and got elected. People would not have supported that if they liked the health care system as is.

            “and Sandra Fluke likes the idea of “free” contraception.”

            Haha, that was all long after the PPACA was signed into law, redneck. Libertarians should support contraceptives being part of insurance plans: more contraception means less babies born at inopportune times, meaning less welfare dependent mothers and children and more women participating in the job market.

            1. How the fuck do you know when Sandra Fluke started liking the idea of “free” contraception?

              1. You recall that the original PPACA bill excluded contraception for plans offered by certain employers. That changed when Obama decided that Catholic employers could not prevent Presbyterian employees from getting contraception via employer-provided insurance.

                1. “You recall that the original PPACA bill excluded contraception for plans offered by certain employers…..blah blah blah”

                  So, you think Sandra Fluke’s views on flow by edict from the government. Don’t project your inability to have an objective opinion on others.
                  Also…fuck off, slaver

                2. “That changed when Obama decided that Catholic employers could not prevent Presbyterian employees from getting contraception via employer-provided insurance.”

                  You mean it changed when Obama decided to go totalitarian micromanger and dictate to employers whatbenefits they must offer. The government has no real legitimate role telling employers the level of benefits they have to provide.

            2. Personal responsibility dude. And unicorns.

            3. I’m pretty sure the healthcare bill passed because a combination of hating bush and the financial collapse gave the dems 60 votes in the senate.

              The electorate has always hated this bill through the whole process. It is only law because of the month on the calender that the financial collapse occurred.

              If the US were a more pure form of democracy and had a unicameral parliamentary system like many countries, the healthcare law would have just been completely repealed by prime minster boehner.

          2. Furthermore, PPACA passed because they deliberately lied about it to the American people. Yeah, it will lower the deficit over a 10 year period(as long as we start the revenue extractions before the big spending hits). Sure, you can keep your current plan (strangely, my old insurance company, Principal, exited the market rather than trying to comply with the law). The mandate is not a tax (unless SCOTUS will only salvage it’s constitutionality by ruling it so, then it totally is).

        3. Government creates the problem, makes it worse, and voters still want government to try to fix it? They’re idiots, another fatal defect of democracy.

          1. And capitalism is inherently predatory, in the sense that it will do anything that creates sustainable net profits for the capital owners. This can create antipathy towards your idea of a laissez-faire utopia.

            1. re: health care, why don’t we try capitalism before concluding it does not work. Most of the problems with health care coincide with govt’s involvement in the game. Fee for service worked pretty well.

              1. “Fee for service worked pretty well.”

                Most democrats I speak with just want people to get Medicare cards and are very much in favor of single-payer. They think employment-tied insurance is a huge chunk of fuck from the Nixon era.

                1. Then they are idiots, employment-tied insurance dates to the FDR era.

                2. then most dems you speak with are political idiots or economically clueless. Giving everyone a Medicare card ensures they get what citizens of socialized countries get – rationing, waiting lines, and all the rest. Single-payer necessarily means that some things will NOT be paid for; it’s why those countries spend so much less than we do. The US says yes to damn near everything; the others frequently say no.

                3. Gee, Apparently a ‘statist’, it looks like your friends are as stupind and/or ignorant as you are if the think employment-tied insurance started with Nixon.

                  You will never be taken seriously when everything you know is wrong.

                4. Then they are pretty stupid since it is a huge clusterfuck left over from World War 2 wage controls

                5. They think employment-tied insurance is a huge chunk of fuck from the Nixon era.

                  Yeah, no way was it an accident of FDR’s war socialism or made permanent by Truman as stepping stone to a socialized system.

        4. You want them to turn America into Galt’s Gulch? What’s in it for them?

          Prosperity
          Liberty
          Self respect
          Reason

          Nothing you are interested in.

          1. “Prosperity”

            That’s a hypothetical.

            “Liberty”

            Only if you think being taxed is antithetical to being free.

            “Self respect”

            I may be starving but at least I am not on welfare? Glorifying asceticism is a subhuman idea originating in Judeo-Christian retardation.

            “Reason”

            People are not reasonable.

            1. Wow AAS, I’ve just had an epiphany based on your post…you are right. I would never have come to this conclusion without reading your well thought out logical arguments. Now I see that I was wrong and have been wasting my life with libertarianism. Thank you so much for setting me straight. Because of you, I’m on my way to becoming a better human being.

              …my hero.

              1. You are wasting your life, not to mention embarrassing yourself by outspokenly associating yourself with the quwasiauthoritarian 4th-rate ‘philosopher’ Ayn Rand.

                I really get it. I went through my Ayn Rand phase. But if you are truly engaged with the ideas of humanity then you inevitably grow out of it.

                1. $

                  1. What’s with the $ thing?

                    1. They’re morons who think spamming “defeats” Tony.

      2. “make Obamacare sustainable yet”

        Nothing parasites do is sustainable.

        1. Wall Street–the parasite capital of the world.

          But that’s not who you’re talking about is it?

          1. $

  6. Today’s “Dog Bites Man” story.

    Thanks, Peter

  7. On Health Care Republicans most if not all Politicians care about politics, not policy.

    FTFY.

    1. Well, Obama’s ACA wasn’t exactly politically popular. You could argue that he continued pursuing it in order to appease his base and therefore it was a political move in some respects, but I wouldn’t state that he didn’t care about the policy.

      As much as we libertarians can be a cynical bunch, I do generally believe that these petty tyrants act in good faith. I just happen to believe that most of them are dumber than dogshit.

      1. You could argue that he continued pursuing it in order to appease his base

        And did so despite warnings from Rahm that this was a bad idea.

        I wouldn’t state that he didn’t care about the policy.

        All he wanted out of it was some sob stories of how President Superman and his Bill saved some poor children or single moms or whatever from dying due to the fact that they were uninsured, so he could prop them up on the bandstand during election to show how he is fighting the good fight and those mean republicans would’ve let them die.

        I do generally believe that these petty tyrants act in good faith.

        I do not. Anyone with an ego big enough to run for president is a borderline psychopath who primarily is concerned with stroking their own ego.

        I do agree that most appear dumber than dogshit.

        1. I shouldn’t say that they always act in good faith, but I do believe that on some issues, politicians act based on their beliefs even if they have to soften them to achieve inroads and tangible legislation.

          Obama believes that insurance coverage is some magic panacea that will result in greater happiness for the common man. He also believes that to be a political advantage for him. The two need not be mutually exclusive. He passed what he could pass that he felt would achieve his ends both policy wise and politically, not realizing that his policy would actually damage those ends in the long run and that those ends are not some magic panacea to begin with.

          1. maybe on some issues, good faith is involved. With Obama, however, it is non-existent regardless of the issue. Health care reform, as written, is a back door means of getting to single payer. It and other policies are back door mechanisms at suppressing employment since people with jobs tend to be less dependent on Mother Washington. The man said transformation change; that is what he meant.

      2. I completely disagree with you. They’re not acting in good faith at all. They’re acting to exercise power, give themselves legacies, pay off contributors, appease bases, and the other usual politician bullshit. 99.99% of the time, that’s what they’re doing.

        They’re also still dumber than dogshit.

        1. Every single politician has issues that they believe in that resonate with people to some extent and issues that believe in that don’t.

          Obama’s campaign for universally available health insurance is politically popular (regardless of the merits of it and, more specifically, the merits of the ACA’s highly restrictive definition of what passes as HI) and something I think he genuinely believes in. He was able to pass a watered down version of what he believes in that happens to also be politically advantageous.

          GWB believed in his War Against Terrorism for Freedom. By 2007, it was about as popular as a Pinkerton’s Recruiting Booth at OWS. But he stuck with it anyways because it was something he firmly believed in, in spite of it’s unpopularity.

  8. I don’t know any libertarian would want politicians to come up with a plan other than the plan to stop meddling in the health care market. There are all kinds of “plans”:

    “One of Mr. Romney’s chief proposals could shake up how the vast majority of Americans get health care ? through employers. He would give a tax break to people who buy insurance individually on the open market, so they would enjoy the same advantage as workers who get insurance as a benefit at work, which is not taxed as income.”

    http://www.nytimes.com/2012/06…..wanted=all

    1. IDK _why_

      1. I don’t think anything has fucked up the health insurance market more than insurance being deductible to employers but not individuals. While I’d greatly prefer the deduction simply be removed from the tax code (simplify rather than add another layer to compensate), this would go a long way toward removing a major market distortion.

        It’s not a panacea or anything, but it’s a start. What’s your beef with it (no snark – it’s a complicated issue and I’m interested in other ideas)?

        1. I don’t have a beef with removing the break for employers. If the employee is compensated the same amount and allowed to pool with the company the net effect is the same

    2. Why not just remove the tax break for employer provided plans, instead of extending the tax break to individual plans?

      1. this way is less politically difficult. Which one is easier to say? I’m giving you a tax credit? Or I’m going to start taxing your employer healthcare?

        I hope this plan also included paying for healthcare out of pocket instead of insurance.

      2. I think the general premise is to create an incentive for employers to provide and for individuals to buy insurance. Sure, you could just take the employer incentive away and let everyone go at it individually. Not sure what that does to costs though

        1. if that is the premise, then it is based on using the tax code for social engineering, not its purpose. It is the sort of thing that pisses off a lot of people – our minders in DC think something is good or bad, so they monkey with tax rates or credits to promote or discourage a certain type of behavior.

          1. Its not possible to have an income tax that isnt used for social engineering.

            But, yeah, it can be minimized.

            1. Its not possible to have an income tax that isnt used for social engineering.

              Yep, begining with the definition of income that is subject to tax.

          2. The code is replete with attempts to steer social behavior. Even the military is, in essence, a huge social engineering structure. That said, I’d much rather promote individuals choosing their own health care than having it shoved up our asses from washington. And no, a tax credit isn’t the same thing as a penalty.

      3. Because I’m against stealing.

  9. Do Republicans care about health policy at all? Not really, at least judging by the party’s twenty-plus year history of erratic and contradictory interest in health care legislation. That’s basically the point that both Jonathan Chait and Josh Barro make in separate pieces today . .

    A little more legislative apathy, please. On second thought, a lot more apathy.

    For the executive supremacist, most progressives that is, the consent of the governed as represented by legislative oversight gets in the way of the effectiveness of the executive to get things done. Why would they expect markets to behave differently? They recognize that the barriers and hurdles rules make for their strong man, but claim the same oversight only makes the markets perform better? Seems like willful blindness, to me.

  10. Didn’t Obamacare originate in the Senate? What about The Constitution?

    http://en.wikipedia.org/wiki/A…..n_7:_Bills

    Johnathan Chait is a snivelling partisan hack, an intellectual light weight, and would do the world a better service if he stopped writing for his Zioncon rag, retired, and did nothing but read Glenn Greenwald and John Locke.

    1. A long-standing procedural trick: they took a bill that originated in the house and “amended” it to be the vehicle for OCare.

  11. repeal n replace is an absolute lie

  12. Every time I see Mitt Romney I wince.

  13. The one policy that they cared about is Health Savings Accounts. Including that in the Medicare Part D law was a big part of inducing a few conservative Rs to vote for it.

    It would be nice to at least have a disclaimer in one of these articles that HSAs were an insufficient response and an insufficient healthcare policy, if that’s what the authors believe.

    Personally, I believe that HSAs combined with a universal contribution for the poor would be the basis for a policy.

    1. With Romney at the helm, he’ll demand that Obamacare will be replaced with something. HSAs will be on the table certainly, but I would put my money on Romney leaning towards a modified public option.

      1. Obamacare will be replaced with something

        I’ve been groggy feeling the entire day 🙁

    2. Actually given what is spent across all levels of government on health care currently it is likely that we could achieve universal health care by providing everyone in the country with an HSA that was partially funded by the government and the level of government funding being dependent on either income or some sort of means test, and do so for the same or less than what we are spending today while snapping the cost curve to move in lock step with inflation + population growth.

      1. If instead of Medicare, we would have been given a mandatory HSA, funded by a payroll tax, we wouldn’t be having these kind of discussions today.

  14. I think it’s pretty simple. Do you care about universal access to healthcare or do you think it’s OK for some to go without? Libertarian hemming and hawing about magical markets and the charity fairy notwithstanding, this is not a false choice.

    Republicans have resisted universal coverage for decades, but have had to deal with the success and popularity of such programs of Medicare with utter but fairly successful hypocrisy (see the election of 2010). Romney is still criticizing the ACA on the hypocritical grounds that it’s too much federal involvement in healthcare AND that it cuts money from Medicare.

    1. Tony, we’re not hemming and hawing about magical markets and the charity fairy.

      We are merely looking around noting that, before OCare, nobody was denied actual healthcare because they couldn’t pay for it.

      Even the sob stories trotted out by the Dems turned out to be frauds. The Dems couldn’t come up with One. Single. Person who was denied healthcare because they were po’.

      So just stop it. You’re only lying to yourself.

      1. And you’re a seriously confused libertarian. Why weren’t people denied care? What did that reason have to do with a free market?

        The entire problem the ACA is supposed to solve is the free riding you’re offering up as a superior alternative. You think socialized universal healthcare, only with people actually footing the bill for free riders in the most inefficient way possible, is superior?

        Or is your preferred system one in which people aren’t treated if they can’t pay?

        1. you picked up on the Pelosi talking point of the day quickly – free riding, something she and the rest made absolutely no mention of during the debate and aftermath. Not. A. Peep.

          Universal coverage is, by definition, aimed at the vast majority that falls outside the free rider ranks and it takes a whole new level of intellectual dishonesty to pretend otherwise. Besides, there is nothing that says those without insurance cannot pay for treatment; many of them choose to not put money into insurance. But, that’s what the last Census said, so..

          1. voting for Obamacare to solve the freerider problem is like voting for rain to solve the wetness problem.

            The whole godamn bill is nothing but a giant free-ride enabler.

        2. The “free riding” — uncompensated care — amounts to a mere 1.7% of total healthcare costs in this country. It’s a vanishingly small problem that in no way justified legislation as burdensome as the ACA.

          I don’t like free riders. I would prefer that they be cast into the intolerable Outer Hell of seeking financial assistance from family, community, and charity than be afforded the privilege of sticking their hands into my wallet. But some fucking perspective is important: 1.7%, for chrissakes.

          1. Those who refuse to go on food stamps are selfish free riders too.

            “Millions of low-income people are not accessing the nutrition benefits for which they qualify,” the “myth” sheet explains. “To be effective, it is important that our national and local outreach efforts counter myths about SNAP among those who think they are not eligible or have beliefs that discourage them from enrolling.”

            USDA claims that eligible people who do not participate are actually harming their communities by preventing additional funds from entering their respective economies.

            http://dailycaller.com/2012/07…..z1zaqNtnWx

        3. Also: your concern about freeloaders is mighty fucking selective. We’re exquisitely worried about the cost of uncompensated healthcare, to the point of refashioning the entire healthcare industry — but boy howdy, that nearly half of all taxpayers pay no federal income tax, that’s a feature, not a bug.

        4. Why weren’t people denied care?

          Because half the hospitals in this country are charities, and they employ thousands of doctors.

          What did that reason have to do with a free market?

          A free market generates enough surplus in private hands to fund charities, if people are moved to freely donate to them.

          The entire problem the ACA is supposed to solve is the free riding you’re offering up as a superior alternative.

          Do, please, tell me why “free riding” on voluntary charity is worse than “free riding” on expanded government welfare (Medicaid) and taxpayer-subsidized insurance premiums.

          My preferred system is one where people are free to do what they want (which includes supporting charities), and take personal responsibility for their decisions (don’t want to buy insurance, and take the risk of paying out of pocket and relying on charity? Go right ahead).

      2. It’s really kind of funny how everyone is suddenly distraught about those with the means having the burden of covering the health care costs of those without the means.
        NOTHING about that will change in the least with OCare. The poor aren’t suddenly going to have money in their pocket to buy insurance or pay a medical bill unless they get it from someone that does.

    2. as usual, you are posing a straw man as though the only conceivable options are prohibition or alcoholism. There is no issue with access – just any anyone in any ER – and access and care are not the same things.

      Perhaps R’s have “resisted universal coverage” because they have seen it play out in other countries. You know why those with socialized medicine spend so much less than we do? It’s because they say “no”, often. Some of the things that we do in hospitals here are not even up for consideration overseas based on a patient’s age, overall condition, and other factors. It’s not better health care, it’s health care based on actuarial decisions.

      1. So you too endorse a system in which ERs double as free primary care clinics for the indigent? You OK with paying an extra $1000 to cover the cost of that freeloading? How is that possibly a libertarian defense of anything?

        And what’s superior about healthcare based on profit considerations as we have here? You don’t know anything about other healthcare systems, you’re just parroting rightwing excuses. But you don’t make any sense–we have universal care because of freeloading ER patients, and thus there’s nothing to fix? What?

        1. I am not endorsing anything, just pointing out that you are wrong about folks being denied care. And you know you are wrong, yet you continue beating that horse.

          Of course, I know about other health systems, because I have seen them and my parents saw them. Don’t try projecting your ignorance on others. No one here has denied that our system has problems, most of them due to way too much govt control. But you be a good liberal and insist that even more govt control will fix everything.

        2. So you too endorse a system in which ERs double as free primary care clinics for the indigent

          No, quite contrary to that I propose that we repeal that provision of EMTALA of 1986. I don’t seem to recall hordes of humanity dying a slow agonizing death from broken bones in the glorious Carter years. Beyond that, the alleged impact of that free-ridership is absolutely pinner compared to the costs insurance companies must bare to subsidize MC/MC under-reimbursement.

    3. Everyone has access to healthcare. What they don’t have is a right to have me pay for it.

      By the way, the “success” of Medicare? WTF are you on?

      1. Medicare is a hugely successful program. It supports a vast bureaucracy, expends hundreds of billions of dollars, and imposes hundreds of pages of regulations.

        What more could any government program aspire to?

    4. $

    5. Universal access to health care cannot possibly exist unless you have an effectively unlimited supply of health care assets. Any system no matter how it is paid for will fail to provide universal access to health care because in the real world scarcity is a fact of life.

      Ergo ok or not your goal is unreachable and how we feel about it is irrelevant. The only relevant question is how we decide to allocate the health care resources that we do have and how we balance allocations of capital (manpower, brainpower, building space, technology assets, raw materials, etc. not just money but capital in the economic sense) towards provisioning of health care and provisioning of other goods/services.

      See the only magical fairy is the one which would have us believe that universal coverage is possible. It is not. If you have “Universal Coverage” that means either “death panels” deciding what care you are allowed to have based on what it will cost and what benefit you provide to the goverment or shortages so severe that many who are officially covered simply cannot find a doctor to serve them (or a mix of both). In the end however you cut it some mix of people will die and be harmed in lesser ways as a direct result of the way the health care system is set up because there can never be enough assets to meet everyones needs/wants.

    6. No one’s talking about universal access, jackass. A universal requirement to pay insurance premiums doesn’t mean you can actually see a doctor.

  15. According to his own statements, Mitt Romney wants to spend 4% of GDP on the military.

    Currently, under Obama, we spend about 3% on the military.

    At the same time, Mitt wants to deeply cut taxes that only the very highest income earners will ever pay. Most of us will never see a reduction in our tax bills from these kinds of ultra-high income-tax cuts, but the revenues foregone by the federal government will be enormous.

    These kinds of giant and radical budgetary shifts — ramping up military spending while drastically reducing revenue in a way that will leave the vast majority of taxpayers unhelped — have to be offset somewhere. Under Mitt Romney, it’s not going to come from the War on Drugs or the Prison-Industrial Complex. It’s not going to come from Big Corn or Big Oil or Big Pharma. Hence, social spending on health care is one of the more likely targets (along with other human services).

    It should come as no surprise that Romney is trying to slip a big nothingburger under our noses as a health care policy. His true political priorities are, quite literally, unspeakable. Contra the author, this is not part of some grand and diffuse longerm trend in GOP politics. This is about nothing less than a true and bona fide “stealth agenda,” advanced by a hollow pseudo-human who sees the Oval Office as the ultimate hunting trophy, and made possible by a politics of nonstop distraction.

    1. Currently, under Obama, we spend about 3% on the military.

      DoD Budget circa 2012: $900bn
      US GDP circa 2012: $15.6tr

      DoD spending as %age of GDP = 900/15600 = 5.76%

      Try harder.

        1. Maybe you should try harder by not mixing up the base budget with the war spending (since the war spending should be winding down in coming years with drawdowns in Iraq and Afghanistan).

          http://money.cnn.com/2012/05/1…../index.htm

          1. I suppose we weren’t in a war in 2007 when it was 4%.
            http://data.worldbank.org/indi…..XPND.GD.ZS

            1. Thanks for crashing my browser with a bum link.

    2. Um, while Romneys desire to increase military spending is misguided at best you are incorrect about the impact of his tax policies. The fact is unless you do something like triple tax rates on the top 1% AND make it harder to shift income there simply aren’t enough “rich” people to make a major impact on the Federal budget. Even the hated Bush tax cuts only have a theoretical impact of $70 billion a year on the Federal Busget (and there is not actually any evidence that it has any impact at all, that is just the simplistic calculation made by the CBO)

  16. Sometimes you jsut gotta throw them hands up in the air and shout, whos your daddy?

    http://www.Planet-Privacy.tk

Please to post comments

Comments are closed.