House Republicans are celebrating a victory Wednesday after successfully voting to roll back health care reform by a margin of 245 to 189. Outright repeal is a fool's errand, of course -- it won't survive the Democratic-controlled Senate or President Obama's veto pen -- but the vote does expose real threats to the law's future.
Wednesday served its purpose partly by providing the requisite theatrics for Republicans to placate their Tea Party base, to which they promised repeal. It also allowed them rub it in President Obama's face that he has failed to win over the public despite bringing health care to millions while reducing the deficit.
Polls say a significant percentage of the public supports repeal of the law (although the figure has dipped in the aftermath of the Tucson massacre). But surveys also reveal the public to be deeply misinformed about what's in it. In large numbers, Americans wrongly believe it will raise their taxes, increase the deficit, cut Medicare benefits, and force them to change their insurance plans.
Meanwhile, the actual elements of the law are mostly popular. The public strongly favors universal coverage and banning insurance companies from discriminating against sick people. The individual mandate is disliked, of course, but it's the third leg of the stool vital to holding the measure together. Also well-liked are provisions that close the Medicare "doughnut hole," offer tax credits to small businesses, and allow young adults to stay on a parent's insurance plan until 27.
So, why is the public so confused? Chalk it up to a ferocious Republican assault on the bill -- much of it based on lies -- throughout the deliberations and the November elections, as Democrats displayed a battlefield timidity early on and then scurried away from their landmark accomplishment after it was signed.
The nonpartisan Congressional Budget Office reports that the Republican repeal plan would prevent 32 million nonelderly Americans from getting insurance while adding roughly $230 billion to the deficit through 2021 -- an awkward fact given GOP claims that the reforms will bankrupt the nation.
It's also awkward because deficit reduction is a core Republican promise that helped win them the House and expand their voices in the Senate. And while party leaders are seeking to resolve this cognitive dissonance by discrediting the official score, it was just years ago that the Republican finance chairman touted the CBO as an arbiter that Congress is "required by law to abide by."
And few realize that Republicans are smiting their own ideas. For Obama's reform law, which conservatives today dismiss as socialism, is virtually identical to the bill Mitt Romney enacted as governor of Massachusetts in 2006, which was championed by the right-wing Heritage Foundation. It's also remarkably similar to the Republican alternative to Bill Clinton's health plan in the early 1990s.
The conservative nature of the law is why progressives have been lukewarm in their enthusiasm, which has also hurt its public perception. But liberal activists can't be blamed for that; they wanted progressive reforms -- ideally Medicare for all, but at least a public option or a Medicare buy-in -- and instead got a Republican bill.
Ultimately, though, the sight of Obama embracing GOP ideas was enough for Republicans to ditch them. That's because, from a political standpoint, spending the next two years waging a full-frontal assault on Obama's top priority weakens him and his party -- it serves the dual purpose of putting Democrats on defense and stalling their agenda ahead of the 2012 elections, in which the White House and Senate are up for grabs.
Thus one shouldn't expect Republican battering of health care to let up, even after repeal dies in the Senate. It's too sweet a target -- their base hates the law, and Democrats have so far failed to boost its image in the public eye. The GOP's Plan B is to choke off the legislation one limb at a time by blocking funds for implementation between now and 2014, when the crux of it kicks in. Plan C is to build judicial support to gut the mandate through the courts. Neither of the two strategies is out of the question.
Democrats are finally rising to the challenge, and have instigated a public relations blitz to tout the law's benefits to consumers while depicting Republicans as pawns of the insurance industry. It's an uphill battle given the lost time, but if successful, it could turn the game against Republicans -- polls show that the more people learn about the measure, the more they like it.
However this unfolds, the writing on the wall is clear: Democrats' biggest achievement in a generation will shrivel up and die unless they change enough minds to persuade enough lawmakers not to cut off its oxygen supply.
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Instead of saying he will "tweak" it to make RepublicanÂs happy, Obama should tweak it by making better what he already has done.
What are the successes of health care?
1. young adults up to 26 years old can be on their parents' accounts.
2. Kids with pre-existiÂng conditions are covered.
http://www.kaiserhealthnews.org/Stories/2010/September/23/kids-preexisting-conditions.aspx
http://www.nytimes.com/2010/03/31/health/policy/31health.html
3. Patients in hospice are no longer denied aggressive care that might save their lives.
http://www.kaiserhealthnews.org/Stories/2010/May/10/Hospice.aspx
4. People are no longer thrown off company rolls when they fall ill.
http://krugman.blogs.nytimes.com/2010/03/17/demons-and-demonization/
http://www.prnewswire.com/news-releases/reuters-and-milwaukee-journal-sentinel-receive-2010-barlett--steele-awards-104329693.html
http://www.cjr.org/the_audit/reuters_is_excellent_in_diggin.php
medical insurance is just the same; no one knows when they will get hurt, have an accident, develop cancer or diabetes or heart disease, etc. when citizens show up in the ER or their MD's office for care and they should get the care, there needs to be a way to pay for all of this care. For most Americans, medical insurance is the only affordable way to actually see a doctor.
Medicare is government insurance for those 65 and over; I would like to have Medicare for all and would sign up today, but I am only 59. Actually, no one is entitled to Medicare unless they are 65, an American citizen and have already paid into the system. So where do you stand?
Car insurance is there to indemnify and protect OTHERS that you might hurt while driving.
Mandated health insurance including what that insurance must contain, whether you want it or not, is another story altogether.
Fanned to the umpteenth power.
Just examine one issue that nobody paid attention to: For the first time, people in hospice can simultaneoÂusly get drugs and therapy that might save their lives while in hospice. Before they had to make the awful choice as to whether they wanted to have hospice care or to be able to receive care that would save their lives.
From Kaiser Health News:
http://www.kaiserhealthnews.org/Stories/2010/May/10/Hospice.aspx
"This dilemma — that you must give up aggressive treatment to get end-of-lifÂe counseling and care — is a major reason many people resist entering hospice, sometimes until just days before they die.
But the new health law could lead to a major change in Medicare policy that allows patients to get treatment and hospice care simultaneoÂusly."
What else? There is also the issue of whether companies should be able to throw off patients when they become ill. Repealing health care reform would end that too.
http://businessjournalism.org/2010/10/04/reuters-and-milwaukee-journal-sentinel-receive-2010-barlett-steele-awards/
http://krugman.blogs.nytimes.com/2010/03/17/demons-and-demonization/