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Will Marshall

Will Marshall

Posted: February 26, 2010 11:51 AM

All in on Health Reform

What's Your Reaction:

This item is cross-posted at Progressive Fix.

There's something poignant about President Obama's attempts to reason with congressional Republicans. He keeps hoping that facts, evidence, and logic can somehow penetrate the depleted-uranium armor of conservative ideology. As yesterday's health summit showed, it hasn't worked, but a public frustrated with Washington's tribal politics will probably appreciate the effort anyway.

The summit nonetheless achieved its real purpose, which was not composing differences but illuminating the two parties' starkly contrasting visions for health care reform so that the voters can make a real comparison. For the past year, Republicans have had the advantage of attacking (often dishonestly) Democrats' plans without anyone paying much attention to what they have to offer.

The summit put them on the spot, and the clear answer was: not much. Here's what we learned about what Republicans mean by reform:

First, they don't much care about health care's "have nots" - 45 million Americans without coverage. Sure, they favor a modest expansion of coverage to about three million people, but that only begs the question of why the lucky few and not everyone? The answer is that Republicans don't really believe it's government's responsibility to make sure everyone can get access to affordable coverage.

Second, Republicans do care about restraining rising health care costs for those with coverage. But their preferred solutions -- medical savings accounts, and allowing people to buy cheaper insurance policies out-of-state -- are tilted toward the healthy. The former takes healthy people out of insurance pools, raising premiums for those who remain. The latter allows people to end-run state mandates on the medical services insurance companies must offer. That's fine for healthy people who can get by with bare-bones coverage, but it doesn't help the sick. In fact, Republicans generally oppose the insurance market reforms that would prevent companies from cherry-picking healthy customers or dropping people when they get sick.

Third, the GOP has no intention of helping Obama and the Democrats improve their plans, let alone pass them. They feel little pressure to do so, because they think they have the public on their side.

It's true that polls show majorities are leery of the Democrats' reform proposals, even if Americans still want Obama to "do something" about health care costs and coverage. Rather than crumble in the face of public skepticism, Obama adroitly used the summit to reframe the health care debate as a choice between action or inaction on one of the nation's most vexing problems.

The spotlight now shifts to his party. Will liberals torpedo health reform because it doesn't include the public option? Will moderates play it safe or take a risk for the larger good of their party and their country? Will health care reform be a casualty of that hardy perennial of the culture wars, abortion?

Can congressional Democrats, in short, summon the will and discipline to rise above their own centripetal forces and govern? It should be obvious that failure would reinforce the Republican narrative: the bill was misbegotten in the first place, an overly ambitious, big-government monster that couldn't even pass muster with Democrats.

Obama has gone all in; now his party needs to follow.

This item is cross-posted at Progressive Fix.

 
 
 
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Henryk A. Kowalczyk
10:51 AM on 02/28/2010
You do not get it.

Most Americans agree that health care needs reform. Most disagree on what should be done.

For example, I prepared the health care reform proposal built around my concept of life-cycle health insurance,
http://www.huffingtonpost.com/henryk-a-kowalczyk/a-better-approach-to-heal_b_440262.html

The proposals circulated by Democrats, in my view (and about 50% of Americans who have some essential reservation in supporting them) have nothing to do with reforming health care. They are an attempt of using health care crisis to change the political system in the U.S. into more socialistic style.

If you click on my icon, you can find plenty of arguments supporting this statement.
06:54 AM on 02/28/2010
You think the public will be grateful that Obama has WASTED more time only to get NOTHING? Boy are you out of touch.
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MelanieMatthias
I am President Obama's biggest fan!
11:01 AM on 02/28/2010
The end result is what matters. President Obama hasn't wasted a minute. He works very hard for all of America.
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05:13 PM on 02/28/2010
You are right. The end result is what matters. I fear if this bill passes it will be the end of our country as we know it. The entitlement mentality of the people in this country will destroy us. Whatever happened to taking care of yourself? Why do people think other people should take care of them instead? Where did that come from?
04:37 PM on 02/27/2010
IMO it's increasingly clear that Democrats are the obstructionist. Republicans may just call their bluff.

Insurance cost can decrease, if healthcare costs decrease. That's possible with the many cost-effective delivery models. If NY State (or City) follows Grand Junction's model, their cost reduces 40%. Follow such practices and all arguments on cost, universal coverage and access becomes moot. We know how to do it. It has been done in many places under different scenarios and models.

http://www .huffingto npost.com/ ann-imse/h ow-to-fix- health-car e_b_475916 .html

Authorities who need "more studies" are not interested in solving the problem and are spinning. Exposing and monitoring practice-patterns and comparing statistics with local and national peers, will reduce over-utilization by 30% in the first year before any corrective action. Healthcare planners and administrators in 'high cost states' like those in the Northeast states should read above article.

After studies of various treatment parameters and comparative analysis are made, the data (physician- and hospital-specific) should be on-line. Local print and TV should publicize the data; starting a community dialog how families and community help medical providers be more efficient in delivering care. This can be facilitated by Chamber of Commerce. Important aspect of good care is patients having effective family and social support during illness and at end-of-life.

Stick for cost-effective healthcare - lack of reimbursement for unnecessary treatment as defined by best practice patterns.
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dsws
No owning ideas. Limit only commercial use.
12:46 PM on 02/27/2010
It's going to pass. A president has enormous leverage over same-party representatives. How many could survive a primary challenge supported by the president?
Bernique
Solar is clean, cheap and plentiful
07:07 PM on 02/26/2010
Will -- you're too kind to try and parse the righties' platform. They only have one -- if you get sick, hurry up and DIE. Ayn Rand showed them the way.

http://www.alternet.org/story/145819/ayn_rand%2C_hugely_popular_author_and_inspiration_to_right-wing_leaders%2C_was_a_big_admirer_of_serial_killer_
02:02 PM on 02/26/2010
Yes. Republicans advocate cheap insurance for those who don't need it. That makes huge profits for the insurance industry, but this product isn't really insurance, because if you happen to be one of those who gets sick.... you'll find out the insurance is only for those who never get sick. I think Obama's Acme Insurance analogy is useful.

Republicans don't mind that there is no insurance for those who are already sick. After all, there is no incentive for insurance companies to have a product like that. Where's the profit?

Republicans don't care about the so-called "under-insured" who get sick and then find out that their insurance is worthless. I guess it's their own fault! Nobody told them to buy it.
12:41 PM on 02/26/2010
All the potential roadblocks to the passage of health care mentioned in this article are proof of how right wing our politics have become since Reagan. The democrats have proposed a very pro-industry bill so quite naturally the progessives are not enthusiastic about it and the religious ayatolllahs in their party want to keep women down with their anti-abortion nonsense and the republicans just oppose any change that they fear may end up helping people.