By ADMIN
Health Care Reform, Political Honesty and the Rhetoric We’ve Been Hearing, in Contrast
Much of a Post on HCR by Bruce Bartlett the other day is worth repeating, for a variety of different reasons:
HCR – A Republican Idea?
That’s what some Republican health policy experts are saying now that it’s too late to matter. I bring this up because it relates very much to the point I raised yesterday about whether the American Enterprise Institute was muzzling its health experts–preventing them from saying publicly that they agreed with much of what Obama and congressional Democrats were doing. (See here and here.)
An excerpt from Bartlett’s second link is also worth noting (emphasis added):
As some readers of this blog may know, I was fired by a right wing think tank called the National Center for Policy Analysis in 2005 for writing a book critical of George W. Bush’s policies, especially his support for Medicare Part D. In the years since, I have lost a great many friends and been shunned by conservative society in Washington, DC.
Now the same thing has happened to David Frum, who has been fired by the American Enterprise Institute. I don’t know all the details, but I presume that his Waterloo post on Sunday condemning Republicans for failing to work with Democrats on healthcare reform was the final straw.
Since, he is no longer affiliated with AEI, I feel free to say publicly something he told me in private a few months ago. He asked if I had noticed any comments by AEI “scholars” on the subject of health care reform. I said no and he said that was because they had been ordered not to speak to the media because they agreed with too much of what Obama was trying to do.
It saddened me to hear this. I have always hoped that my experience was unique. But now I see that I was just the first to suffer from a closing of the conservative mind. Rigid conformity is being enforced, no dissent is allowed, and the conservative brain will slowly shrivel into dementia if it hasn’t already.”
(On the topic of conservative shriveling, a frightening example is the drivel published by the Washington Post op-ed page by a super conservative bemoaning the lack of effective conservative ideas, and in closing proposing that the conservative party look to Glenn Beck for “real thought.”)
Regarding the health care plan, if we are going to reform it, why wouldn’t some kind of moderate public option that people can buy into, and that those tens of millions who don’t make enough to pay significant income taxes above Social Security get some coverage under, in some ways makes more sense? As do other plans, perhaps even more. (Incidentally, it does not seem clear how, under the current bill, those who most need insurance the most will actually be able to afford it, since tax credits are only effective for those who make above a certain threshold. Presumably many will be covered by forcible employer coverage, but isn’t that a bigger action of government intrusion than merely providing expanded Medicare or Medicaid, being as the government already expends gargauntuan sums as it is, into an out of control, escalating system that soaks it all up often without providing adequate care as it is?)
Still, Bartlett’s point about the rigid tendency for lockstep political opposition even at the expense of sound policy and informed discussion (and, it seems, this past decade, increasingly far right, thinking and expression), is well taken. How was it that instead of all this babble from the media about false “bipartisanship,” Americans were not instead hearing about, and wondering, why one of the two political parties was not contributing any ideas of value – but was contributing a lot of misinformation — on a critical policy area where better policy was clearly needed?
Or why were Democrats themselves not framing this far better? (But that’s an old Story. Here is an example of a vintage Democrat attitude on Health care, for instance.)
Bartlett makes some other interesting points as well:
Every Washington think tank these days has an ideological/political tilt and everyone who works there knows perfectly well which side they are on. They work or are affiliated with it knowing that tilt and presumably agreeing with it. And these are smart people who don’t need to have it explained to them explicitly what comments are helpful to their side and which ones aren’t. This is the essence of the point I was trying to make about muzzling.
A more interesting question is why the Obama administration never pointed out the similarity between its proposals and Republican plans such as the one implemented by Mitt Romney in Massachusetts. I assume it is because it would be equally counterproductive to Democrats, costing votes among the party’s left wing, which badly wanted the public option. Forcing them to acknowledge that their plan owed more to Republican ideas than Democratic ideas on health would have been like pouring salt in their wounds.
This does not appear as the likely explanation as to why Democrats did not make some sort of story out of these points. Assuming it to be true, there was no grandeur in being the architect of the actual ideas behind this plan. Many people did not like the plan, including, quite possibly, some who voted for it. The grandeur was in getting some sort of bill passed (For those who see it that way anway; also note the significance by some that was being attached to what was merely getting what many believe is a bad bill passed)– something their opponents were doing everything possible it seemed, to prevent– that is, opposition to any kind of bill.
Democrats did not make this point because they repeatedly fail to use their opponents own words and positions to effectively illustrate, when present, the hypocrisy, negative anti-bipartisanship, and increasing polarization, among other things,of their opponents. And because they don’t tend to focus on properly framing things in ways — or providing this information to the media — that directly communicates with a very broad cross section of America as opposed to those within, or possibly on the fringes of, their own party, whom they often mistake in turn for the whole of America. (See this site — the most popular political website in America – for examples on a hourly, if not more frequent, basis.) They often think that because many of their opponents’ ideas are often extreme, that it is their opponents who are not communicating with a wider cross section of people; confusing the underlying policy positions, or the hypocrisies or misrepresentations that Democrats often believe they perceive, with the political communications of their opponents themselves, when these are something very different.
Bartlett concludes:
In the weeks to come I anticipate that many Republican health experts will acknowledge that HCR owes much to their thinking and little at all to liberal ideas. These Republicans will explain that HCR just needs a little tweaking and gradually talk leaders of their party out of repealing it. These leaders already know that isn’t going to happen anyway, but their public posture will be that HCR must be repealed as long as it animates the Republican base going into November’s elections.
The health care plan in some ways seems very misplaced. It forces things on people. It does imposes a justifiable pre existing condition rule but with no attendant strategies to balance out the inevitable rise in cost. Said rise in cost is already a big part of the health care dilemma in this country — we spend almost twice as much money on health care per capita than any other country in the world, and yet we rank not first, but 38th, in life expectancy.
Of course, there are other factors that go into life expectancy. But the fact remains that our health care is already enormously expensive; both in terms of public and private money, and it is particularly expensive relative to the average quality of care that Americans receive.
To be fair to Bruce’s position, and that of the Bill’s proponents, the first link that Bartlett provided above noted how even Scott Brown in Massachusetts supported a similar proposal, seemingly on the idea that if preexisting condition clauses were going to be prohibited, then some sort of involuntary participation would help prevent a higher rate of non participation by the “healthy” until such time as they become “ill” (at least in theory).
But isn’t this still at heart forcing people in terms of what to do?
The claim is that this plan will lower costs; but even by mandating in the few healthy who can afford it but don’t have health insurance in order to balance out the risk from others, it is hard to fathom how it really controls costs when it forces people, against their own free will, to purchase what forms the basis of much of the problem: Excessive and highly bureaucratic middleman “insurance” for, and often semi control over, routine (i.e.,non catastrophic) health care costs.
The problem with this “forced balancing out” or risk type thinking is that it is essentially forcing everyone to collectivize their risk. But why then force it through private companies ? A public option would do this at likely lower cost, and ultimately no more public involvement, while providing a choice for people and not mandating further individual and employer obligations.
As far as the bill goes, one who is not much in favor of it might ask Bruce if he is saying that in some ways saying Republicans are as much to blame for this as Democrats? That it was their bad ideas, and Democrats, so hungry for any type of otherwise needed health care reform, went ahead and implemented them without getting any Republicans on board?
From another perspective, these are ideas which could have perhaps been much improved upon, had we an honest and informed discussion rather than the circus that it turned into. A circus that it turned into due to poor Democratic framing, possible Republican manipulation obfuscation on the issue, and poor media coverage (here’s a classical example for which the Washington Post newspaper had no answer.) And also because,with almost no effective checks upon it any more (with an increasingly emasculated and kow towing “he said/she said” and “false balance” media) it seems like rhetoric is slowly getting out of control in America this new millenium.
As for this bill being as much if not more based upon “Republican” rather than “Democratic” ideas, perhaps Bartlett should also tell that to the increasingly radical wing of his own party.
It is his last paragraph which in some ways is the most notable however. That the bill will probably stand,with Republican approval.
People seem to complain about big government, but they also seem to like it at the same time. (Anyone who can afford to buy health insurance probably will anyway — because bad as it is, one often receives far worse care without it. Those who don’t get health insurance and actually pay their health care bills, also subsidize the cost of both those with health insurance– who almost always get far more favorable rates for the exact same tests, visits and procedures by the exact same care providers– and those who don’t or can’t pay their health care bills. ) Thus the bill is likely to stick around rather than be repealed — or significantly changed. Unfortunately.
